Sample records for academic alert system

  1. Developing an Early-Alert System to Promote Student Visits to Tutor Center

    ERIC Educational Resources Information Center

    Cai, Qijie; Lewis, Carrie L.; Higdon, Jude

    2015-01-01

    An early-alert system (MavCLASS) was developed and piloted in a large gateway math class with 611 freshman students to identify academically at-risk students and provide alert messages. It was found that there was significant association between the alert messages students received and their visits to the university's tutor center. Further, the…

  2. Use of a Web-Based Academic Alert System for Identification of Underachieving Students at an Urban Research Institution

    ERIC Educational Resources Information Center

    Donnelly, John E.

    2010-01-01

    Early alert strategies are an increasingly common way to address students' ongoing needs for greater academic and social engagement by enabling a positive campus environment and appropriate academic support; Kuh et al. find these to be necessary engagement conditions. Young and Fry show the benefits of student metacognition, or awareness of…

  3. Jetliner Alert Systems

    NASA Technical Reports Server (NTRS)

    1983-01-01

    NASA research and design has significantly improved crew alert systems. The Engine Indication and Crew Alerting System (EICAS), developed by Psycho-Linguistic Research Associates, is technologically advanced and able to order alerts by priority. Ames has also developed computer controlled voice synthesizers for readouts during difficult landing approaches. This is available to airplane manufacturers.

  4. Visual Alert System

    NASA Technical Reports Server (NTRS)

    1985-01-01

    A visual alert system resulted from circuitry developed by Applied Cybernetics Systems for Langley as part of a space related telemetry system. James Campman, Applied Cybernetics president, left the company and founded Grace Industries, Inc. to manufacture security devices based on the Langley technology. His visual alert system combines visual and audible alerts for hearing impaired people. The company also manufactures an arson detection device called the electronic nose, and is currently researching additional applications of the NASA technology.

  5. The COMESEP Alert System

    NASA Astrophysics Data System (ADS)

    Crosby, Norma; Veronig, Astrid; Rodriguez, Luciano; Vrsnak, Bojan; Vennerstrom, Susanne; Malandraki, Olga; Dalla, Silvia; Srivastava, Nandita; Hesse, Michael; Odstrcil, Dusan; Robbrecht, Eva

    2014-05-01

    Tools for forecasting geomagnetic storms and solar energetic particle (SEP) radiation storms have been developed under the three-year EU FP7 COMESEP (COronal Mass Ejections and Solar Energetic Particles) collaborative project. To enhance our understanding of the 3D kinematics and interplanetary propagation of coronal mass ejections (CMEs), the structure, propagation and evolution of CMEs have been investigated. In parallel, the sources and propagation of SEPs have been examined and modeled. During the third year of the COMESEP project the produced tools have been validated and implemented into an operational space weather alert system. The COMESEP Alert System provides notifications for the space weather community. To achieve this the system relies on both models and data, the latter including near real-time data as well as historical data. Geomagnetic and SEP radiation storm alerts are based on the COMESEP definition of risk. The COMESEP Alert System has recently been launched. Receiving COMESEP alerts are free of charge, but registration is required. For more information see the project website (http://www.comesep.eu/). This work has received funding from the European Commission FP7 Project COMESEP (263252).

  6. Detecting alerts, notifying the physician, and offering action items: a comprehensive alerting system.

    PubMed Central

    Kuperman, G. J.; Teich, J. M.; Bates, D. W.; Hiltz, F. L.; Hurley, J. M.; Lee, R. Y.; Paterno, M. D.

    1996-01-01

    We developed and evaluated a system to automatically identify serious clinical conditions in inpatients. The system notifies the patient's covering physician via his pager that an alert is present and offers potential therapies for the patient's condition (action items) at the time he views the alert information. Over a 6 month period, physicians responded to 1214 (70.2%) of 1730 alerts for which they were paged; they responded to 1002 (82.5% of the 1214) in less than 15 minutes. They said they would take action in 71.5% of the alerts, and they placed an order directly from the alert display screen in 39.4%. Further study is needed to determine if this alerting system improves processes or outcomes of care. PMID:8947756

  7. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Alert system. 26.20 Section 26.20 Food and Drugs... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... Provisions for Pharmaceutical Good Manufacturing Practices § 26.20 Alert system. (a) The details of an alert...

  8. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Alert system. 26.20 Section 26.20 Food and Drugs... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... Provisions for Pharmaceutical Good Manufacturing Practices § 26.20 Alert system. (a) The details of an alert...

  9. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Alert system. 26.20 Section 26.20 Food and Drugs... Provisions for Pharmaceutical Good Manufacturing Practices § 26.20 Alert system. (a) The details of an alert...

  10. 77 FR 41331 - Commercial Mobile Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... Mobile Alert System AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of... with the Commission's Commercial Mobile Alert System (CMS), Second Report and Order (``CMAS Second... Alert System rules contained in the Commission's Second Report and Order, FCC 08- 164, published at 73...

  11. Development and implementation of sepsis alert systems

    PubMed Central

    Harrison, Andrew M.; Gajic, Ognjen; Pickering, Brian W.; Herasevich, Vitaly

    2016-01-01

    Synopsis/Summary Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Important barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload & alert fatigue, due to suboptimal alert performance. Outside the ICU, additional barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Currently available evidence does not support routine use of sepsis alert systems in clinical practice. However, continuous improvement in both the afferent (data availability and accuracy of detection algorithms) and efferent (evidence-based decision support and smoother integration into clinical workflow) limbs of sepsis alert systems will help translate theoretical advantages into measurable patient benefit. PMID:27229639

  12. Alert generation and cockpit presentation for an integrated microburst alerting system

    NASA Technical Reports Server (NTRS)

    Wanke, Craig; Hansman, R. John, Jr.

    1991-01-01

    Alert generation and cockpit presentation issues for low level wind shear (microburst) alerts are investigated. Alert generation issues center on the development of a hazard criterion which allows integration of both ground based and airborne wind shear detection systems to form an accurate picture of the aviation hazard posed by a particular wind shear situation. A methodology for the testing of a hazard criteria through flight simulation has been developed, and has been used to examine the effectiveness and feasibility of several possible criteria. Also, an experiment to evaluate candidate graphical cockpit displays for microburst alerts using a piloted simulator has been designed.

  13. Pilot Non-Conformance to Alerting System Commands

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.; Hansman, R. John

    1997-01-01

    Instances of pilot non-conformance to alerting system commands have been identified in previous studies. Pilot non-conformance changes the final behavior of the system, and therefore may reduce actual performance from that anticipated. A simulator study has examined pilot non-conformance, using the task of collision avoidance during closely spaced parallel approaches as a case study. Consonance between the display and the alerting system was found to significantly improve subject agreement with automatic alerts. Based on these results, a more general discussion of the factors involved in pilot conformance is given, and design guidelines for alerting systems are given.

  14. Development and Implementation of Sepsis Alert Systems.

    PubMed

    Harrison, Andrew M; Gajic, Ognjen; Pickering, Brian W; Herasevich, Vitaly

    2016-06-01

    Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload, and alert fatigue, due to suboptimal alert performance. Outside the ICU, barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Current evidence does not support routine use of sepsis alert systems in clinical practice. Continuous improvement in the afferent and efferent aspects will help translate theoretic advantages into measurable patient benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital

    PubMed Central

    Engels, Melanie J.

    2015-01-01

    Background: High-alert medications pose a greater risk of causing significant harm to patients if used in error. The Joint Commission requires that hospitals define institution-specific high-alert medications and implement processes to ensure safe medication use. Method: Nursing, pharmacy, and prescribers were asked to voluntarily complete a 34-question survey to assess their knowledge, experience, and perceptions regarding high-alert medications in an academic hospital. Results: The majority of respondents identified the organization’s high-alert medications, the consequences of an error involving a high-alert medication, and the reversal agent. Most of the risk-reduction strategies within the institution were viewed as being effective by respondents. Forty-five percent of the respondents utilized a high-alert medication in the previous 24 hours. Only 14.2% had experienced an error with a high-alert medication in the previous 12 months, with 46% being near misses. The survey found the 5 rights for medication administration were not being utilized consistently. Respondents indicated that work experience or hospital orientation is the preferred learning experience for high-alert medications. Conclusions: This study assessed all disciplines involved in the medication use process. Perceptions about high-alert medications differ between disciplines. Ongoing discipline-specific education is required to ensure that individuals accept accountability in the medication use process and to close knowledge gaps on high-alert medications and risk-reduction strategies. PMID:26446747

  16. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Ship Security Alert System (SSAS). 80.277... Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety..., “RTCM Standard 11020.0—Ship Security Alert Systems (SSAS) using the Cospas-Sarsat System,” Version 1.0...

  17. Auditory alert systems with enhanced detectability

    NASA Technical Reports Server (NTRS)

    Begault, Durand R. (Inventor)

    2008-01-01

    Methods and systems for distinguishing an auditory alert signal from a background of one or more non-alert signals. In a first embodiment, a prefix signal, associated with an existing alert signal, is provided that has a signal component in each of three or more selected frequency ranges, with each signal component in each of three or more selected level at least 3-10 dB above an estimated background (non-alert) level in that frequency range. The alert signal may be chirped within one or more frequency bands. In another embodiment, an alert signal moves, continuously or discontinuously, from one location to another over a short time interval, introducing a perceived spatial modulation or jitter. In another embodiment, a weighted sum of background signals adjacent to each ear is formed, and the weighted sum is delivered to each ear as a uniform background; a distinguishable alert signal is presented on top of this weighted sum signal at one ear, or distinguishable first and second alert signals are presented at two ears of a subject.

  18. Wearable PPG sensor based alertness scoring system.

    PubMed

    Dey, Jishnu; Bhowmik, Tanmoy; Sahoo, Saswata; Tiwari, Vijay Narayan

    2017-07-01

    Quantifying mental alertness in today's world is important as it enables the person to adopt lifestyle changes for better work efficiency. Miniaturized sensors in wearable devices have facilitated detection/monitoring of mental alertness. Photoplethysmography (PPG) sensors through Heart Rate Variability (HRV) offer one such opportunity by providing information about one's daily alertness levels without requiring any manual interference from the user. In this paper, a smartwatch based alertness estimation system is proposed. Data collected from PPG sensor of smartwatch is processed and fed to machine learning based model to get a continuous alertness score. Utility functions are designed based on statistical analysis to give a quality score on different stages of alertness such as awake, long sleep and short duration power nap. An intelligent data collection approach is proposed in collaboration with the motion sensor in the smartwatch to reduce battery drainage. Overall, our proposed wearable based system provides a detailed analysis of alertness over a period in a systematic and optimized manner. We were able to achieve an accuracy of 80.1% for sleep/awake classification along with alertness score. This opens up the possibility for quantifying alertness levels using a single PPG sensor for better management of health related activities including sleep.

  19. Analysis of Alerting System Failures in Commercial Aviation Accidents

    NASA Technical Reports Server (NTRS)

    Mumaw, Randall J.

    2017-01-01

    The role of an alerting system is to make the system operator (e.g., pilot) aware of an impending hazard or unsafe state so the hazard can be avoided or managed successfully. A review of 46 commercial aviation accidents (between 1998 and 2014) revealed that, in the vast majority of events, either the hazard was not alerted or relevant hazard alerting occurred but failed to aid the flight crew sufficiently. For this set of events, alerting system failures were placed in one of five phases: Detection, Understanding, Action Selection, Prioritization, and Execution. This study also reviewed the evolution of alerting system schemes in commercial aviation, which revealed naive assumptions about pilot reliability in monitoring flight path parameters; specifically, pilot monitoring was assumed to be more effective than it actually is. Examples are provided of the types of alerting system failures that have occurred, and recommendations are provided for alerting system improvements.

  20. 76 FR 80780 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Commission amends its rules governing the Emergency Alert System (EAS) rules to extend the deadline for EAS Participants to be able to receive Common Alerting Protocol (CAP)- formatted EAS alerts to...

  1. Validation of the CME Geomagnetic Forecast Alerts Under the COMESEP Alert System

    NASA Astrophysics Data System (ADS)

    Dumbović, Mateja; Srivastava, Nandita; Rao, Yamini K.; Vršnak, Bojan; Devos, Andy; Rodriguez, Luciano

    2017-08-01

    Under the European Union 7th Framework Programme (EU FP7) project Coronal Mass Ejections and Solar Energetic Particles (COMESEP, http://comesep.aeronomy.be), an automated space weather alert system has been developed to forecast solar energetic particles (SEP) and coronal mass ejection (CME) risk levels at Earth. The COMESEP alert system uses the automated detection tool called Computer Aided CME Tracking (CACTus) to detect potentially threatening CMEs, a drag-based model (DBM) to predict their arrival, and a CME geoeffectiveness tool (CGFT) to predict their geomagnetic impact. Whenever CACTus detects a halo or partial halo CME and issues an alert, the DBM calculates its arrival time at Earth and the CGFT calculates its geomagnetic risk level. The geomagnetic risk level is calculated based on an estimation of the CME arrival probability and its likely geoeffectiveness, as well as an estimate of the geomagnetic storm duration. We present the evaluation of the CME risk level forecast with the COMESEP alert system based on a study of geoeffective CMEs observed during 2014. The validation of the forecast tool is made by comparing the forecasts with observations. In addition, we test the success rate of the automatic forecasts (without human intervention) against the forecasts with human intervention using advanced versions of the DBM and CGFT (independent tools available at the Hvar Observatory website, http://oh.geof.unizg.hr). The results indicate that the success rate of the forecast in its current form is unacceptably low for a realistic operation system. Human intervention improves the forecast, but the false-alarm rate remains unacceptably high. We discuss these results and their implications for possible improvement of the COMESEP alert system.

  2. 77 FR 33661 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

    ... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of... Commission's Review of the Emergency Alert System, Fifth Report and Order (Order). This document is... Expiration Date: November 30, 2012. Title: Part 11--Emergency Alert System, Fifth Report and Order, FCC 12-7...

  3. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Ship Security Alert System (SSAS). 80.277... SERVICES STATIONS IN THE MARITIME SERVICES Equipment Authorization for Compulsory Ships § 80.277 Ship Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety...

  4. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Ship Security Alert System (SSAS). 80.277... SERVICES STATIONS IN THE MARITIME SERVICES Equipment Authorization for Compulsory Ships § 80.277 Ship Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety...

  5. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Ship Security Alert System (SSAS). 80.277... SERVICES STATIONS IN THE MARITIME SERVICES Equipment Authorization for Compulsory Ships § 80.277 Ship Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety...

  6. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Ship Security Alert System (SSAS). 80.277... SERVICES STATIONS IN THE MARITIME SERVICES Equipment Authorization for Compulsory Ships § 80.277 Ship Security Alert System (SSAS). (a) Vessels equipped with a Ship Security Alert System pursuant to the Safety...

  7. Modeling, Analyzing, and Mitigating Dissonance Between Alerting Systems

    NASA Technical Reports Server (NTRS)

    Song, Lixia; Kuchar, James K.

    2003-01-01

    Alerting systems are becoming pervasive in process operations, which may result in the potential for dissonance or conflict in information from different alerting systems that suggests different threat levels and/or actions to resolve hazards. Little is currently available to help in predicting or solving the dissonance problem. This thesis presents a methodology to model and analyze dissonance between alerting systems, providing both a theoretical foundation for understanding dissonance and a practical basis from which specific problems can be addressed. A state-space representation of multiple alerting system operation is generalized that can be tailored across a variety of applications. Based on the representation, two major causes of dissonance are identified: logic differences and sensor error. Additionally, several possible types of dissonance are identified. A mathematical analysis method is developed to identify the conditions for dissonance originating from logic differences. A probabilistic analysis methodology is developed to estimate the probability of dissonance originating from sensor error, and to compare the relative contribution to dissonance of sensor error against the contribution from logic differences. A hybrid model, which describes the dynamic behavior of the process with multiple alerting systems, is developed to identify dangerous dissonance space, from which the process can lead to disaster. Methodologies to avoid or mitigate dissonance are outlined. Two examples are used to demonstrate the application of the methodology. First, a conceptual In-Trail Spacing example is presented. The methodology is applied to identify the conditions for possible dissonance, to identify relative contribution of logic difference and sensor error, and to identify dangerous dissonance space. Several proposed mitigation methods are demonstrated in this example. In the second example, the methodology is applied to address the dissonance problem between two air

  8. The NAS Alert System: A look at the first eight years

    USGS Publications Warehouse

    Fuller, Pamela L.; Neilson, Matt; Huge, Dane H.

    2013-01-01

    The U.S. Geological Survey's Nonindigenous Aquatic Species (NAS) database program (http://nas.er.usgs.gov) tracks the distribution of introduced aquatic organisms across the United States. Awareness of, and timely response to, novel species introductions by those involved in nonindigenous aquatic species management and research requires a framework for rapid dissemination of occurrence data as it is incorporated into the NAS database. In May 2004, the NAS program developed an alert system to notify registered users of new introductions as part of a national early detection/rapid response system. This article summarizes information on system users and dispatched alerts from the system's inception through the end of 2011. The NAS alert system has registered over 1,700 users, with approximately 800 current subscribers. A total of 1,189 alerts had been transmitted through 2011. More alerts were sent for Florida (134 alerts) than for any other state. Fishes comprise the largest taxonomic group of alerts (440), with mollusks, plants, and crustaceans each containing over 100 alerts. Most alerts were for organisms that were intentionally released (414 alerts), with shipping, escape from captivity, and hitchhiking also representing major vectors. To explore the archive of sent alerts and to register, the search and signup page for the alert system can be found online at http://nas.er.usgs.gov/AlertSystem/default.aspx.

  9. Real-time alerts and reminders using information systems.

    PubMed

    Wanderer, Jonathan P; Sandberg, Warren S; Ehrenfeld, Jesse M

    2011-09-01

    Adoption of information systems throughout the hospital environment has enabled the development of real-time physiologic alerts and clinician reminder systems. These clinical tools can be made available through the deployment of anesthesia information management systems (AIMS). Creating usable alert systems requires understanding of technical considerations. Various successful implementations are reviewed, encompassing cost reduction, improved revenue capture, timely antibiotic administration, and postoperative nausea and vomiting prophylaxis. Challenges to the widespread use of real-time alerts and reminders include AIMS adoption rates and the difficulty in choosing appropriate areas and approaches for information systems support. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Validation of the CME Geomagnetic forecast alerts under COMESEP alert system

    NASA Astrophysics Data System (ADS)

    Dumbovic, Mateja; Srivastava, Nandita; Khodia, Yamini; Vršnak, Bojan; Devos, Andy; Rodriguez, Luciano

    2017-04-01

    An automated space weather alert system has been developed under the EU FP7 project COMESEP (COronal Mass Ejections and Solar Energetic Particles: http://comesep.aeronomy.be) to forecast solar energetic particles (SEP) and coronal mass ejection (CME) risk levels at Earth. COMESEP alert system uses automated detection tool CACTus to detect potentially threatening CMEs, drag-based model (DBM) to predict their arrival and CME geo-effectiveness tool (CGFT) to predict their geomagnetic impact. Whenever CACTus detects a halo or partial halo CME and issues an alert, DBM calculates its arrival time at Earth and CGFT calculates its geomagnetic risk level. Geomagnetic risk level is calculated based on an estimation of the CME arrival probability and its likely geo-effectiveness, as well as an estimate of the geomagnetic-storm duration. We present the evaluation of the CME risk level forecast with COMESEP alert system based on a study of geo-effective CMEs observed during 2014. The validation of the forecast tool is done by comparing the forecasts with observations. In addition, we test the success rate of the automatic forecasts (without human intervention) against the forecasts with human intervention using advanced versions of DBM and CGFT (self standing tools available at Hvar Observatory website: http://oh.geof.unizg.hr). The results implicate that the success rate of the forecast is higher with human intervention and using more advanced tools. This work has received funding from the European Commission FP7 Project COMESEP (263252). We acknowledge the support of Croatian Science Foundation under the project 6212 „Solar and Stellar Variability".

  11. The Common Alerting Protocol (CAP) adaption in National Early Warning Alerting Systems of China

    NASA Astrophysics Data System (ADS)

    Li, Chao

    2017-04-01

    The Common Alerting Protocol (CAP) [1] is an XML-based data format for exchanging public warnings and emergencies between alerting technologies. In China, from local communities to entire nations, there was a patchwork of specialized hazard public alerting systems. And each system was often designed just for certain emergency situations and for certain communications media. Application took place in the NEWAS (National Early Warning Alerting Systems) [2]project where CAP serves as central message to integrate all kind of hazard situations, including the natural calamity, accident disaster, public health emergency , social safety etc. Officially operated on May 2015, NEWAS now has completed docking work with 14 departments including civil administration, safety supervision, forestry, land, water conservancy, earthquake, traffic, meteorology, agriculture, tourism, food and drug supervision, public security and oceanic administration. Thus, several items in CAP has been modified, redefined and extended according to the various grading standards and publishing strategies, as well as the characteristics of Chinese Geocoding. NEWAS successfully delivers information to end users through 4 levels (i.e. State, province, prefecture and county) structure and by various means. [1] CAP, http://www.oasis-emergency.org/cap [2] http://www.12379.cn/

  12. 78 FR 16806 - The Commercial Mobile Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 10 [PS Docket No. 07-287; DA 13-280] The Commercial Mobile Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Commission amends its rules to change the name of the Commercial Mobile Alert System (CMAS...

  13. 77 FR 26701 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

    ... Emergency Alert System AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY: In this document, the Federal Communications Commission (Commission) amends its rules governing the Emergency Alert... the manner in which EAS Participants must be able to receive alert messages formatted in the Common...

  14. Pilot Non-Conformance to Alerting System Commands During Closely Spaced Parallel Approaches

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy Ruth; Hansman, R. John; Corker, Kevin (Technical Monitor)

    1997-01-01

    Cockpit alerting systems monitor potentially hazardous situations, both inside and outside the aircraft. When a hazard is projected to occur, the alerting system displays alerts and/or command decisions to the pilot. However, pilots have been observed to not conform to alerting system commands by delaying their response or by not following the automatic commands exactly. This non-conformance to the automatic alerting system can reduce its benefit. Therefore, a need exists to understand the causes and effects of pilot non-conformance in order to develop automatic alerting systems whose commands the pilots are more likely to follow. These considerations were examined through flight simulator evaluations of the collision avoidance task during closely spaced parallel approaches. This task provided a useful case-study because the effects of non-conformance can be significant, given the time-critical nature of the task. A preliminary evaluation of alerting systems identified non-conformance in over 40% of the cases and a corresponding drop in collision avoidance performance. A follow-on experiment found subjects' alerting and maneuver selection criteria were consistent with different strategies than those used by automatic systems, indicating the pilot may potentially disagree with the alerting system if the pilot attempts to verify automatic alerts and commanded avoidance maneuvers. A final experiment found supporting automatic alerts with the explicit display of its underlying criteria resulted in more consistent subject reactions. In light of these experimental results, a general discussion of pilot non-conformance is provided. Contributing factors in pilot non-conformance include a lack of confidence in the automatic system and mismatches between the alerting system's commands and the pilots' own decisions based on the information available to them. The effects of non-conformance on system performance are discussed. Possible methods of reconciling mismatches are

  15. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    PubMed

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Evaluating Alerting and Guidance Performance of a UAS Detect-And-Avoid System

    NASA Technical Reports Server (NTRS)

    Lee, Seung Man; Park, Chunki; Thipphavong, David P.; Isaacson, Douglas R.; Santiago, Confesor

    2016-01-01

    A key challenge to the routine, safe operation of unmanned aircraft systems (UAS) is the development of detect-and-avoid (DAA) systems to aid the UAS pilot in remaining "well clear" of nearby aircraft. The goal of this study is to investigate the effect of alerting criteria and pilot response delay on the safety and performance of UAS DAA systems in the context of routine civil UAS operations in the National Airspace System (NAS). A NAS-wide fast-time simulation study was conducted to assess UAS DAA system performance with a large number of encounters and a broad set of DAA alerting and guidance system parameters. Three attributes of the DAA system were controlled as independent variables in the study to conduct trade-off analyses: UAS trajectory prediction method (dead-reckoning vs. intent-based), alerting time threshold (related to predicted time to LoWC), and alerting distance threshold (related to predicted Horizontal Miss Distance, or HMD). A set of metrics, such as the percentage of true positive, false positive, and missed alerts, based on signal detection theory and analysis methods utilizing the Receiver Operating Characteristic (ROC) curves were proposed to evaluate the safety and performance of DAA alerting and guidance systems and aid development of DAA system performance standards. The effect of pilot response delay on the performance of DAA systems was evaluated using a DAA alerting and guidance model and a pilot model developed to support this study. A total of 18 fast-time simulations were conducted with nine different DAA alerting threshold settings and two different trajectory prediction methods, using recorded radar traffic from current Visual Flight Rules (VFR) operations, and supplemented with DAA-equipped UAS traffic based on mission profiles modeling future UAS operations. Results indicate DAA alerting distance threshold has a greater effect on DAA system performance than DAA alerting time threshold or ownship trajectory prediction method

  17. An Obstacle Alerting System for Agricultural Application

    NASA Technical Reports Server (NTRS)

    DeMaio, Joe

    2003-01-01

    Wire strikes are a significant cause of helicopter accidents. The aircraft most at risk are aerial applicators. The present study examines the effectiveness of a wire alert delivered by way of the lightbar, a GPS-based guidance system for aerial application. The alert lead-time needed to avoid an invisible wire is compared with that to avoid a visible wire. A flight simulator was configured to simulate an agricultural application helicopter. Two pilots flew simulated spray runs in fields with visible wires, invisible wires, and no wires. The wire alert was effective in reducing wire strikes. A lead-time of 3.5 sec was required for the alert to be effective. The lead- time required was the same whether the pilot could see the wire or not.

  18. ShakeAlert Users Transition to the Production Prototype System

    NASA Astrophysics Data System (ADS)

    Strauss, J. A.; Vinci, M.; Steele, W. P.; Hellweg, M.; Allen, R. M.; DeGroot, R. M.

    2016-12-01

    The ShakeAlert Earthquake Early Warning system transitioned from the demonstration system into the fully-fledged production prototype system this year. Users were migrated over to the new system concurrent with the release of the ShakeAlert UserDisplay Version 2.5.0. The production prototype system provides robust connectivity, fail-over mechanisms to ensure that alarms are deliverd even if one connection fails, and provides a framework to connect future stations, participants, and other sources as the project expands to the full public system. We will present an overview of key user sectors that are either testing or launching pilot projects for the system within their organizations. We will outline the implementation of certain actions, and highlight accomplishments and challenges the Beta Users encounter in fully implementing ShakeAlert within their organizations. By better studying these issues, project partners can better assist the users in incorporating early warning in their operations. Opening up the system to allow for pilot projects enables ShakeAlert users to develop hardware, software, and policy solutions for actions in response to early warning alerts in a controlled environment. This is the first step on the path toward limited rollouts. The pilot groups leverage the expertise of our stakeholders to develop the `last mile' alert distribution and responses. The transition went smoothly in February 2015, for users in California, and we expect to connect with more beta users and pilot groups in this next phase. User transition is planned for Fall 2016 for users in the Pacific Northwest. Beta Users, such as municipalities, emergency response groups, and county officials, lifelines, schools, and private industry continue to meet with ShakeAlert partners to 1) further education and training on both benefits and limitations 2) strategize on implementation actions, such as opening fire house bay doors in response to an alarm, and 3) coordinate continued

  19. Modeling Pilot State in Next Generation Aircraft Alert Systems

    NASA Technical Reports Server (NTRS)

    Carlin, Alan S.; Alexander, Amy L.; Schurr, Nathan

    2011-01-01

    The Next Generation Air Transportation System will introduce new, advanced sensor technologies into the cockpit that must convey a large number of potentially complex alerts. Our work focuses on the challenges associated with prioritizing aircraft sensor alerts in a quick and efficient manner, essentially determining when and how to alert the pilot This "alert decision" becomes very difficult in NextGen due to the following challenges: 1) the increasing number of potential hazards, 2) the uncertainty associated with the state of potential hazards as well as pilot slate , and 3) the limited time to make safely-critical decisions. In this paper, we focus on pilot state and present a model for anticipating duration and quality of pilot behavior, for use in a larger system which issues aircraft alerts. We estimate pilot workload, which we model as being dependent on factors including mental effort, task demands. and task performance. We perform a mathematically rigorous analysis of the model and resulting alerting plans. We simulate the model in software and present simulated results with respect to manipulation of the pilot measures.

  20. An Evaluation of the Early Alert (STAR) Program at Central Piedmont Community College

    ERIC Educational Resources Information Center

    Gammon, J. B.

    2017-01-01

    Central Piedmont Community College is exploring ways to help at-risk students achieve academic success by utilizing an early-alert system called Success Through Academic Reporting (STAR). All First-Time, Full-time Degree-seeking students (FFD) receive an opportunity for follow-up services that support a centralized strategy, which has the…

  1. [Detection of Brucella with an automatic hemoculture system: Bact/Alert].

    PubMed

    Casas, J; Partal, Y; Llosá, J; Leiva, J; Navarro, J M; de la Rosa, M

    1994-12-01

    The ability of in vitro and in vivo detection of Brucella spp. with the Bact/Alert system was studied. Three strains of Brucella melitensis and two of Brucella abortus were used. Different dilutions of the five strains were performed in trypticase soy broth (TSB), achieving concentrations of 1 cfu/ml, 5 cfu/ml, 10 cfu/ml and 100 cfu/ml. Ten ml of each dilution and strain were inoculated into 5 aerobic bottles Bact/Alert and 5 biphasic Hemóline bottles. Furthermore, over a 9 month period, 8,216 bottles of Bact/Alert bottles from hospitalized patients and from the emergency department were processed in the authors' laboratory. The mean detection time for Brucella growth was from 2 to 3 days with the Bact/Alert system, and 14 days in the biphasic bottles. Former bottles processed in the authors' laboratory, 11 aerobic bottles belonged to 5 patients in whom brucelosis was confirmed by bloodculture. The Bact/Alert system detected Brucella melitensis in only on bottle at 2.9 days of incubation. In 7 bottles Bact/Alert detected B. melitensis by a blind pass of these bottles at 10 to 20 days of incubation. These results suggest that the Bact/Alert system does not totally solve the diagnosis of brucellosis. Blind passes of the bloodcultures are required.

  2. CISN ShakeAlert Earthquake Early Warning System Monitoring Tools

    NASA Astrophysics Data System (ADS)

    Henson, I. H.; Allen, R. M.; Neuhauser, D. S.

    2015-12-01

    CISN ShakeAlert is a prototype earthquake early warning system being developed and tested by the California Integrated Seismic Network. The system has recently been expanded to support redundant data processing and communications. It now runs on six machines at three locations with ten Apache ActiveMQ message brokers linking together 18 waveform processors, 12 event association processes and 4 Decision Module alert processes. The system ingests waveform data from about 500 stations and generates many thousands of triggers per day, from which a small portion produce earthquake alerts. We have developed interactive web browser system-monitoring tools that display near real time state-of-health and performance information. This includes station availability, trigger statistics, communication and alert latencies. Connections to regional earthquake catalogs provide a rapid assessment of the Decision Module hypocenter accuracy. Historical performance can be evaluated, including statistics for hypocenter and origin time accuracy and alert time latencies for different time periods, magnitude ranges and geographic regions. For the ElarmS event associator, individual earthquake processing histories can be examined, including details of the transmission and processing latencies associated with individual P-wave triggers. Individual station trigger and latency statistics are available. Detailed information about the ElarmS trigger association process for both alerted events and rejected events is also available. The Google Web Toolkit and Map API have been used to develop interactive web pages that link tabular and geographic information. Statistical analysis is provided by the R-Statistics System linked to a PostgreSQL database.

  3. Optimizing the real-time ground level enhancement alert system based on neutron monitor measurements: Introducing GLE Alert Plus

    NASA Astrophysics Data System (ADS)

    Souvatzoglou, G.; Papaioannou, A.; Mavromichalaki, H.; Dimitroulakos, J.; Sarlanis, C.

    2014-11-01

    Whenever a significant intensity increase is being recorded by at least three neutron monitor stations in real-time mode, a ground level enhancement (GLE) event is marked and an automated alert is issued. Although, the physical concept of the algorithm is solid and has efficiently worked in a number of cases, the availability of real-time data is still an open issue and makes timely GLE alerts quite challenging. In this work we present the optimization of the GLE alert that has been set into operation since 2006 at the Athens Neutron Monitor Station. This upgrade has led to GLE Alert Plus, which is currently based upon the Neutron Monitor Database (NMDB). We have determined the critical values per station allowing us to issue reliable GLE alerts close to the initiation of the event while at the same time we keep the false alert rate at low levels. Furthermore, we have managed to treat the problem of data availability, introducing the Go-Back-N algorithm. A total of 13 GLE events have been marked from January 2000 to December 2012. GLE Alert Plus issued an alert for 12 events. These alert times are compared to the alert times of GOES Space Weather Prediction Center and Solar Energetic Particle forecaster of the University of Málaga (UMASEP). In all cases GLE Alert Plus precedes the GOES alert by ≈8-52 min. The comparison with UMASEP demonstrated a remarkably good agreement. Real-time GLE alerts by GLE Alert Plus may be retrieved by http://cosray.phys.uoa.gr/gle_alert_plus.html, http://www.nmdb.eu, and http://swe.ssa.esa.int/web/guest/space-radiation. An automated GLE alert email notification system is also available to interested users.

  4. Advanced alerting features: displaying new relevant data and retracting alerts.

    PubMed Central

    Kuperman, G. J.; Hiltz, F. L.; Teich, J. M.

    1997-01-01

    We added two advanced features to our automated alerting system. The first feature identifies and displays, at the time an alert is reviewed, relevant data filed between the login time of a specimen leading to an alerting result and the time the alert is reviewed. Relevant data is defined as data of the same kind as generated the alert. The other feature retracts alerts when the alerting value is edited and no longer satisfies the alerting criteria. We evaluated the two features for a 14-week period (new relevant data) and a 6-week period (retraction). Of a total of 1104 alerts in the 14-week evaluation, 286 (25.9%) had new relevant data displayed at alert review time. Of the 286, 75.2% were due to additions of comments to the original piece of alerting data; 24.1% were due to new or pending laboratory results of the same type that generated the alert. Two alerts (out of 490) were retracted in a 6 week period. We conclude that in our system, new clinically relevant data is often added between the time of specimen login and the time that an alerting result from that specimen is reviewed. Retractions occur rarely but are important to detect and communicate. PMID:9357625

  5. 76 FR 62321 - Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) Units AGENCY... certain Aviation Communication & Surveillance Systems (ACSS) traffic alert and collision avoidance system...) traffic alert and collision avoidance system (TCAS) units with part numbers identified in ACSS Technical...

  6. Reaching out to clinicians: implementation of a computerized alert system.

    PubMed

    Degnan, Dan; Merryfield, Dave; Hultgren, Steve

    2004-01-01

    Several published articles have identified that providing automated, computer-generated clinical alerts about potentially critical clinical situations should result in better quality of care. In 1999, the pharmacy department at a community hospital network implemented and refined a commercially available, computerized clinical alert system. This case report discusses the implementation process, gives examples of how the system is used, and describes results following implementation. The use of the clinical alert system in this hospital network resulted in improved patient safety as well as in greater efficiency and decreased costs.

  7. Prescription errors before and after introduction of electronic medication alert system in a pediatric emergency department.

    PubMed

    Sethuraman, Usha; Kannikeswaran, Nirupama; Murray, Kyle P; Zidan, Marwan A; Chamberlain, James M

    2015-06-01

    Prescription errors occur frequently in pediatric emergency departments (PEDs).The effect of computerized physician order entry (CPOE) with electronic medication alert system (EMAS) on these is unknown. The objective was to compare prescription errors rates before and after introduction of CPOE with EMAS in a PED. The hypothesis was that CPOE with EMAS would significantly reduce the rate and severity of prescription errors in the PED. A prospective comparison of a sample of outpatient, medication prescriptions 5 months before and after CPOE with EMAS implementation (7,268 before and 7,292 after) was performed. Error types and rates, alert types and significance, and physician response were noted. Medication errors were deemed significant if there was a potential to cause life-threatening injury, failure of therapy, or an adverse drug effect. There was a significant reduction in the errors per 100 prescriptions (10.4 before vs. 7.3 after; absolute risk reduction = 3.1, 95% confidence interval [CI] = 2.2 to 4.0). Drug dosing error rates decreased from 8 to 5.4 per 100 (absolute risk reduction = 2.6, 95% CI = 1.8 to 3.4). Alerts were generated for 29.6% of prescriptions, with 45% involving drug dose range checking. The sensitivity of CPOE with EMAS in identifying errors in prescriptions was 45.1% (95% CI = 40.8% to 49.6%), and the specificity was 57% (95% CI = 55.6% to 58.5%). Prescribers modified 20% of the dosing alerts, resulting in the error not reaching the patient. Conversely, 11% of true dosing alerts for medication errors were overridden by the prescribers: 88 (11.3%) resulted in medication errors, and 684 (88.6%) were false-positive alerts. A CPOE with EMAS was associated with a decrease in overall prescription errors in our PED. Further system refinements are required to reduce the high false-positive alert rates. © 2015 by the Society for Academic Emergency Medicine.

  8. Optimizing drug-dose alerts using commercial software throughout an integrated health care system.

    PubMed

    Saiyed, Salim M; Greco, Peter J; Fernandes, Glenn; Kaelber, David C

    2017-11-01

    All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold. Drug-specific strategies included changing drug-specific maximum single and maximum daily drug-dose alerting parameters for the top 22 drug categories by alert frequency. System-level approaches decreased alerting to 5% (46 988/834 911) and drug-specific approaches decreased alerts to 3% (25 455/834 911). Drug-dose alerts varied between care settings and patient populations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. PleurAlert: an augmented chest drainage system with electronic sensing, automated alerts and internet connectivity.

    PubMed

    Leeson, Cory E; Weaver, Robert A; Bissell, Taylor; Hoyer, Rachel; McClain, Corinne; Nelson, Douglas A; Samosky, Joseph T

    2012-01-01

    We have enhanced a common medical device, the chest tube drainage container, with electronic sensing of fluid volume, automated detection of critical alarm conditions and the ability to automatically send alert text messages to a nurse's cell phone. The PleurAlert system provides a simple touch-screen interface and can graphically display chest tube output over time. Our design augments a device whose basic function dates back 50 years by adding technology to automate and optimize a monitoring process that can be time consuming and inconvenient for nurses. The system may also enhance detection of emergency conditions and speed response time.

  10. The Seismic Alert System of Mexico (SASMEX): Performance and Evolution

    NASA Astrophysics Data System (ADS)

    Espinosa Aranda, J.

    2013-05-01

    Originally the Seismic Alert System of Mexico (SASMEX) was proposed to integrate the Seismic Alert System of Mexico City (SAS), operating since 1991, with the Seismic Alert System of Oaxaca City (SASO), in services since 2003. And today, after the intense big earthquake activity observed in our world during 2010 and 2011, local governments of Mexico City, Oaxaca Estate, and the Mexican Ministry of the Interior have been promoting the expansion of this technological EEW development. Until 2012 SASMEX better coverage includes 48 new field seismic sensors (FS) deployed over the seismic region of Jalisco, Colima, Michoacan and Puebla, with someone enhancements over Guerrero and Oaxaca, to reach 97 FS. During 2013, 35 new FS has been proposed to SASMEX enhancements covering the Chiapas and Veracruz seismic regions. The SASMEX, with the support of the Mexico Valley Broadcasters Association (ARVM) since 1993, automatically issue Public and Preventive earthquake early warning signals in the Cities of Mexico, Toluca, Acapulco, Chilpancingo, and Oaxaca. The seismic warning range in each case is seated in accordance with local Civil Protection Authorities: Public Alert, if they expect strong earthquake effects, and Preventive Alert one, the effect could be moderated. Now the SASMEX warning time opportunity could be different to the 60 sec. average typically generated when SAS warned earthquake effects coming from Guerrero to Mexico City valley. Mexican EEW issued today reach: 16 Public and 62 Preventive Alert in Mexico City; 25 Public and 19 Preventive Alerts in Oaxaca City; also 14 Public and 4 Preventive Alerts in Acapulco; 14 Public and 5 Preventive Alerts in Chilpancingo. The earthquakes events registered by SASMEX FS until now reach 3448. With the support of private and Federal telecommunications infrastructure like, TELMEX, Federal Electric Commission, and the Mexican Security Ministry, it was developed a redundant communication system with pads to link the different

  11. Earthquake Early Warning ShakeAlert System: Testing and certification platform

    USGS Publications Warehouse

    Cochran, Elizabeth S.; Kohler, Monica D.; Given, Douglas; Guiwits, Stephen; Andrews, Jennifer; Meier, Men-Andrin; Ahmad, Mohammad; Henson, Ivan; Hartog, Renate; Smith, Deborah

    2017-01-01

    Earthquake early warning systems provide warnings to end users of incoming moderate to strong ground shaking from earthquakes. An earthquake early warning system, ShakeAlert, is providing alerts to beta end users in the western United States, specifically California, Oregon, and Washington. An essential aspect of the earthquake early warning system is the development of a framework to test modifications to code to ensure functionality and assess performance. In 2016, a Testing and Certification Platform (TCP) was included in the development of the Production Prototype version of ShakeAlert. The purpose of the TCP is to evaluate the robustness of candidate code that is proposed for deployment on ShakeAlert Production Prototype servers. TCP consists of two main components: a real‐time in situ test that replicates the real‐time production system and an offline playback system to replay test suites. The real‐time tests of system performance assess code optimization and stability. The offline tests comprise a stress test of candidate code to assess if the code is production ready. The test suite includes over 120 events including local, regional, and teleseismic historic earthquakes, recentering and calibration events, and other anomalous and potentially problematic signals. Two assessments of alert performance are conducted. First, point‐source assessments are undertaken to compare magnitude, epicentral location, and origin time with the Advanced National Seismic System Comprehensive Catalog, as well as to evaluate alert latency. Second, we describe assessment of the quality of ground‐motion predictions at end‐user sites by comparing predicted shaking intensities to ShakeMaps for historic events and implement a threshold‐based approach that assesses how often end users initiate the appropriate action, based on their ground‐shaking threshold. TCP has been developed to be a convenient streamlined procedure for objectively testing algorithms, and it has

  12. The agile alert system for gamma-ray transients

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.

    2014-01-20

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a newmore » algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.« less

  13. The AGILE Alert System for Gamma-Ray Transients

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Parmiggiani, N.; Fioretti, V.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Beneventano, D.; Argan, A.; Trois, A.; Scalise, E.; Longo, F.; Pellizzoni, A.; Pucella, G.; Colafrancesco, S.; Conforti, V.; Tempesta, P.; Cerone, M.; Sabatini, P.; Annoni, G.; Valentini, G.; Salotti, L.

    2014-01-01

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  14. Solar radiation alert system : final report.

    DOT National Transportation Integrated Search

    2009-03-01

    The Solar Radiation Alert (SRA) system continuously evaluates measurements of high-energy protons made by instruments on GOES satellites. If the measurements indicate a substantial elevation of effective dose rates at aircraft flight altitudes, the C...

  15. Wide variation and patterns of physicians' responses to drug-drug interaction alerts.

    PubMed

    Cho, Insook; Lee, Yura; Lee, Jae-Ho; Bates, David W

    2018-05-08

    Providing physicians with alerts about potentially harmful drug-drug interactions (DDIs) is only moderately effective due to high alert override rates. To understand high override behavior on DDI alerts, we investigated how physicians respond to DDIs and their behavior patterns and variations. Retrospective system log data analysis and records review (sampling 2% of total overrides). A large tertiary academic hospital. About 560 physicians and their override responses to DDI alerts generated from 1 September to 31 December 2014. Not applicable. DDI alert frequency and override rate. We found significant variation in both the number of alerts and override rates at the levels of physicians, departments and drug-class pairs. Physician-level variations were wider for residents than for faculty staff (number of alerts: t = 254.17, P = 0.011; override rates: t = -4.77, P < 0.0001). Using the number of alerts and their override rate, we classified physicians into four groups: inexperienced incautious users, inexperienced cautious users, experienced cautious users and experienced incautious users. Medical department influenced both alert numbers and override rates. Nearly 90% of the overrides involved only five drug-class combinations, which had a wide range of appropriateness in the chart review. The variations at drug-class levels suggest issues with system design and the DDI rules. Department-level variation may be best addressed at the department level, and the rest of the variation appears related to individual physician responses, suggesting the need for interventions at an individual level.

  16. Rapid deployable global sensing hazard alert system

    DOEpatents

    Cordaro, Joseph V; Tibrea, Steven L; Shull, Davis J; Coleman, Jerry T; Shuler, James M

    2015-04-28

    A rapid deployable global sensing hazard alert system and associated methods of operation are provided. An exemplary system includes a central command, a wireless backhaul network, and a remote monitoring unit. The remote monitoring unit can include a positioning system configured to determine a position of the remote monitoring unit based on one or more signals received from one or more satellites located in Low Earth Orbit. The wireless backhaul network can provide bidirectional communication capability independent of cellular telecommunication networks and the Internet. An exemplary method includes instructing at least one of a plurality of remote monitoring units to provide an alert based at least in part on a location of a hazard and a plurality of positions respectively associated with the plurality of remote monitoring units.

  17. MyEEW: A Smartphone App for the ShakeAlert System

    NASA Astrophysics Data System (ADS)

    Strauss, J. A.; Allen, S.; Allen, R. M.; Hellweg, M.

    2015-12-01

    Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds warning prior to ground shaking at a user's location. The goal and purpose of such a system is to reduce, or minimize, the damage, costs, and casualties resulting from an earthquake. A demonstration earthquake early warning system (ShakeAlert) is undergoing testing in the United States by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, the USGS, and beta users in California and the Pacific Northwest. The UC Berkeley Seismological Laboratory has created a smartphone app called MyEEW, which interfaces with the ShakeAlert system to deliver early warnings to individual users. Many critical facilities (transportation, police, and fire) have control rooms, which could run a centralized interface, but our ShakeAlert Beta Testers have also expressed their need for mobile options. This app augments the basic ShakeAlert Java desktop applet by allowing workers off-site (or merely out of hearing range) to be informed of coming hazards. MyEEW receives information from the ShakeAlert system to provide users with real-time information about shaking that is about to happen at their individual location. It includes a map, timer, and earthquake information similar to the Java desktop User Display. The app will also feature educational material to help users craft their own response and resiliency strategies. The app will be open to UC Berkeley Earthquake Research Affiliates members for testing in the near future.

  18. Real-Time Mapping alert system; user's manual

    USGS Publications Warehouse

    Torres, L.A.

    1996-01-01

    The U.S. Geological Survey has an extensive hydrologic network that records and transmits precipitation, stage, discharge, and other water- related data on a real-time basis to an automated data processing system. Data values are recorded on electronic data collection platforms at field monitoring sites. These values are transmitted by means of orbiting satellites to receiving ground stations, and by way of telecommunication lines to a U.S. Geological Survey office where they are processed on a computer system. Data that exceed predefined thresholds are identified as alert values. These alert values can help keep water- resource specialists informed of current hydrologic conditions. The current alert status at monitoring sites is of critical importance during floods, hurricanes, and other extreme hydrologic events where quick analysis of the situation is needed. This manual provides instructions for using the Real-Time Mapping software, a series of computer programs developed by the U.S. Geological Survey for quick analysis of hydrologic conditions, and guides users through a basic interactive session. The software provides interactive graphics display and query of real-time information in a map-based, menu-driven environment.

  19. 77 FR 6000 - Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-07

    ... Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and Collision... Communication & Surveillance Systems (ACSS) traffic alert and collision avoidance system (TCAS) units with part...

  20. Postural control system influences intrinsic alerting state.

    PubMed

    Barra, Julien; Auclair, Laurent; Charvillat, Agnès; Vidal, Manuel; Pérennou, Dominic

    2015-03-01

    Numerous studies using dual-task paradigms (postural and cognitive) have shown that postural control requires cognitive resources. However, the influence of postural control on attention components has never been directly addressed. Using the attention network test (ANT), which assesses specifically each of the 3 components of attention-alertness, orientation, and executive control-within a single paradigm, we investigated the effect of postural balance demand on these 3 components. Forty-two participants completed the ANT in 3 postural conditions: (a) supine, a very stable position; (b) sitting on a chair, an intermediate position; and (c) standing with feet lined up heel to toe, a very instable position known as the Romberg position. Our results revealed that the difficulty of postural control does modulate alerting in such a way that it improves with the level of instability of the position. Regarding the orienting and executive control components of attention, performance was not different when participants were standing upright or seated, whereas in the supine position, performance dropped. The strong and specific interaction between postural control and the alerting system suggests that these mechanisms may share parts of the underlying neural circuits. We discuss the possible implication of the locus coeruleus, known to be involved in both postural balance and alerting. Also, our findings concerning orienting and executive control systems suggest that supine posture could have a specific effect on cognitive activities. These effects are discussed in terms of particularities resulting from the supine position. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  1. 47 CFR 76.1711 - Emergency alert system (EAS) tests and activation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Emergency alert system (EAS) tests and activation. 76.1711 Section 76.1711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection § 76.1711 Emergency alert system (EAS)...

  2. 47 CFR 76.1711 - Emergency alert system (EAS) tests and activation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Emergency alert system (EAS) tests and activation. 76.1711 Section 76.1711 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Documents to be Maintained for Inspection § 76.1711 Emergency alert system (EAS)...

  3. Real Time Alert System: A Disease Management System Leveraging Health Information Exchange

    PubMed Central

    Anand, Vibha; Sheley, Meena E.; Xu, Shawn; Downs, Stephen M.

    2012-01-01

    Background Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Methods: Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA’s performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Results: Our results show that RTA was successfully able to deliver “just in time” patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. Conclusions: We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient’s asthma related emergency room admission so further follow up can happen in near real time. PMID:23569648

  4. Real time alert system: a disease management system leveraging health information exchange.

    PubMed

    Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

    2012-01-01

    Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

  5. Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program - Recommendations for Public Alerts Via Cell Phones

    NASA Astrophysics Data System (ADS)

    DeGroot, R. M.; Long, K.; Strauss, J. A.

    2017-12-01

    The United States Geological Survey (USGS) and its partners are developing the ShakeAlert Earthquake Early Warning System for the West Coast of the United States. To be an integral part of successful implementation, ShakeAlert engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education and communication efforts. The ShakeAlert Joint Committee for Communication, Education, and Outreach (JCCEO), is identifying, developing, and cultivating partnerships with ShakeAlert stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on ShakeAlert, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive a ShakeAlert warning. In February 2017, the JCCEO convened the Warning Message Focus Group (WMFG) to provide findings and recommendations to the Alliance for Telecommunications Industry Solutions on the use of earthquake early warning message content standards for public alerts via cell phones. The WMFG represents communications, education, and outreach stakeholders from various sectors including ShakeAlert regional coordinators, industry, emergency managers, and subject matter experts from the social sciences. The group knowledge was combined with an in-depth literature review to ensure that all groups who could receive the message would be taken into account. The USGS and the participating states and agencies acknowledge that the implementation of ShakeAlert is a collective effort requiring the participation of hundreds of

  6. An MFC-Based Online Monitoring and Alert System for Activated Sludge Process

    PubMed Central

    Xu, Gui-Hua; Wang, Yun-Kun; Sheng, Guo-Ping; Mu, Yang; Yu, Han-Qing

    2014-01-01

    In this study, based on a simple, compact and submersible microbial fuel cell (MFC), a novel online monitoring and alert system with self-diagnosis function was established for the activated sludge (AS) process. Such a submersible MFC utilized organic substrates and oxygen in the AS reactor as the electron donor and acceptor respectively, and could provide an evaluation on the status of the AS reactor and thus give a reliable early warning of potential risks. In order to evaluate the reliability and sensitivity of this online monitoring and alert system, a series of tests were conducted to examine the response of this system to various shocks imposed on the AS reactor. The results indicate that this online monitoring and alert system was highly sensitive to the performance variations of the AS reactor. The stability, sensitivity and repeatability of this online system provide feasibility of being incorporated into current control systems of wastewater treatment plants to real-time monitor, diagnose, alert and control the AS process. PMID:25345502

  7. CEI-PEA Alert, Summer 2006

    ERIC Educational Resources Information Center

    Center for Educational Innovation - Public Education Association, 2006

    2006-01-01

    The "CEI-PEA Alert" is an advocacy newsletter that deals with topics of interest to all concerned with the New York City public schools. This issue includes: (1) Practical Skills & High Academic Standards: Career Technical Education; (2) Parents: Help Your Children Gain "Soft Skills" for the Workforce; (3) Culinary Arts…

  8. 21 CFR 26.50 - Alert system and exchange of postmarket vigilance reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT EVALUATION REPORTS: UNITED STATES AND THE EUROPEAN COMMUNITY Specific Sector Provisions for Medical Devices § 26.50 Alert system and exchange of... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Alert system and exchange of postmarket vigilance...

  9. Wireless alerting system using vibration for vehicles dashboard

    NASA Astrophysics Data System (ADS)

    Raj, Sweta; Rai, Shweta; Magaramagara, Wilbert; Sivacoumar, R.

    2017-11-01

    This paper aims at improving the engine life of any vehicle through a continuous measurement and monitoring of vital engine operational parameters and providing an effective alerting to drivers for any abnormality. Vehicles currently are using audio and visible alerting signals through alarms and light as a warning to the driver but these are not effective in noisy environments and during daylight. Through the use of the sense of feeling a driver can be alerted effectively. The need to no other vehicle parameter needs to be aided through the mobile display (phone).Thus a system is designed and implements to measure engine temperature, RPM, Oil level and Coolant level using appropriate sensors and a wireless communication (Bluetooth) is established to actuate a portable vibration control device and to read the different vehicle sensor readings through an android application for display and diagnosis.

  10. Alerts Analysis and Visualization in Network-based Intrusion Detection Systems

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yang, Dr. Li

    2010-08-01

    The alerts produced by network-based intrusion detection systems, e.g. Snort, can be difficult for network administrators to efficiently review and respond to due to the enormous number of alerts generated in a short time frame. This work describes how the visualization of raw IDS alert data assists network administrators in understanding the current state of a network and quickens the process of reviewing and responding to intrusion attempts. The project presented in this work consists of three primary components. The first component provides a visual mapping of the network topology that allows the end-user to easily browse clustered alerts. Themore » second component is based on the flocking behavior of birds such that birds tend to follow other birds with similar behaviors. This component allows the end-user to see the clustering process and provides an efficient means for reviewing alert data. The third component discovers and visualizes patterns of multistage attacks by profiling the attacker s behaviors.« less

  11. Advanced LED warning system for rural intersections : phase 2 (ALERT-2) : final report.

    DOT National Transportation Integrated Search

    2014-02-01

    This report presents findings of the second phase of the Advanced LED Warning System for Rural : Intersections (ALERT) project. Since it is the next generation of the same system, the second phase : system is referred to as the ALERT-2 system while t...

  12. Practitioners’ Views on Computerized Drug–Drug Interaction Alerts in the VA System

    PubMed Central

    Ko, Yu; Abarca, Jacob; Malone, Daniel C.; Dare, Donna C.; Geraets, Doug; Houranieh, Antoun; Jones, William N.; Nichol, W. Paul; Schepers, Gregory P.; Wilhardt, Michelle

    2007-01-01

    Objectives To assess Veterans Affairs (VA) prescribers’ and pharmacists’ opinions about computer-generated drug–drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. Design A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. Measurements A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. Results The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). Conclusion Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility. PMID:17068346

  13. Usability Flaws in Medication Alerting Systems: Impact on Usage and Work System.

    PubMed

    Marcilly, R; Ammenwerth, E; Roehrer, E; Pelayo, S; Vasseur, F; Beuscart-Zéphir, M-C

    2015-08-13

    Previous research has shown that medication alerting systems face usability issues. There has been no previous attempt to systematically explore the consequences of usability flaws in such systems on users (i.e. usage problems) and work systems (i.e. negative outcomes). This paper aims at exploring and synthesizing the consequences of usability flaws in terms of usage problems and negative outcomes on the work system. A secondary analysis of 26 papers included in a prior systematic review of the usability flaws in medication alerting was performed. Usage problems and negative outcomes were extracted and sorted. Links between usability flaws, usage problems, and negative outcomes were also analyzed. Poor usability generates a large variety of consequences. It impacts the user from a cognitive, behavioral, emotional, and attitudinal perspective. Ultimately, usability flaws have negative consequences on the workflow, the effectiveness of the technology, the medication management process, and, more importantly, patient safety. Only few complete pathways leading from usability flaws to negative outcomes were identified. Usability flaws in medication alerting systems impede users, and ultimately their work system, and negatively impact patient safety. Therefore, the usability dimension may act as a hidden explanatory variable that could explain, at least partly, the (absence of) intended outcomes of new technology.

  14. Usability Flaws in Medication Alerting Systems: Impact on Usage and Work System

    PubMed Central

    Ammenwerth, E.; Roehrer, E.; Pelayo, S.; Vasseur, F.; Beuscart-Zéphir, M.-C.

    2015-01-01

    Summary Objectives Previous research has shown that medication alerting systems face usability issues. There has been no previous attempt to systematically explore the consequences of usability flaws in such systems on users (i.e. usage problems) and work systems (i.e. negative outcomes). This paper aims at exploring and synthesizing the consequences of usability flaws in terms of usage problems and negative outcomes on the work system. Methods A secondary analysis of 26 papers included in a prior systematic review of the usability flaws in medication alerting was performed. Usage problems and negative outcomes were extracted and sorted. Links between usability flaws, usage problems, and negative outcomes were also analyzed. Results Poor usability generates a large variety of consequences. It impacts the user from a cognitive, behavioral, emotional, and attitudinal perspective. Ultimately, usability flaws have negative consequences on the workflow, the effectiveness of the technology, the medication management process, and, more importantly, patient safety. Only few complete pathways leading from usability flaws to negative outcomes were identified. Conclusion Usability flaws in medication alerting systems impede users, and ultimately their work system, and negatively impact patient safety. Therefore, the usability dimension may act as a hidden explanatory variable that could explain, at least partly, the (absence of) intended outcomes of new technology. PMID:26123906

  15. A mobile care system with alert mechanism.

    PubMed

    Lee, Ren-Guey; Chen, Kuei-Chien; Hsiao, Chun-Chieh; Tseng, Chwan-Lu

    2007-09-01

    Hypertension and arrhythmia are chronic diseases, which can be effectively prevented and controlled only if the physiological parameters of the patient are constantly monitored, along with the full support of the health education and professional medical care. In this paper, a role-based intelligent mobile care system with alert mechanism in chronic care environment is proposed and implemented. The roles in our system include patients, physicians, nurses, and healthcare providers. Each of the roles represents a person that uses a mobile device such as a mobile phone to communicate with the server setup in the care center such that he or she can go around without restrictions. For commercial mobile phones with Bluetooth communication capability attached to chronic patients, we have developed physiological signal recognition algorithms that were implemented and built-in in the mobile phone without affecting its original communication functions. It is thus possible to integrate several front-end mobile care devices with Bluetooth communication capability to extract patients' various physiological parameters [such as blood pressure, pulse, saturation of haemoglobin (SpO2), and electrocardiogram (ECG)], to monitor multiple physiological signals without space limit, and to upload important or abnormal physiological information to healthcare center for storage and analysis or transmit the information to physicians and healthcare providers for further processing. Thus, the physiological signal extraction devices only have to deal with signal extraction and wireless transmission. Since they do not have to do signal processing, their form factor can be further reduced to reach the goal of microminiaturization and power saving. An alert management mechanism has been included in back-end healthcare center to initiate various strategies for automatic emergency alerts after receiving emergency messages or after automatically recognizing emergency messages. Within the time

  16. Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts

    PubMed Central

    McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras

    2016-01-01

    Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < .001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < .001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. PMID:26499101

  17. Intrusion Detection System Visualization of Network Alerts

    DTIC Science & Technology

    2010-07-01

    Intrusion Detection System Visualization of Network Alerts Dolores M. Zage and Wayne M. Zage Ball State University Final Report July 2010...contracts. Staff Wayne Zage, Director of the S2ERC and Professor, Department of Computer Science, Ball State University Dolores Zage, Research

  18. INITIATE: An Intelligent Adaptive Alert Environment.

    PubMed

    Jafarpour, Borna; Abidi, Samina Raza; Ahmad, Ahmad Marwan; Abidi, Syed Sibte Raza

    2015-01-01

    Exposure to a large volume of alerts generated by medical Alert Generating Systems (AGS) such as drug-drug interaction softwares or clinical decision support systems over-whelms users and causes alert fatigue in them. Some of alert fatigue effects are ignoring crucial alerts and longer response times. A common approach to avoid alert fatigue is to devise mechanisms in AGS to stop them from generating alerts that are deemed irrelevant. In this paper, we present a novel framework called INITIATE: an INtellIgent adapTIve AlerT Environment to avoid alert fatigue by managing alerts generated by one or more AGS. We have identified and categories the lifecycle of different alerts and have developed alert management logic as per the alerts' lifecycle. Our framework incorporates an ontology that represents the alert management strategy and an alert management engine that executes this strategy. Our alert management framework offers the following features: (1) Adaptability based on users' feedback; (2) Personalization and aggregation of messages; and (3) Connection to Electronic Medical Records by implementing a HL7 Clinical Document Architecture parser.

  19. Technologic Distractions (Part 1): Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics.

    PubMed

    Kane-Gill, Sandra L; O'Connor, Michael F; Rothschild, Jeffrey M; Selby, Nicholas M; McLean, Barbara; Bonafide, Christopher P; Cvach, Maria M; Hu, Xiao; Konkani, Avinash; Pelter, Michele M; Winters, Bradford D

    2017-09-01

    To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. Focus on critically ill patients and included evaluations in other patient care settings, as well. Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems. Study selection was based on one primary key question to identify effective interventions that attempted to reduce alert fatigue and three secondary key questions that covered the negative effects of alert fatigue, potential unintended consequences of efforts to reduce alert fatigue, and ideal alert quantity. Data were abstracted by two reviewers independently using a standardized abstraction tool. Surveys, meeting abstracts, "gray" literature, studies not available in English, and studies with non-original data were excluded. For the primary key question, articles were excluded if they did not provide a comparator as key question 1 was designed as a problem, intervention, comparison, and outcome question. We anticipated that reduction in alert fatigue, including the concept of desensitization may not be directly measured and thus considered interventions that reduced alert quantity as a surrogate marker for alert fatigue. Twenty-six articles met the inclusion criteria. Approaches for managing alert fatigue in the ICU are provided as a result of reviewing tested interventions that reduced alert quantity with the anticipated effect of reducing fatigue. Suggested alert management strategies include prioritizing alerts, developing sophisticated alerts, customizing commercially available alerts, and including end user opinion in alert selection. Alert fatigue itself is studied less frequently, as an outcome, and there is a need for more precise evaluation. Standardized metrics for alert fatigue is

  20. Evaluation of Antimicrobial Stewardship-Related Alerts Using a Clinical Decision Support System.

    PubMed

    Ghamrawi, Riane J; Kantorovich, Alexander; Bauer, Seth R; Pallotta, Andrea M; Sekeres, Jennifer K; Gordon, Steven M; Neuner, Elizabeth A

    2017-11-01

    Background: Information technology, including clinical decision support systems (CDSS), have an increasingly important and growing role in identifying opportunities for antimicrobial stewardship-related interventions. Objective: The aim of this study was to describe and compare types and outcomes of CDSS-built antimicrobial stewardship alerts. Methods: Fifteen alerts were evaluated in the initial antimicrobial stewardship program (ASP) review. Preimplementation, alerts were reviewed retrospectively. Postimplementation, alerts were reviewed in real-time. Data collection included total number of actionable alerts, recommendation acceptance rates, and time spent on each alert. Time to de-escalation to narrower spectrum agents was collected. Results: In total, 749 alerts were evaluated. Overall, 306 (41%) alerts were actionable (173 preimplementation, 133 postimplementation). Rates of actionable alerts were similar for custom-built and prebuilt alert types (39% [53 of 135] vs 41% [253 of 614], P = .68]. In the postimplementation group, an intervention was attempted in 97% of actionable alerts and 70% of interventions were accepted. The median time spent per alert was 7 minutes (interquartile range [IQR], 5-13 minutes; 15 [12-17] minutes for actionable alerts vs 6 [5-7] minutes for nonactionable alerts, P < .001). In cases where the antimicrobial was eventually de-escalated, the median time to de-escalation was 28.8 hours (95% confidence interval [CI], 10.0-69.1 hours) preimplementation vs 4.7 hours (95% CI, 2.4-22.1 hours) postimplementation, P < .001. Conclusions: CDSS have played an important role in ASPs to help identify opportunities to optimize antimicrobial use through prebuilt and custom-built alerts. As ASP roles continue to expand, focusing time on customizing institution specific alerts will be of vital importance to help redistribute time needed to manage other ASP tasks and opportunities.

  1. Reduction in alert fatigue in an assisted electronic prescribing system, through the Lean Six Sigma methodology.

    PubMed

    Cuéllar Monreal, Mª Jesús; Reig Aguado, Jorge; Font Noguera, Isabel; Poveda Andrés, José Luis

    2017-01-01

    To reduce the alert fatigue in our Assisted Electronic Prescribing System (AEPS), through the Lean Six Sigma (LSS) methodology. An observational (transversal) and retrospective study, in a general hospital with 850 beds and AEPS. The LSS methodology was followed in order to evaluate the alert fatigue situation in the AEPS system, to implement improvements, and to assess outcomes. The alerts generated during two trimesters studied (before and after the intervention) were analyzed. In order to measure the qualitative indicators, the most frequent alert types were analyzed, as well as the molecules responsible for over 50% of each type of alert. The action by the prescriber was analyzed in a sample of 496 prescriptions that generated such alerts. For each type of alert and molecule, there was a prioritization of the improvements to be implemented according to the alert generated and its quality. A second survey evaluated the pharmacist action for the alerts most highly valued by physicians. The problem, the objective, the work team and the project schedule were defined. A survey was designed in order to understand the opinion of the client about the alert system in the program. Based on the surveys collected (n = 136), the critical characteristics and the quanti/qualitative indicators were defined. Sixty (60) fields in the alert system were modified, corresponding to 32 molecules, and this led to a 28% reduction in the total number of alerts. Regarding quality indicators, false po sitive results were reduced by 25% (p < 0.05), 100% of those alerts ignored with justification were sustained, and there were no significant differences in user adherence to the system. The project improvements and outcomes were reviewed by the work team. LSS methodology has demonstrated being a valid tool for the quantitative and qualitative improvement of the alert system in an Assisted Electronic Prescription Program, thus reducing alert fatigue. Copyright AULA MEDICA EDICIONES 2014

  2. Assessing contextual factors that influence acceptance of pedestrian alerts by a night vision system.

    PubMed

    Källhammer, Jan-Erik; Smith, Kip

    2012-08-01

    We investigated five contextual variables that we hypothesized would influence driver acceptance of alerts to pedestrians issued by a night vision active safety system to inform the specification of the system's alerting strategies. Driver acceptance of automotive active safety systems is a key factor to promote their use and implies a need to assess factors influencing driver acceptance. In a field operational test, 10 drivers drove instrumented vehicles equipped with a preproduction night vision system with pedestrian detection software. In a follow-up experiment, the 10 drivers and 25 additional volunteers without experience with the system watched 57 clips with pedestrian encounters gathered during the field operational test. They rated the acceptance of an alert to each pedestrian encounter. Levels of rating concordance were significant between drivers who experienced the encounters and participants who did not. Two contextual variables, pedestrian location and motion, were found to influence ratings. Alerts were more accepted when pedestrians were close to or moving toward the vehicle's path. The study demonstrates the utility of using subjective driver acceptance ratings to inform the design of active safety systems and to leverage expensive field operational test data within the confines of the laboratory. The design of alerting strategies for active safety systems needs to heed the driver's contextual sensitivity to issued alerts.

  3. Developing, Implementing, and Assessing an Early Alert System

    ERIC Educational Resources Information Center

    Tampke, Dale R.

    2013-01-01

    Early alert systems offer institutions systematic approaches to identifying and intervening with students exhibiting at-risk behaviors. Many of these systems rely on a common format for student referral to central receiving point. Systems at larger institutions often use web-based technology to allow for a scalable (available campus wide) approach…

  4. Earthquake early Warning ShakeAlert system: West coast wide production prototype

    USGS Publications Warehouse

    Kohler, Monica D.; Cochran, Elizabeth S.; Given, Douglas; Guiwits, Stephen; Neuhauser, Doug; Hensen, Ivan; Hartog, Renate; Bodin, Paul; Kress, Victor; Thompson, Stephen; Felizardo, Claude; Brody, Jeff; Bhadha, Rayo; Schwarz, Stan

    2017-01-01

    Earthquake early warning (EEW) is an application of seismological science that can give people, as well as mechanical and electrical systems, up to tens of seconds to take protective actions before peak earthquake shaking arrives at a location. Since 2006, the U.S. Geological Survey has been working in collaboration with several partners to develop EEW for the United States. The goal is to create and operate an EEW system, called ShakeAlert, for the highest risk areas of the United States, starting with the West Coast states of California, Oregon, and Washington. In early 2016, the Production Prototype v.1.0 was established for California; then, in early 2017, v.1.2 was established for the West Coast, with earthquake notifications being distributed to a group of beta users in California, Oregon, and Washington. The new ShakeAlert Production Prototype was an outgrowth from an earlier demonstration EEW system that began sending test notifications to selected users in California in January 2012. ShakeAlert leverages the considerable physical, technical, and organizational earthquake monitoring infrastructure of the Advanced National Seismic System, a nationwide federation of cooperating seismic networks. When fully implemented, the ShakeAlert system may reduce damage and injury caused by large earthquakes, improve the nation’s resilience, and speed recovery.

  5. Notification of real-time clinical alerts generated by pharmacy expert systems.

    PubMed Central

    Miller, J. E.; Reichley, R. M.; McNamee, L. A.; Steib, S. A.; Bailey, T. C.

    1999-01-01

    We developed and implemented a strategy for notifying clinical pharmacists of alerts generated in real-time by two pharmacy expert systems: one for drug dosing and the other for adverse drug event prevention. Display pagers were selected as the preferred notification method and a concise, yet readable, format for displaying alert data was developed. This combination of real-time alert generation and notification via display pagers was shown to be efficient and effective in a 30-day trial. PMID:10566374

  6. Some human factors issues in the development and evaluation of cockpit alerting and warning systems

    NASA Technical Reports Server (NTRS)

    Randle, R. J., Jr.; Larsen, W. E.; Williams, D. H.

    1980-01-01

    A set of general guidelines for evaluating a newly developed cockpit alerting and warning system in terms of human factors issues are provided. Although the discussion centers around a general methodology, it is made specifically to the issues involved in alerting systems. An overall statement of the current operational problem is presented. Human factors problems with reference to existing alerting and warning systems are described. The methodology for proceeding through system development to system test is discussed. The differences between traditional human factors laboratory evaluations and those required for evaluation of complex man-machine systems under development are emphasized. Performance evaluation in the alerting and warning subsystem using a hypothetical sample system is explained.

  7. 21 CFR 26.50 - Alert system and exchange of postmarket vigilance reports.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Alert system and exchange of postmarket vigilance reports. 26.50 Section 26.50 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... postmarket vigilance reports. (a) An alert system will be set up during the transition period and maintained...

  8. Novel online monitoring and alert system for anaerobic digestion reactors.

    PubMed

    Dong, Fang; Zhao, Quan-Bao; Li, Wen-Wei; Sheng, Guo-Ping; Zhao, Jin-Bao; Tang, Yong; Yu, Han-Qing; Kubota, Kengo; Li, Yu-You; Harada, Hideki

    2011-10-15

    Effective monitoring and diagnosis of anaerobic digestion processes is a great challenge for anaerobic digestion reactors, which limits their stable operation. In this work, an online monitoring and alert system for upflow anaerobic sludge blanket (UASB) reactors is developed on the basis of a set of novel evaluating indexes. The two indexes, i.e., stability index S and auxiliary index a, which incorporate both gas- and liquid-phase parameters for UASB, enable a quantitative and comprehensive evaluation of reactor status. A series of shock tests is conducted to evaluate the response of the monitoring and alert system to organic overloading, hydraulic, temperature, and toxicant shocks. The results show that this system enables an accurate and rapid monitoring and diagnosis of the reactor status, and offers reliable early warnings on the potential risks. As the core of this system, the evaluating indexes are demonstrated to be of high accuracy and sensitivity in process evaluation and good adaptability to the artificial intelligence and automated control apparatus. This online monitoring and alert system presents a valuable effort to promote the automated monitoring and control of anaerobic digestion process, and holds a high promise for application.

  9. A CCTV system with SMS alert (CMDSA): An implementation of pixel processing algorithm for motion detection

    NASA Astrophysics Data System (ADS)

    Rahman, Nurul Hidayah Ab; Abdullah, Nurul Azma; Hamid, Isredza Rahmi A.; Wen, Chuah Chai; Jelani, Mohamad Shafiqur Rahman Mohd

    2017-10-01

    Closed-Circuit TV (CCTV) system is one of the technologies in surveillance field to solve the problem of detection and monitoring by providing extra features such as email alert or motion detection. However, detecting and alerting the admin on CCTV system may complicate due to the complexity to integrate the main program with an external Application Programming Interface (API). In this study, pixel processing algorithm is applied due to its efficiency and SMS alert is added as an alternative solution for users who opted out email alert system or have no Internet connection. A CCTV system with SMS alert (CMDSA) was developed using evolutionary prototyping methodology. The system interface was implemented using Microsoft Visual Studio while the backend components, which are database and coding, were implemented on SQLite database and C# programming language, respectively. The main modules of CMDSA are motion detection, capturing and saving video, image processing and Short Message Service (SMS) alert functions. Subsequently, the system is able to reduce the processing time making the detection process become faster, reduce the space and memory used to run the program and alerting the system admin instantly.

  10. Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.

    PubMed

    McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras; Hoffman, James M

    2016-04-01

    Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time-the time elapsed from when an interruptive alert is generated to when it is dismissed-could be calculated by using historical alert data from log files. Drug-drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1-4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < 001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < 001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Implementation and evaluation of the Sacramento Regional Transportation Management Center Weather Alert Notification System.

    DOT National Transportation Integrated Search

    2010-08-01

    This report presents the results of an evaluation of Caltrans District 3 Regional Transportation Management Centers (RTMC) implementation of a weather alert notification system. This alert system was selected for implementation from among several ...

  12. DAIDALUS: Detect and Avoid Alerting Logic for Unmanned Systems

    NASA Technical Reports Server (NTRS)

    Munoz, Cesar; Narkawicz, Anthony; Hagen, George; Upchurch, Jason; Dutle, Aaron; Consiglio, Maria; Chamberlain, James

    2015-01-01

    This paper presents DAIDALUS (Detect and Avoid Alerting Logic for Unmanned Systems), a reference implementation of a detect and avoid concept intended to support the integration of Unmanned Aircraft Systems into civil airspace. DAIDALUS consists of self-separation and alerting algorithms that provide situational awareness to UAS remote pilots. These algorithms have been formally specified in a mathematical notation and verified for correctness in an interactive theorem prover. The software implementation has been verified against the formal models and validated against multiple stressing cases jointly developed by the US Air Force Research Laboratory, MIT Lincoln Laboratory, and NASA. The DAIDALUS reference implementation is currently under consideration for inclusion in the appendices to the Minimum Operational Performance Standards for Unmanned Aircraft Systems presently being developed by RTCA Special Committee 228.

  13. Feature-based alert correlation in security systems using self organizing maps

    NASA Astrophysics Data System (ADS)

    Kumar, Munesh; Siddique, Shoaib; Noor, Humera

    2009-04-01

    The security of the networks has been an important concern for any organization. This is especially important for the defense sector as to get unauthorized access to the sensitive information of an organization has been the prime desire for cyber criminals. Many network security techniques like Firewall, VPN Concentrator etc. are deployed at the perimeter of network to deal with attack(s) that occur(s) from exterior of network. But any vulnerability that causes to penetrate the network's perimeter of defense, can exploit the entire network. To deal with such vulnerabilities a system has been evolved with the purpose of generating an alert for any malicious activity triggered against the network and its resources, termed as Intrusion Detection System (IDS). The traditional IDS have still some deficiencies like generating large number of alerts, containing both true and false one etc. By automatically classifying (correlating) various alerts, the high-level analysis of the security status of network can be identified and the job of network security administrator becomes much easier. In this paper we propose to utilize Self Organizing Maps (SOM); an Artificial Neural Network for correlating large amount of logged intrusion alerts based on generic features such as Source/Destination IP Addresses, Port No, Signature ID etc. The different ways in which alerts can be correlated by Artificial Intelligence techniques are also discussed. . We've shown that the strategy described in the paper improves the efficiency of IDS by better correlating the alerts, leading to reduced false positives and increased competence of network administrator.

  14. Increased appropriateness of customized alert acknowledgement reasons for overridden medication alerts in a computerized provider order entry system.

    PubMed

    Dekarske, Brian M; Zimmerman, Christopher R; Chang, Robert; Grant, Paul J; Chaffee, Bruce W

    2015-12-01

    Computerized provider order entry systems commonly contain alerting mechanisms for patient allergies, incorrect doses, or drug-drug interactions when ordering medications. Providers have the option to override (bypass) these alerts and continue with the order unchanged. This study examines the effect of customizing medication alert override options on the appropriateness of override selection related to patient allergies, drug dosing, and drug-drug interactions when ordering medications in an electronic medical record. In this prospective, randomized crossover study, providers were randomized into cohorts that required a reason for overriding a medication alert from a customized or non-customized list of override reasons and/or by free-text entry. The primary outcome was to compare override responses that appropriately correlate with the alert type between the customized and non-customized configurations. The appropriateness of a subset of free-text responses that represented an affirmative and active acknowledgement of the alert without further explanation was classified as "indeterminate." Results were analyzed in three different ways by classifying indeterminate answers as either appropriate, inappropriate, or excluded entirely. Secondary outcomes included the appropriateness of override reasons when comparing cohorts and individual providers, reason selection based on order within the override list, and the determination of the frequency of free-text use, nonsensical responses, and multiple selection responses. Twenty-two clinicians were randomized into 2 cohorts and a total of 1829 alerts with a required response were generated during the study period. The customized configuration had a higher rate of appropriateness when compared to the non-customized configuration regardless of how indeterminate responses were classified (p<0.001). When comparing cohorts, appropriateness was significantly higher in the customized configuration regardless of the

  15. Impact of e-alert systems on the care of patients with acute kidney injury.

    PubMed

    Breighner, Crystal M; Kashani, Kianoush B

    2017-09-01

    With the recent advancement in electronic health record systems and meaningful use of information technology incentive programs (i.e., the American Recovery and Reinvestment Act, the Health Information Technology for Economic and Clinical Health Act, and the Centers for Medicare & Medicaid Services), interest in clinical decision support systems has risen. These systems have been used to examine a variety of different syndromes with variable reported effects. In recent years, electronic alerts (e-alerts) have been implemented at various institutions to decrease the morbidity associated with acute kidney injury (AKI). AKI is common, accounting for 1 in 7 hospital admissions, and is associated with increased length of hospital stay and mortality. AKI is often underrecognized, causing delayed intervention. The use of e-alerts may result in earlier recognition and intervention, as well as decreased morbidity and mortality. This must be balanced with the possibility of increased resource utilization that e-alerts may cause. Before widespread implementation, the ethical and legal consequences of not following e-alert recommendations must be established, and the optimal algorithm for AKI e-alert detection must be determined. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Alert Triage v 0.1 beta

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Doak, Justin E.; Ingram, Joe; Johnson, Josh

    2016-01-06

    In the cyber security operations of a typical organization, data from multiple sources are monitored, and when certain conditions in the data are met, an alert is generated in an alert management system. Analysts inspect these alerts to decide if any deserve promotion to an event requiring further scrutiny. This triage process is manual, time-consuming, and detracts from the in-depth investigation of events. We have created a software system that uses supervised machine learning to automatically prioritize these alerts. In particular we utilize active learning to make efficient use of the pool of unlabeled alerts, thereby improving the performance ofmore » our ranking models over passive learning. We have demonstrated the effectiveness of our system on a large, real-world dataset of cyber security alerts.« less

  17. Microcontroller based driver alertness detection systems to detect drowsiness

    NASA Astrophysics Data System (ADS)

    Adenin, Hasibah; Zahari, Rahimi; Lim, Tiong Hoo

    2018-04-01

    The advancement of embedded system for detecting and preventing drowsiness in a vehicle is a major challenge for road traffic accident systems. To prevent drowsiness while driving, it is necessary to have an alert system that can detect a decline in driver concentration and send a signal to the driver. Studies have shown that traffc accidents usually occur when the driver is distracted while driving. In this paper, we have reviewed a number of detection systems to monitor the concentration of a car driver and propose a portable Driver Alertness Detection System (DADS) to determine the level of concentration of the driver based on pixelated coloration detection technique using facial recognition. A portable camera will be placed at the front visor to capture facial expression and the eye activities. We evaluate DADS using 26 participants and have achieved 100% detection rate with good lighting condition and a low detection rate at night.

  18. Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users.

    PubMed

    Campmans, Zizi; van Rhijn, Arianne; Dull, René M; Santen-Reestman, Jacqueline; Taxis, Katja; Borgsteede, Sander D

    2018-01-01

    Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. 'Alert fatigue' was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.

  19. Alert Exchange Process Protocol

    NASA Technical Reports Server (NTRS)

    Groen, Frank

    2015-01-01

    The National Aeronautics and Space Administration of the United States of America (NASA), and the European Space Agency (ESA), and the Japanese Aerospace Exploration Agency (JAXA), acknowledging that NASA, ESA and JAXA have a mutual interest in exchanging Alerts and Alert Status Lists to enhance the information base for each system participant while fortifying the general level of cooperation between the policy agreement subscribers, and each Party will exchange Alert listings on regular basis and detailed Alert information on a need to know basis to the extent permitted by law.

  20. Real-Time Mapping alert system; characteristics and capabilities

    USGS Publications Warehouse

    Torres, L.A.; Lambert, S.C.; Liebermann, T.D.

    1995-01-01

    The U.S. Geological Survey has an extensive hydrologic network that records and transmits precipitation, stage, discharge, and other water-related data on a real-time basis to an automated data processing system. Data values are recorded on electronic data collection platforms at field sampling sites. These values are transmitted by means of orbiting satellites to receiving ground stations, and by way of telecommunication lines to a U.S. Geological Survey office where they are processed on a computer system. Data that exceed predefined thresholds are identified as alert values. The current alert status at monitoring sites within a state or region is of critical importance during floods, hurricanes, and other extreme hydrologic events. This report describes the characteristics and capabilities of a series of computer programs for real-time mapping of hydrologic data. The software provides interactive graphics display and query of hydrologic information from the network in a real-time, map-based, menu-driven environment.

  1. 47 CFR 10.300 - Alert aggregator. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Alert aggregator. [Reserved] 10.300 Section 10.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.300 Alert aggregator. [Reserved] ...

  2. 47 CFR 10.300 - Alert aggregator. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Alert aggregator. [Reserved] 10.300 Section 10.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.300 Alert aggregator. [Reserved] ...

  3. 47 CFR 10.300 - Alert aggregator. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Alert aggregator. [Reserved] 10.300 Section 10.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.300 Alert aggregator. [Reserved] ...

  4. ToxAlerts: a Web server of structural alerts for toxic chemicals and compounds with potential adverse reactions.

    PubMed

    Sushko, Iurii; Salmina, Elena; Potemkin, Vladimir A; Poda, Gennadiy; Tetko, Igor V

    2012-08-27

    The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly

  5. ToxAlerts: A Web Server of Structural Alerts for Toxic Chemicals and Compounds with Potential Adverse Reactions

    PubMed Central

    2012-01-01

    The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly

  6. AMON: a wearable multiparameter medical monitoring and alert system.

    PubMed

    Anliker, Urs; Ward, Jamie A; Lukowicz, Paul; Tröster, Gerhard; Dolveck, François; Baer, Michel; Keita, Fatou; Schenker, Eran B; Catarsi, Fabrizio; Coluccini, Luca; Belardinelli, Andrea; Shklarski, Dror; Alon, Menachem; Hirt, Etienne; Schmid, Rolf; Vuskovic, Milica

    2004-12-01

    This paper describes an advanced care and alert portable telemedical monitor (AMON), a wearable medical monitoring and alert system targeting high-risk cardiac/respiratory patients. The system includes continuous collection and evaluation of multiple vital signs, intelligent multiparameter medical emergency detection, and a cellular connection to a medical center. By integrating the whole system in an unobtrusive, wrist-worn enclosure and applying aggressive low-power design techniques, continuous long-term monitoring can be performed without interfering with the patients' everyday activities and without restricting their mobility. In the first two and a half years of this EU IST sponsored project, the AMON consortium has designed, implemented, and tested the described wrist-worn device, a communication link, and a comprehensive medical center software package. The performance of the system has been validated by a medical study with a set of 33 subjects. The paper describes the main concepts behind the AMON system and presents details of the individual subsystems and solutions as well as the results of the medical validation.

  7. Physician response to a medication alert system in inpatients with levodopa-treated diseases

    PubMed Central

    Morris, Marie; Willis, Allison W.; Searles Nielsen, Susan; McCann, Franklin; Birke, Angela

    2015-01-01

    Objective: To evaluate the appropriateness of dopamine receptor antagonist prescriptions in hospitalized patients with dopamine-requiring diseases after implementation of an automated prescription alert system. Methods: We examined dopamine receptor antagonist prescriptions in hospitalized patients with dopamine-requiring diseases and physician response to an automated drug contraindication alert system at Barnes-Jewish Hospital from 2009 to 2013. A detailed review of patient medical records was performed for all alert events generated when a physician prescribed a dopamine receptor antagonist concurrently with a dopamine receptor agonist in hospitalized patients. Two movement disorders neurologists determined the appropriateness of each prescription, based on patient medical history, through consensus. Physician response to alert was compared by indication for the prescription and physician specialty. Results: Of 237 orders, 197 (83.1%) prescriptions for dopamine receptor antagonists were considered inappropriate. The prevalence of inappropriate dopamine receptor antagonist prescriptions per levodopa prescriptions was 16.10% (95% confidence interval 9.47, 22.73) in psychiatry, 7.51% (6.16, 8.86) in general medicine, 6.14% (4.49, 7.79) in the surgical specialties, and 0.85% (0.46, 1.25) in the neurologic/neurosurgical specialties. Of the inappropriate prescriptions, 146 (74.1%) were continued despite the alert. The strongest predictor of discontinuation of dopamine receptor antagonist medications was use of the medication to treat nausea or emesis (p < 0.001). Conclusions: Despite successfully identifying instances when dopamine antagonists were prescribed to patients with dopamine-requiring diseases, the alert system modestly affected physician prescribing behavior, highlighting the need for improved education of health care providers. PMID:26092916

  8. A low-cost wireless system for autonomous generation of road safety alerts

    NASA Astrophysics Data System (ADS)

    Banks, B.; Harms, T.; Sedigh Sarvestani, S.; Bastianini, F.

    2009-03-01

    This paper describes an autonomous wireless system that generates road safety alerts, in the form of SMS and email messages, and sends them to motorists subscribed to the service. Drivers who regularly traverse a particular route are the main beneficiaries of the proposed system, which is intended for sparsely populated rural areas, where information available to drivers about road safety, especially bridge conditions, is very limited. At the heart of this system is the SmartBrick, a wireless system for remote structural health monitoring that has been presented in our previous work. Sensors on the SmartBrick network regularly collect data on water level, temperature, strain, and other parameters important to safety of a bridge. This information is stored on the device, and reported to a remote server over the GSM cellular infrastructure. The system generates alerts indicating hazardous road conditions when the data exceeds thresholds that can be remotely changed. The remote server and any number of designated authorities can be notified by email, FTP, and SMS. Drivers can view road conditions and subscribe to SMS and/or email alerts through a web page. The subscription-only form of alert generation has been deliberately selected to mitigate privacy concerns. The proposed system can significantly increase the safety of travel through rural areas. Real-time availability of information to transportation authorities and law enforcement officials facilitates early or proactive reaction to road hazards. Direct notification of drivers further increases the utility of the system in increasing the safety of the traveling public.

  9. IP telephony based danger alert communication system and its implementation

    NASA Astrophysics Data System (ADS)

    Rezac, Filip; Safarik, Jakub; Voznak, Miroslav; Tomala, Karel; Partila, Pavol

    2013-05-01

    This article discusses a danger alert system created as a part of the research project at Department of Telecommunications of Technical University of Ostrava. The aim of the system is to distribute pre-recorded voice messages in order to alert the called party in danger. This article describes individual technologies, which the application uses for its operation as well as issues relating to hardware requirements and transfer line bandwidth load. The article also describes new algorithms, which had to be developed in order to ensure the reliability of the system. Our intent is focused on disaster management, the message, which should be delivered within specified time span, is typed in the application and text-to-speech module ensures its transformation to a speech format, after that a particular scenario or warned area is selected and a target group is automatically unloaded. For this purpose, we have defined XML format for delivery of phone numbers which are located in the target area and these numbers are obtained from mobile BTS's (Base transmission stations). The benefit of such communication compared to others, is the fact, that it uses a phone call and, therefore, it is possible to get feedback who accepted the message and to improve efficiency of alert system. Finally, the list of unanswered calls is exported and these users can be informed via SMS.

  10. Motivational Correlates of Academic Success in an Educational Psychology Course

    ERIC Educational Resources Information Center

    Herman, William E.

    2011-01-01

    The variables of class attendance and the institution-wide Early Alert Grading System were employed to predict academic success at the end of the semester. Classroom attendance was found to be statistically and significantly related to final average and accounted for 14-16% of the variance in academic performance. Class attendance was found to…

  11. A business rules design framework for a pharmaceutical validation and alert system.

    PubMed

    Boussadi, A; Bousquet, C; Sabatier, B; Caruba, T; Durieux, P; Degoulet, P

    2011-01-01

    Several alert systems have been developed to improve the patient safety aspects of clinical information systems (CIS). Most studies have focused on the evaluation of these systems, with little information provided about the methodology leading to system implementation. We propose here an 'agile' business rule design framework (BRDF) supporting both the design of alerts for the validation of drug prescriptions and the incorporation of the end user into the design process. We analyzed the unified process (UP) design life cycle and defined the activities, subactivities, actors and UML artifacts that could be used to enhance the agility of the proposed framework. We then applied the proposed framework to two different sets of data in the context of the Georges Pompidou University Hospital (HEGP) CIS. We introduced two new subactivities into UP: business rule specification and business rule instantiation activity. The pharmacist made an effective contribution to five of the eight BRDF design activities. Validation of the two new subactivities was effected in the context of drug dosage adaption to the patients' clinical and biological contexts. Pilot experiment shows that business rules modeled with BRDF and implemented as an alert system triggered an alert for 5824 of the 71,413 prescriptions considered (8.16%). A business rule design framework approach meets one of the strategic objectives for decision support design by taking into account three important criteria posing a particular challenge to system designers: 1) business processes, 2) knowledge modeling of the context of application, and 3) the agility of the various design steps.

  12. Warning Alert HITL Experiment Results

    NASA Technical Reports Server (NTRS)

    Monk, Kevin J.; Ferm, Lisa; Roberts, Zach

    2018-01-01

    Minimum Operational Performance Standards (MOPS) are being developed to support the integration of Unmanned Aircraft Systems (UAS) in the National Airspace (NAS). Input from subject matter experts and multiple research studies have informed display requirements for Detect-and-Avoid (DAA) systems aimed at supporting timely and appropriate pilot responses to collision hazards. Phase 1 DAA MOPS alerting is designed to inform pilots if an avoidance maneuver is necessary; the two highest alert levels - caution and warning - indicate how soon pilot action is required and whether there is adequate time to coordinate with the air traffic controller (ATC). Additional empirical support is needed to clarify the extent to which warning-level alerting impacts DAA task performance. The present study explores the differential effects of the auditory and visual cues provided by the DAA Warning alert, and performance implications compared to caution-only alerting are discussed.

  13. A review of human factors principles for the design and implementation of medication safety alerts in clinical information systems.

    PubMed

    Phansalkar, Shobha; Edworthy, Judy; Hellier, Elizabeth; Seger, Diane L; Schedlbauer, Angela; Avery, Anthony J; Bates, David W

    2010-01-01

    The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide examples of the implementation of human factors principles in current clinical information systems using alerts to provide medication decision support. Last, we suggest actionable recommendations for delivering effective clinical decision support using alerts. A review of studies from the medical informatics literature suggests that many basic human factors principles are not followed, possibly contributing to the lack of acceptance of alerts in clinical information systems. We evaluate the limitations of current alerting philosophies and provide recommendations for improving acceptance of alerts by incorporating human factors principles in their design.

  14. Alert Notification System Router

    NASA Technical Reports Server (NTRS)

    Gurganus, Joseph; Carey, Everett; Antonucci, Robert; Hitchener, Peter

    2009-01-01

    The Alert Notification System Router (ANSR) software provides satellite operators with notifications of key events through pagers, cell phones, and e-mail. Written in Java, this application is specifically designed to meet the mission-critical standards for mission operations while operating on a variety of hardware environments. ANSR is a software component that runs inside the Mission Operations Center (MOC). It connects to the mission's message bus using the GMSEC [Goddard Space Flight Center (GSFC) Mission Services Evolution Center (GMSEC)] standard. Other components, such as automation and monitoring components, can use ANSR to send directives to notify users or groups. The ANSR system, in addition to notifying users, can check for message acknowledgements from a user and escalate the notification to another user if there is no acknowledgement. When a firewall prevents ANSR from accessing the Internet directly, proxies can be run on the other side of the wall. These proxies can be configured to access the Internet, notify users, and poll for their responses. Multiple ANSRs can be run in parallel, providing a seamless failover capability in the event that one ANSR system becomes incapacitated.

  15. Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System

    PubMed Central

    Beccaro, M. A. Del; Villanueva, R.; Knudson, K. M.; Harvey, E. M.; Langle, J. M.; Paul, W.

    2010-01-01

    Objective We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system. Measurement/Results Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors. Conclusion We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors PMID:23616845

  16. Effect of an obesity best practice alert on physician documentation and referral practices.

    PubMed

    Fitzpatrick, Stephanie L; Dickins, Kirsten; Avery, Elizabeth; Ventrelle, Jennifer; Shultz, Aaron; Kishen, Ekta; Rothschild, Steven

    2017-12-01

    The Centers for Medicare & Medicaid Services Electronic Health Record Meaningful Use Incentive Program requires physicians to document body mass index (BMI) and a follow-up treatment plan for adult patients with BMI ≥ 25. To examine the effect of a best practice alert on physician documentation of obesity-related care and referrals to weight management treatment, in a cluster-randomized design, 14 primary care clinics at an academic medical center were randomized to best practice alert intervention (n = 7) or comparator (n = 7). The alert was triggered when both height and weight were entered and BMI was ≥30. Both intervention and comparator clinics could document meaningful use by selecting a nutrition education handout within the alert. Intervention clinics could also select a referral option from the list of clinic and community-based weight management programs embedded in the alert. Main outcomes were proportion of eligible patients with (1) obesity-related documentation and (2) referral. There were 26,471 total primary care encounters with 12,981 unique adult patients with BMI ≥ 30 during the 6-month study period. Documentation doubled (17 to 33%) with implementation of the alert. However, intervention clinics were not significantly more likely to refer patients to weight management than comparator clinics (2.8 vs. 1.3%, p = 0.07). Although the alert was associated with increased physician meaningful use compliance, it was not an effective strategy for improving patient access to weight management services. Further research is needed to understand system-level characteristics that influence obesity management in primary care.

  17. JPL's GNSS Real-Time Earthquake and Tsunami (GREAT) Alert System

    NASA Astrophysics Data System (ADS)

    Bar-Sever, Yoaz; Miller, Mark; Vallisneri, Michele; Khachikyan, Robert; Meyer, Robert

    2017-04-01

    We describe recent developments to the GREAT Alert natural hazard monitoring service from JPL's Global Differential GPS (GDGPS) System. GREAT Alert provides real-time, 1 Hz positioning solutions for hundreds of GNSS tracking sites, from both global and regional networks, aiming to monitor ground motion in the immediate aftermath of earthquakes. We take advantage of the centralized data processing, which is collocated with the GNSS orbit determination operations of the GDGPS System, to combine orbit determination with large-scale point-positioning in a grand estimation scheme, and as a result realize significant improvement to the positioning accuracy compared to conventional stand-alone point positioning techniques. For example, the measured median site (over all sites) real-time horizontal positioning accuracy is 2 cm 1DRMS, and the median real-time vertical accuracy is 4 cm RMS. The GREAT Alert positioning service is integrated with automated global earthquake notices from the United States Geodetic Survey (USGS) to support near-real-time calculations of co-seismic displacements with attendant formal errors based both short-term and long-term error analysis for each individual site. We will show the millimeter-level resolution of co-seismic displacement can be achieved by this system. The co-seismic displacements, in turn, are fed into a JPL geodynamics and ocean models, that estimate the Earthquake magnitude and predict the potential tsunami scale.

  18. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Federal alert gateway. [Reserved] 10.310 Section 10.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.310 Federal alert gateway. [Reserved] ...

  19. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Federal alert gateway. [Reserved] 10.310 Section 10.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.310 Federal alert gateway. [Reserved] ...

  20. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Federal alert gateway. [Reserved] 10.310 Section 10.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.310 Federal alert gateway. [Reserved] ...

  1. Technical implementation plan for the ShakeAlert production system: an Earthquake Early Warning system for the West Coast of the United States

    USGS Publications Warehouse

    Given, Douglas D.; Cochran, Elizabeth S.; Heaton, Thomas; Hauksson, Egill; Allen, Richard; Hellweg, Peggy; Vidale, John; Bodin, Paul

    2014-01-01

    Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing such an EEW system, called ShakeAlert, for the West Coast of the United States. This document describes the technical implementation of that system, which leverages existing stations and infrastructure of the Advanced National Seismic System (ANSS) regional networks to achieve this new capability. While significant progress has been made in developing the ShakeAlert early warning system, improved robustness of each component of the system and additional testing and certification are needed for the system to be reliable enough to issue public alerts. Major components of the system include dense networks of ground motion sensors, telecommunications from those sensors to central processing systems, algorithms for event detection and alert creation, and distribution systems to alert users. Capital investment costs for a West Coast EEW system are projected to be $38.3M, with additional annual maintenance and operations totaling $16.1M—in addition to current ANSS expenditures for earthquake monitoring. An EEW system is complementary to, but does not replace, other strategies to mitigate earthquake losses. The system has limitations: false and missed alerts are possible, and the area very near to an earthquake epicenter may receive little or no warning. However, such an EEW system would save lives, reduce injuries and damage, and improve community resilience by reducing longer-term economic losses for both public and private entities.

  2. Radar-based alert system to operate a sewerage network: relevance and operational effectiveness after several years of use.

    PubMed

    Faure, D; Payrastre, O; Auchet, P

    2005-01-01

    Since January 2000, the sewerage network of a very urbanised catchment area in the Greater Nancy Urban Community has been operated according to the alarms generated in real time by a storm alert system using weather radar data. This alert system is based on an automatic identification of intense rain cells in the radar images. This paper presents the characteristics of this alert system and synthesises the main results of two complementary studies realised in 2002 in order to estimate the relevance and the operational effectiveness of the alert system. The first study consisted in an off-line analysis of almost 50,000 intense rain cells detected in four years of historical radar data. The second study was an analysis of the experience feedback after two years of operational use of this alert system. The results of these studies are discussed in function of the initial operational objectives.

  3. 47 CFR 10.300 - Alert aggregator. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Alert aggregator. [Reserved] 10.300 Section 10.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.300 Alert aggregator. [Reserved] ...

  4. 47 CFR 10.300 - Alert aggregator. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Alert aggregator. [Reserved] 10.300 Section 10.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.300 Alert aggregator. [Reserved] ...

  5. Wireless clinical alerts for physiologic, laboratory and medication data.

    PubMed Central

    Shabot, M. M.; LoBue, M.; Chen, J.

    2000-01-01

    A fully interfaced clinical information system (CIS) contains physiologic, laboratory, blood gas, medication and other data that can be used as the information base for a comprehensive alerting system. Coupled with an event driven rules engine, a CIS can generate clinical alerts which may both prevent medical errors and assist caregivers in responding to critical events in a timely way. The authors have developed a clinical alerting system which delivers alerts and reminders to clinicians in real time via a alphanumeric display pagers. This paper will describe the system, the type and number of alerts generated, and the impact on clinical practice. A major issue remains in measuring the impact of wireless alerts on patient outcomes. PMID:11079992

  6. 78 FR 53774 - Guide for the Evaluation of Alert and Notification Systems for Nuclear Power Plants, FEMA-REP-10...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ...] Guide for the Evaluation of Alert and Notification Systems for Nuclear Power Plants, FEMA-REP-10, Rev. 1... the Guide for the Evaluation of Alert and Notification Systems for Nuclear Power Plants, FEMA-REP-10... Agency (FEMA) issued FEMA-REP-10, Guide for the Evaluation of Alert and Notification Systems for Nuclear...

  7. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

  8. System and Method for Providing Model-Based Alerting of Spatial Disorientation to a Pilot

    NASA Technical Reports Server (NTRS)

    Johnson, Steve (Inventor); Conner, Kevin J (Inventor); Mathan, Santosh (Inventor)

    2015-01-01

    A system and method monitor aircraft state parameters, for example, aircraft movement and flight parameters, applies those inputs to a spatial disorientation model, and makes a prediction of when pilot may become spatially disoriented. Once the system predicts a potentially disoriented pilot, the sensitivity for alerting the pilot to conditions exceeding a threshold can be increased and allow for an earlier alert to mitigate the possibility of an incorrect control input.

  9. Impact-based earthquake alerts with the U.S. Geological Survey's PAGER system: what's next?

    USGS Publications Warehouse

    Wald, D.J.; Jaiswal, K.S.; Marano, K.D.; Garcia, D.; So, E.; Hearne, M.

    2012-01-01

    In September 2010, the USGS began publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses with its Prompt Assessment of Global Earthquakes for Response (PAGER) system. These estimates significantly enhanced the utility of the USGS PAGER system which had been, since 2006, providing estimated population exposures to specific shaking intensities. Quantifying earthquake impacts and communicating estimated losses (and their uncertainties) to the public, the media, humanitarian, and response communities required a new protocol—necessitating the development of an Earthquake Impact Scale—described herein and now deployed with the PAGER system. After two years of PAGER-based impact alerting, we now review operations, hazard calculations, loss models, alerting protocols, and our success rate for recent (2010-2011) events. This review prompts analyses of the strengths, limitations, opportunities, and pressures, allowing clearer definition of future research and development priorities for the PAGER system.

  10. Comparison of warfarin therapy clinical outcomes following implementation of an automated mobile phone-based critical laboratory value text alert system.

    PubMed

    Lin, Shu-Wen; Kang, Wen-Yi; Lin, Dong-Tsamn; Lee, James; Wu, Fe-Lin; Chen, Chuen-Liang; Tseng, Yufeng J

    2014-01-01

    Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time

  11. Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy

    DTIC Science & Technology

    2012-03-01

    for the consumer at the mo- ment but will soon become a commoditized, basic requirement. For example, as the baby boomers grow older, mobile services...Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy The WEA Project Team March 2012 SPECIAL REPORT CMU/SEI-2012-TR-019 CERT...report presents a taxonomy developed for the Commercial Mobile Alert Service (CMAS). The CMAS Alerting Pipeline Taxonomy is a hierarchical classification

  12. Aircraft Alerting Systems Standardization Study. Phase IV. Accident Implications on Systems Design.

    DTIC Science & Technology

    1982-06-01

    computing and processing to assimilate and process status informa- 5 tion using...provided with capabilities in computing and processing , sensing, interfacing, and controlling and displaying. 17 o Computing and Processing - Algorithms...alerting system to perform a flight status monitor function would require additional sensinq, computing and processing , interfacing, and controlling

  13. Mobile Traffic Alert and Tourist Route Guidance System Design Using Geospatial Data

    NASA Astrophysics Data System (ADS)

    Bhattacharya, D.; Painho, M.; Mishra, S.; Gupta, A.

    2017-09-01

    The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

  14. 47 CFR 11.11 - The Emergency Alert System (EAS).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... through the use of a single set of EAS equipment at the hub station (or common studio or control point... as low earth orbiting satellites, that wish to participate in the EAS may contact the FCC's Public... 47 Telecommunication 1 2010-10-01 2010-10-01 false The Emergency Alert System (EAS). 11.11 Section...

  15. 47 CFR 11.11 - The Emergency Alert System (EAS).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... through the use of a single set of EAS equipment at the hub station (or common studio or control point... the FCC in any agreements. (e) Other technologies and public service providers, such as low earth... 47 Telecommunication 1 2014-10-01 2014-10-01 false The Emergency Alert System (EAS). 11.11 Section...

  16. 47 CFR 11.11 - The Emergency Alert System (EAS).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... through the use of a single set of EAS equipment at the hub station (or common studio or control point... the FCC in any agreements. (e) Other technologies and public service providers, such as low earth... 47 Telecommunication 1 2013-10-01 2013-10-01 false The Emergency Alert System (EAS). 11.11 Section...

  17. 47 CFR 11.11 - The Emergency Alert System (EAS).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... through the use of a single set of EAS equipment at the hub station (or common studio or control point... the FCC in any agreements. (e) Other technologies and public service providers, such as low earth... 47 Telecommunication 1 2012-10-01 2012-10-01 false The Emergency Alert System (EAS). 11.11 Section...

  18. 47 CFR 11.11 - The Emergency Alert System (EAS).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... through the use of a single set of EAS equipment at the hub station (or common studio or control point... as low earth orbiting satellites, that wish to participate in the EAS may contact the FCC's Public... 47 Telecommunication 1 2011-10-01 2011-10-01 false The Emergency Alert System (EAS). 11.11 Section...

  19. TALON: the telescope alert operation network system: intelligent linking of distributed autonomous robotic telescopes

    NASA Astrophysics Data System (ADS)

    White, Robert R.; Wren, James; Davis, Heath R.; Galassi, Mark; Starr, Daniel; Vestrand, W. T.; Wozniak, P.

    2004-09-01

    The internet has brought about great change in the astronomical community, but this interconnectivity is just starting to be exploited for use in instrumentation. Utilizing the internet for communicating between distributed astronomical systems is still in its infancy, but it already shows great potential. Here we present an example of a distributed network of telescopes that performs more efficiently in synchronous operation than as individual instruments. RAPid Telescopes for Optical Response (RAPTOR) is a system of telescopes at LANL that has intelligent intercommunication, combined with wide-field optics, temporal monitoring software, and deep-field follow-up capability all working in closed-loop real-time operation. The Telescope ALert Operations Network (TALON) is a network server that allows intercommunication of alert triggers from external and internal resources and controls the distribution of these to each of the telescopes on the network. TALON is designed to grow, allowing any number of telescopes to be linked together and communicate. Coupled with an intelligent alert client at each telescope, it can analyze and respond to each distributed TALON alert based on the telescopes needs and schedule.

  20. Development of an Alert System to Detect Drug Interactions with Herbal Supplements using Medical Record Data.

    PubMed

    Archer, Melissa; Proulx, Joshua; Shane-McWhorter, Laura; Bray, Bruce E; Zeng-Treitler, Qing

    2014-01-01

    While potential medication-to-medication interaction alerting engines exist in many clinical applications, few systems exist to automatically alert on potential medication to herbal supplement interactions. We have developed a preliminary knowledge base and rules alerting engine that detects 259 potential interactions between 9 supplements, 62 cardiac medications, and 19 drug classes. The rules engine takes into consideration 12 patient risk factors and 30 interaction warning signs to help determine which of three different alert levels to categorize each potential interaction. A formative evaluation was conducted with two clinicians to set initial thresholds for each alert level. Additional work is planned add more supplement interactions, risk factors, and warning signs as well as to continue to set and adjust the inputs and thresholds for each potential interaction.

  1. AGILE/GRID Science Alert Monitoring System: The Workflow and the Crab Flare Case

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Conforti, V.; Parmiggiani, N.

    2013-10-01

    During the first five years of the AGILE mission we have observed many gamma-ray transients of Galactic and extragalactic origin. A fast reaction to unexpected transient events is a crucial part of the AGILE monitoring program, because the follow-up of astrophysical transients is a key point for this space mission. We present the workflow and the software developed by the AGILE Team to perform the automatic analysis for the detection of gamma-ray transients. In addition, an App for iPhone will be released enabling the Team to access the monitoring system through mobile phones. In 2010 September the science alert monitoring system presented in this paper recorded a transient phenomena from the Crab Nebula, generating an automated alert sent via email and SMS two hours after the end of an AGILE satellite orbit, i.e. two hours after the Crab flare itself: for this discovery AGILE won the 2012 Bruno Rossi prize. The design of this alert system is maximized to reach the maximum speed, and in this, as in many other cases, AGILE has demonstrated that the reaction speed of the monitoring system is crucial for the scientific return of the mission.

  2. NAS-Wide Fast-Time Simulation Study for Evaluating Performance of UAS Detect-and-Avoid Alerting and Guidance Systems

    NASA Technical Reports Server (NTRS)

    Lee, Seung Man; Park, Chunki; Cone, Andrew Clayton; Thipphavong, David P.; Santiago, Confesor

    2016-01-01

    This presentation contains the analysis results of NAS-wide fast-time simulations with UAS and VFR traffic for a single day for evaluating the performance of Detect-and-Avoid (DAA) alerting and guidance systems. This purpose of this study was to help refine and validate MOPS alerting and guidance requirements. In this study, we generated plots of all performance metrics that are specified by RTCA SC-228 Minimum Operational Performance Standards (MOPS): 1) to evaluate the sensitivity of alerting parameters on the performance metrics of each DAA alert type: Preventive, Corrective, and Warning alerts and 2) to evaluate the effect of sensor uncertainty on DAA alerting and guidance performance.

  3. Participatory design for drug-drug interaction alerts.

    PubMed

    Luna, Daniel; Otero, Carlos; Almerares, Alfredo; Stanziola, Enrique; Risk, Marcelo; González Bernaldo de Quirós, Fernán

    2015-01-01

    The utilization of decision support systems, in the point of care, to alert drug-drug interactions has been shown to improve quality of care. Still, the use of these systems has not been as expected, it is believed, because of the difficulties in their knowledge databases; errors in the generation of the alerts and the lack of a suitable design. This study expands on the development of alerts using participatory design techniques based on user centered design process. This work was undertaken in three stages (inquiry, participatory design and usability testing) it showed that the use of these techniques improves satisfaction, effectiveness and efficiency in an alert system for drug-drug interactions, a fact that was evident in specific situations such as the decrease of errors to meet the specified task, the time, the workload optimization and users overall satisfaction in the system.

  4. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Federal alert gateway. [Reserved] 10.310 Section 10.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.310 Federal alert gateway. [Reserved] ...

  5. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Federal alert gateway. [Reserved] 10.310 Section 10.310 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.310 Federal alert gateway. [Reserved] ...

  6. Use of a Clinical Decision Support System Alert to Prevent Supratherapeutic Vancomycin Concentrations

    PubMed Central

    Ralph, Rachel; Patel, Jean A.; Postelnick, Michael; Ziauddin, Salma; Flis, Weronika; Galal, Audrey N.

    2014-01-01

    Background: Alerts issued by clinical decision support systems (CDSS) may be useful to identify and prevent the occurrence of acute kidney injury among patients on nephrotoxic drugs, particularly vancomycin. Objective: The purpose of this instructive study was to determine the effectiveness of using a pharmacist-run CDSS alert of early serum creatinine increases in patients receiving intravenous vancomycin to decrease the proportion of severely elevated vancomycin concentrations. Methods: This was a retrospective study of a prospectively reviewed CDSS alert that triggered in patients with an increase in serum creatinine by 25% from baseline within 24 hours. Severely elevated vancomycin concentrations were divided into a control group (before alert implementation) and a study group (after alert implementation) and considered for study inclusion. The proportion of severely elevated vancomycin concentrations (ie, >30 mg/L) were collected in the control and study groups. Results: There were 1290 and 1501 vancomycin concentrations in the control group and the study group, respectively. A total of 696 CDSS alerts triggered during the study period. The proportion of severely elevated vancomycin troughs decreased from 5.3% (n = 68, median = 36.6 mg/L, interquartile range = 33.75-43.2 mg/L) in the control group to 3.7% (n = 55, median = 34.7 mg/L, interquartile range = 31.3-39.3 mg/L) in the study group. This reflects a statistically significant decrease in the proportion of severely elevated vancomycin concentrations (P = .04). Conclusion: Overall, this instructive analysis on a novel use of CDSS software suggests that the implementation of an alert based on early detection of serum creatinine changes led to a significant decrease in the proportion of severely elevated serum vancomycin concentrations.

  7. Predictive Information: Status or Alert Information?

    NASA Technical Reports Server (NTRS)

    Trujillo, Anna C.; Bruneau, Daniel; Press, Hayes N.

    2008-01-01

    Previous research investigating the efficacy of predictive information for detecting and diagnosing aircraft system failures found that subjects like to have predictive information concerning when a parameter would reach an alert range. This research focused on where the predictive information should be located, whether the information should be more closely associated with the parameter information or with the alert information. Each subject saw 3 forms of predictive information: (1) none, (2) a predictive alert message, and (3) predictive information on the status display. Generally, subjects performed better and preferred to have predictive information available although the difference between status and alert predictive information was minimal. Overall, for detection and recalling what happened, status predictive information is best; however for diagnosis, alert predictive information holds a slight edge.

  8. Vehicle proximity alert system for highway-railroad grade crossings-prototype research

    DOT National Transportation Integrated Search

    2001-04-01

    This report describes testing of prototype vehicle proximity alert system (VPAS) technologies, and presents and evaluates the results. The object was to determine the feasibility of VPAS for possible use in priority vehicles (i.e., emergency vehicles...

  9. Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

    PubMed Central

    Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

    2013-01-01

    Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (p<0.05) of renal disorders, anxiety, and cardiac arrhythmias emerged as predictors of telehealth alerts through quantitative analysis (n = 168) using multiple regression. Inappropriate telehealth measurement technique by patients (54%) and home healthcare system inefficiencies (37%) contributed to most telehealth false alerts in the purposive qualitative sub-sample (n = 35) of patients with high telehealth alerts. Conclusion Encouraging patient engagement with the telehealth process, fostering a collaborative approach among all the clinicians involved with the telehealth intervention, tailoring telehealth alert thresholds to patient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

  10. Evaluation of health alerts from an early illness warning system in independent living.

    PubMed

    Rantz, Marilyn J; Scott, Susan D; Miller, Steven J; Skubic, Marjorie; Phillips, Lorraine; Alexander, Greg; Koopman, Richelle J; Musterman, Katy; Back, Jessica

    2013-06-01

    Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician's written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.

  11. TALON - The Telescope Alert Operation Network System : intelligent linking of distributed autonomous robotic telescopes

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    White, R. R.; Wren, J.; Davis, H. R.

    2004-01-01

    The internet has brought about great change in the astronomical community, but this interconnectivity is just starting to be exploited for use in instrumentation. Utilizing the internet for communicating between distributed astronomical systems is still in its infancy, but it already shows great potential. Here we present an example of a distributed network of telescopes that performs more efficienfiy in synchronous operation than as individual instruments. RAPid Telescopes for Optical Response (RAPTOR) is a system of telescopes at LANL that has intelligent intercommunication, combined with wide-field optics, temporal monitoring software, and deep-field follow-up capability all working in closed-loop real-time operation.more » The Telescope ALert Operations Network (TALON) is a network server that allows intercommunication of alert triggers from external and internal resources and controls the distribution of these to each of the telescopes on the network. TALON is designed to grow, allowing any number of telescopes to be linked together and communicate. Coupled with an intelligent alert client at each telescope, it can analyze and respond to each distributed TALON alert based on the telescopes needs and schedule.« less

  12. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

  13. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL WIRELESS EMERGENCY ALERTS System Architecture § 10.320 Provider alert gateway requirements. This section specifies the functions...

  14. Determining Inappropriate Medication Alerts from "Inaccurate Warning" Overrides in the Intensive Care Unit.

    PubMed

    Rehr, Christine A; Wong, Adrian; Seger, Diane L; Bates, David W

    2018-04-01

     This article aims to understand provider behavior around the use of the override reason "Inaccurate warning," specifically whether it is an effective way of identifying unhelpful medication alerts.  We analyzed alert overrides that occurred in the intensive care units (ICUs) of a major academic medical center between June and November 2016, focused on the following high-significance alert types: dose, drug-allergy alerts, and drug-drug interactions (DDI). Override appropriateness was analyzed by two independent reviewers using predetermined criteria.  A total of 268 of 26,501 ICU overrides (1.0%) used the reason "Inaccurate warning," with 93 of these overrides associated with our included alert types. Sixty-one of these overrides (66%) were identified to be appropriate. Twenty-one of 30 (70%) dose alert overrides were appropriate. Forty of 48 drug-allergy alert overrides (83%) were appropriate, for reasons ranging from prior tolerance ( n  = 30) to inaccurate ingredient matches ( n  = 5). None of the 15 DDI overrides were appropriate.  The "Inaccurate warning" reason was selectively used by a small proportion of providers and overrides using this reason identified important opportunities to reduce excess alerts. Potential opportunities include improved evaluation of dosing mechanisms based on patient characteristics, inclusion of institutional dosing protocols to alert logic, and evaluation of a patient's prior tolerance to a medication that they have a documented allergy for. This resource is not yet routinely used for alert tailoring at our institution but may prove to be a valuable resource to evaluate available alerts. Schattauer GmbH Stuttgart.

  15. Evaluation of the 3D BacT/ALERT automated culture system for the detection of microbial contamination of platelet concentrates.

    PubMed

    McDonald, C P; Rogers, A; Cox, M; Smith, R; Roy, A; Robbins, S; Hartley, S; Barbara, J A J; Rothenberg, S; Stutzman, L; Widders, G

    2002-10-01

    Bacterial transmission remains the major component of morbidity and mortality associated with transfusion-transmitted infections. Platelet concentrates are the most common cause of bacterial transmission. The BacT/ALERT 3D automated blood culture system has the potential to screen platelet concentrates for the presence of bacteria. Evaluation of this system was performed by spiking day 2 apheresis platelet units with individual bacterial isolates at final concentrations of 10 and 100 colony-forming units (cfu) mL-1. Fifteen organisms were used which had been cited in platelet transmission and monitoring studies. BacT/ALERT times to detection were compared with thioglycollate broth cultures, and the performance of five types of BacT/ALERT culture bottles was evaluated. Sampling was performed immediately after the inoculation of the units, and 10 replicates were performed per organism concentration for each of the five types of BacT/ALERT bottles. The mean times for the detection of these 15 organisms by BacT/ALERT, with the exception of Propionibacterium acnes, ranged from 9.1 to 48.1 h (all 10 replicates were positive). In comparison, the time range found using thioglycollate was 12.0-32.3 h (all 10 replicates were positive). P. acnes' BacT/ALERT mean detection times ranged from 89.0 to 177.6 h compared with 75.6-86.4 h for the thioglycollate broth. BacT/ALERT, with the exception of P. acnes, which has dubious clinical significance, gave equivalent or shorter detection times when compared with the thioglycollate broth system. The BacT/ALERT system detected a range of organisms at levels of 10 and 100 cfu mL-1. This study validates the BacT/ALERT microbial detection system for screening platelets. Currently, the system is the only practically viable option available for routinely screening platelet concentrates to prevent bacterial transmission.

  16. Collaborative knowledge acquisition for the design of context-aware alert systems.

    PubMed

    Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L; Bernstam, Elmer Victor

    2012-01-01

    To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Five internal medicine residents reviewed 18 anemia alerts, while 'talking aloud'. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules.

  17. The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006-2013.

    PubMed

    Guzman-Herrador, B; Vold, L; Berg, T; Berglund, T M; Heier, B; Kapperud, G; Lange, H; Nygård, K

    2016-01-01

    In 2005, the Norwegian Institute of Public Health established a web-based outbreak rapid alert system called Vesuv. The system is used for mandatory outbreak alerts from municipal medical officers, healthcare institutions, and food safety authorities. As of 2013, 1426 outbreaks have been reported, involving 32913 cases. More than half of the outbreaks occurred in healthcare institutions (759 outbreaks, 53·2%). A total of 474 (33·2%) outbreaks were associated with food or drinking water. The web-based rapid alert system has proved to be a helpful tool by enhancing reporting and enabling rapid and efficient information sharing between different authorities at both the local and national levels. It is also an important tool for event-based reporting, as required by the International Health Regulations (IHR) 2005. Collecting information from all the outbreak alerts and reports in a national database is also useful for analysing trends, such as occurrence of certain microorganisms, places or sources of infection, or route of transmission. This can facilitate the identification of specific areas where more general preventive measures are needed.

  18. Diagnostic accuracy of a screening electronic alert tool for severe sepsis and septic shock in the emergency department.

    PubMed

    Alsolamy, Sami; Al Salamah, Majid; Al Thagafi, Majed; Al-Dorzi, Hasan M; Marini, Abdellatif M; Aljerian, Nawfal; Al-Enezi, Farhan; Al-Hunaidi, Fatimah; Mahmoud, Ahmed M; Alamry, Ahmed; Arabi, Yaseen M

    2014-12-05

    Early recognition of severe sepsis and septic shock is challenging. The aim of this study was to determine the diagnostic accuracy of an electronic alert system in detecting severe sepsis or septic shock among emergency department (ED) patients. An electronic sepsis alert system was developed as a part of a quality-improvement project for severe sepsis and septic shock. The system screened all adult ED patients for a combination of systemic inflammatory response syndrome and organ dysfunction criteria (hypotension, hypoxemia or lactic acidosis). This study included all patients older than 14 years who presented to the ED of a tertiary care academic medical center from Oct. 1, 2012 to Jan. 31, 2013. As a comparator, emergency medicine physicians or the critical care physician identified the patients with severe sepsis or septic shock. In the ED, vital signs were manually entered into the hospital electronic heath record every hour in the critical care area and every two hours in other areas. We also calculated the time from the alert to the intensive care unit (ICU) referral. Of the 49,838 patients who presented to the ED, 222 (0.4%) were identified to have severe sepsis or septic shock. The electronic sepsis alert had a sensitivity of 93.18% (95% CI, 88.78% - 96.00%), specificity of 98.44 (95% CI, 98.33% - 98.55%), positive predictive value of 20.98% (95% CI, 18.50% - 23.70%) and negative predictive value of 99.97% (95% CI, 99.95% - 99.98%) for severe sepsis and septic shock. The alert preceded ICU referral by a median of 4.02 hours (Q1 - Q3: 1.25-8.55). Our study shows that electronic sepsis alert tool has high sensitivity and specificity in recognizing severe sepsis and septic shock, which may improve early recognition and management.

  19. An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

    NASA Astrophysics Data System (ADS)

    Zhang, Ru; Guo, Tao; Liu, Jianyi

    2018-03-01

    Within a system in which has been deployed several IDS, a great number of alerts can be triggered by a single security event, making real alerts harder to be found. To deal with redundant alerts, we propose a scheme based on rough set theory. In combination with basic concepts in rough set theory, the importance of attributes in alerts was calculated firstly. With the result of attributes importance, we could compute the similarity of two alerts, which will be compared with a pre-defined threshold to determine whether these two alerts can be aggregated or not. Also, time interval should be taken into consideration. Allowed time interval for different types of alerts is computed individually, since different types of alerts may have different time gap between two alerts. In the end of this paper, we apply proposed scheme on DAPRA98 dataset and the results of experiment show that our scheme can efficiently reduce the redundancy of alerts so that administrators of security system could avoid wasting time on useless alerts.

  20. Collaborative knowledge acquisition for the design of context-aware alert systems

    PubMed Central

    Joffe, Erel; Havakuk, Ofer; Herskovic, Jorge R; Patel, Vimla L

    2012-01-01

    Objective To present a framework for combining implicit knowledge acquisition from multiple experts with machine learning and to evaluate this framework in the context of anemia alerts. Materials and Methods Five internal medicine residents reviewed 18 anemia alerts, while ‘talking aloud’. They identified features that were reviewed by two or more physicians to determine appropriate alert level, etiology and treatment recommendation. Based on these features, data were extracted from 100 randomly-selected anemia cases for a training set and an additional 82 cases for a test set. Two staff internists assigned an alert level, etiology and treatment recommendation before and after reviewing the entire electronic medical record. The training set of 118 cases (100 plus 18) and the test set of 82 cases were explored using RIDOR and JRip algorithms. Results The feature set was sufficient to assess 93% of anemia cases (intraclass correlation for alert level before and after review of the records by internists 1 and 2 were 0.92 and 0.95, respectively). High-precision classifiers were constructed to identify low-level alerts (precision p=0.87, recall R=0.4), iron deficiency (p=1.0, R=0.73), and anemia associated with kidney disease (p=0.87, R=0.77). Discussion It was possible to identify low-level alerts and several conditions commonly associated with chronic anemia. This approach may reduce the number of clinically unimportant alerts. The study was limited to anemia alerts. Furthermore, clinicians were aware of the study hypotheses potentially biasing their evaluation. Conclusion Implicit knowledge acquisition, collaborative filtering and machine learning were combined automatically to induce clinically meaningful and precise decision rules. PMID:22744961

  1. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  2. The Low-Level Wind Shear Alert System (LLWSAS)

    DTIC Science & Technology

    1980-05-01

    ALERT SYSTEM (LLWSAS). (May R.. a.-ol - 8..’P" Imng Organization Report No, 9, Perfo~ring Or~ni-otlon Ro-r. -andAddress 10. Work Unit No. (TRAIS) Federal...rather than electronic approach. The 2-minute average adheres to recommended International Civil Aviation Organization (ICAO) standards (referernce 14...speed of 140 knots. **Cold front. 80 ’ # 90 0 STRONG CASES: COFF , 1975 80 9STRONG CASES: UNPU1BLISHED 70 60 A STRONG CASES: COFF , et al., 1978 50 \\ 50 -0

  3. Computerized pharmacy surveillance and alert system for drug-related problems.

    PubMed

    Ferrández, O; Urbina, O; Grau, S; Mateu-de-Antonio, J; Marin-Casino, M; Portabella, J; Mojal, S; Riu, M; Salas, E

    2017-04-01

    Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR). The PWS was developed in 2003-2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012. Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention. The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature. © 2017 John Wiley & Sons Ltd.

  4. Alerts Visualization and Clustering in Network-based Intrusion Detection

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yang, Dr. Li; Gasior, Wade C; Dasireddy, Swetha

    2010-04-01

    Today's Intrusion detection systems when deployed on a busy network overload the network with huge number of alerts. This behavior of producing too much raw information makes it less effective. We propose a system which takes both raw data and Snort alerts to visualize and analyze possible intrusions in a network. Then we present with two models for the visualization of clustered alerts. Our first model gives the network administrator with the logical topology of the network and detailed information of each node that involves its associated alerts and connections. In the second model, flocking model, presents the network administratormore » with the visual representation of IDS data in which each alert is represented in different color and the alerts with maximum similarity move together. This gives network administrator with the idea of detecting various of intrusions through visualizing the alert patterns.« less

  5. Effectiveness of a computerized alert system based on re-testing intervals for limiting the inappropriateness of laboratory test requests.

    PubMed

    Lippi, Giuseppe; Brambilla, Marco; Bonelli, Patrizia; Aloe, Rosalia; Balestrino, Antonio; Nardelli, Anna; Ceda, Gian Paolo; Fabi, Massimo

    2015-11-01

    There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma. The effectiveness of the system for limiting potentially inappropriate tests was monitored for 6months. Overall, 765/3539 (22%) test requests violated the preset criteria of appropriateness and generated the appearance of electronic alert. After alert appearance, 591 requests were annulled (17% of total tests requested and 77% of tests alerted, respectively). The total number of test requests violating the preset criteria of inappropriateness constantly decreased over time (26% in the first three months of implementation versus 17% in the following period; p<0.001). The total financial saving of test withdrawn was 3387 Euros (12.8% of the total test cost) throughout the study period. The results of this study suggest that a computerized alert system may be effective to limit the inappropriateness of laboratory test requests, generating significant economic saving and educating physicians to a more efficient use of laboratory resources. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  6. The Hub Population Health System: distributed ad hoc queries and alerts

    PubMed Central

    Anane, Sheila; Taverna, John; Amirfar, Sam; Stubbs-Dame, Remle; Singer, Jesse

    2011-01-01

    The Hub Population Health System enables the creation and distribution of queries for aggregate count information, clinical decision support alerts at the point-of-care for patients who meet specified conditions, and secure messages sent directly to provider electronic health record (EHR) inboxes. Using a metronidazole medication recall, the New York City Department of Health was able to determine the number of affected patients and message providers, and distribute an alert to participating practices. As of September 2011, the system is live in 400 practices and within a year will have over 532 practices with 2500 providers, representing over 2.5 million New Yorkers. The Hub can help public health experts to evaluate population health and quality improvement activities throughout the ambulatory care network. Multiple EHR vendors are building these features in partnership with the department's regional extension center in anticipation of new meaningful use requirements. PMID:22071531

  7. Provider acceptance of an automated electronic alert for acute kidney injury

    PubMed Central

    Oh, Janice; Bia, Joshua R.; Ubaid-Ullah, Muhamad; Testani, Jeffrey M.; Wilson, Francis Perry

    2016-01-01

    Background Clinical decision support systems, including electronic alerts, ideally provide immediate and relevant patient-specific information to improve clinical decision-making. Despite the growing capabilities of such alerts in conjunction with an expanding electronic medical record, there is a paucity of information regarding their perceived usefulness. We surveyed healthcare providers' opinions concerning the practicality and efficacy of a specific text-based automated electronic alert for acute kidney injury (AKI) in a single hospital during a randomized trial of AKI alerts. Methods Providers who had received at least one electronic AKI alert in the previous 6 months, as part of a separate randomized controlled trial (clinicaltrials.gov #01862419), were asked to complete a survey concerning their opinions about this specific AKI alert system. Individual approval of the alert system was defined by a provider's desire to continue receiving the alert after termination of the trial. Results A total of 98 individuals completed the survey, including 62 physicians, 27 pharmacists and 7 non-physician providers. Sixty-nine percent of responders approved the alert, with no significant difference among the various professions (P = 0.28). Alert approval was strongly correlated with the belief that the alerts improved patient care (P < 0.0001), and negatively correlated with the belief that alerts did not provide novel information (P = 0.0001). With each additional 30 days of trial duration, odds of approval decreased by 20% (3–35%) (P = 0.02). Conclusions The alert system was generally well received, although approval waned with time. Approval was correlated with the belief that this type of alert improved patient care. These findings suggest that perceived efficacy is critical to the success of future alert trials. PMID:27478598

  8. Tone-activated, remote, alert communication system

    NASA Technical Reports Server (NTRS)

    Baker, C. D.; Couvillon, L. A.; Hubbard, W. P.; Kollar, F. J.; Postal, R. B.; Tegnelia, C. R.

    1971-01-01

    Pocket sized transmitter, frequency modulated by crystal derived tones, with integral loop antenna provides police with easy operating alert signal communicator which uses patrol car radio to relay signal. Communication channels are time shared by several patrol units.

  9. Analysis of UAS DAA Alerting in Fast-Time Simulations without DAA Mitigation

    NASA Technical Reports Server (NTRS)

    Thipphavong, David P.; Santiago, Confesor; Isaacson, Douglas R.; Lee, Seung Man; Park, Chunki; Refai, Mohamad Said; Snow, James

    2015-01-01

    Realization of the expected proliferation of Unmanned Aircraft System (UAS) operations in the National Airspace System (NAS) depends on the development and validation of performance standards for UAS Detect and Avoid (DAA) Systems. The RTCA Special Committee 228 is charged with leading the development of draft Minimum Operational Performance Standards (MOPS) for UAS DAA Systems. NASA, as a participating member of RTCA SC-228 is committed to supporting the development and validation of draft requirements for DAA alerting system performance. A recent study conducted using NASA's ACES (Airspace Concept Evaluation System) simulation capability begins to address questions surrounding the development of draft MOPS for DAA alerting systems. ACES simulations were conducted to study the performance of alerting systems proposed by the SC-228 DAA Alerting sub-group. Analysis included but was not limited to: 1) correct alert (and timeliness), 2) false alert (and severity and duration), 3) missed alert, and 4) probability of an alert type at the time of loss of well clear. The performance of DAA alerting systems when using intent vs. dead-reckoning for UAS ownship trajectories was also compared. The results will be used by SC-228 to inform decisions about the surveillance standards of UAS DAA systems and future requirements development and validation efforts.

  10. Improved satellite-based emergency alerting system

    NASA Astrophysics Data System (ADS)

    Bernard, E. N.; Milburn, H. B.

    1991-12-01

    Rapid-onset natural hazards have claimed more than 2.8 million lives worldwide in the past 20 years. This category includes such events as earthquakes, landslides, hurricanes, tornadoes, floods, volcanic eruptions, wildfires, and tsunamis. Effective hazard mitigation is particularly difficult in such cases, since the time available to issue warnings can be very short or even nonexistent. A general approach to mitigate the effects of these disasters was demonstrated in 1988 that included preevent emergency planning, real-time hazard assessment, and rapid warning via satellite communication links. This article reports on improvements in this satellite-based emergency alerting communication system that have reduced the response time from 87 to 17 sec and expanded the broadcast coverage from 40 percent to 62 percent of the earth's surface.

  11. 75 FR 4760 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-29

    ...; State, Local or Tribal Governments; Non-profit entities. Number of Respondents: 3,569,028. Estimated... hours. Total Annual Cost: $3,086,044. Privacy Impact Assessment: No impact(s). Nature and Extent of... retransmitted the alert; and (3) if they were not able to receive and/ or transmit the alert, their `best effort...

  12. Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

    NASA Astrophysics Data System (ADS)

    Gerber, M.

    2011-12-01

    The Personal Localized Alert Network (PLAN), aka Commercial Mobile Alert System (CMAS), is readying for roll out and will be broadcasting emergency public alerts to millions of cell phones by the middle of 2012. Learn how the National Weather Serivce (NWS) is supplying PLAN with geo-referenced weather alert information in the industry standard Common Alerting Protocol (CAP) format and how you can access this same information for integration with mobile devices, other consumer electronics, and decision support systems. Information will also be provided on the NWS' new collaborative venue that encourages wide participation in the evolution and use of NWS CAP alerts in a variety of applications.

  13. Conditional outlier detection for clinical alerting.

    PubMed

    Hauskrecht, Milos; Valko, Michal; Batal, Iyad; Clermont, Gilles; Visweswaran, Shyam; Cooper, Gregory F

    2010-11-13

    We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

  14. A trial of a real-time alert for clinical deterioration in patients hospitalized on general medical wards.

    PubMed

    Bailey, Thomas C; Chen, Yixin; Mao, Yi; Lu, Chenyang; Hackmann, Gregory; Micek, Scott T; Heard, Kevin M; Faulkner, Kelly M; Kollef, Marin H

    2013-05-01

    With limited numbers of intensive care unit (ICU) beds available, increasing patient acuity is expected to contribute to episodes of inpatient deterioration on general wards. To prospectively validate a predictive algorithm for clinical deterioration in general-medical ward patients, and to conduct a trial of real-time alerts based on this algorithm. Randomized, controlled crossover study. Academic center with patients hospitalized on 8 general wards between July 2007 and December 2011. Real-time alerts were generated by an algorithm designed to predict the need for ICU transfer using electronically available data. The alerts were sent by text page to the nurse manager on intervention wards. Intensive care unit transfer, hospital mortality, and hospital length of stay. Patients meeting the alert threshold were at nearly 5.3-fold greater risk of ICU transfer (95% confidence interval [CI]: 4.6-6.0) than those not satisfying the alert threshold (358 of 2353 [15.2%] vs 512 of 17678 [2.9%]). Patients with alerts were at 8.9-fold greater risk of death (95% CI: 7.4-10.7) than those without alerts (244 of 2353 [10.4%] vs 206 of 17678 [1.2%]). Among patients identified by the early warning system, there were no differences in the proportion of patients who were transferred to the ICU or who died in the intervention group as compared with the control group. Real-time alerts were highly specific for clinical deterioration resulting in ICU transfer and death, and were associated with longer hospital length of stay. However, an intervention notifying a nurse of the risk did not result in improvement in these outcomes. Copyright © 2013 Society of Hospital Medicine.

  15. Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015

    DTIC Science & Technology

    2016-03-11

    Control and Prevention Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease — Guinea, 2014...principally through the use of a telephone alert system. Community members and health facilities report deaths and suspected Ebola cases to local alert ...sensitivity of the national call center with the local alerts system, the CDC country team performed probabilistic record linkage of the combined

  16. Modeling Pilot Behavior for Assessing Integrated Alert and Notification Systems on Flight Decks

    NASA Technical Reports Server (NTRS)

    Cover, Mathew; Schnell, Thomas

    2010-01-01

    Numerous new flight deck configurations for caution, warning, and alerts can be conceived; yet testing them with human-in-the-Ioop experiments to evaluate each one would not be practical. New sensors, instruments, and displays are being put into cockpits every day and this is particularly true as we enter the dawn of the Next Generation Air Transportation System (NextGen). By modeling pilot behavior in a computer simulation, an unlimited number of unique caution, warning, and alert configurations can be evaluated 24/7 by a computer. These computer simulations can then identify the most promising candidate formats to further evaluate in higher fidelity, but more costly, Human-in-the-Ioop (HITL) simulations. Evaluations using batch simulations with human performance models saves time, money, and enables a broader consideration of possible caution, warning, and alerting configurations for future flight decks.

  17. Context-Sensitive Clinical Alert Packages Written in Arden Syntax.

    PubMed

    Zeckl, Julia; Adlassnig, Katharina; Fossler, Renate; Blacky, Alexander; de Bruin, Jeroen S; Koller, Walter; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

    2017-01-01

    An increasing body of raw patient data is generated on each day of a patient's stay at a hospital. It is of paramount importance that critical patient information be extracted from these large data volumes and presented to the patient's clinical caregivers as early as possible. Contemporary clinical alert systems attempt to provide this service with moderate success. The efficacy of the systems is limited by the fact that they are too general to fit specific patient populations or healthcare institutions. In this study we present an extendable alerting framework implemented in Arden Syntax, which can be configured to the needs and preferences of healthcare institutions and individual patient caregivers. We illustrate the potential of this alerting framework via an alert package that analyzes hematological laboratory results with data from intensive care units at the Vienna General Hospital, Austria. The results show the effectiveness of this alert package and its ability to generate key alerts while avoiding over-alerting.

  18. Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting.

    PubMed

    Harrison, Andrew M; Thongprayoon, Charat; Aakre, Christopher A; Jeng, Jack Y; Dziadzko, Mikhail A; Gajic, Ognjen; Pickering, Brian W; Herasevich, Vitaly

    2017-01-01

    Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. The alert acknowledgement rate from the severe sepsis alert system was 3% ( N  = 148) and 51% ( N  = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min ( N  = 5) and median 2 min ( N  = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.

  19. Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting

    PubMed Central

    Harrison, Andrew M.; Thongprayoon, Charat; Aakre, Christopher A.; Jeng, Jack Y.; Dziadzko, Mikhail A.; Gajic, Ognjen; Pickering, Brian W.

    2017-01-01

    Background Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148) and 51% (N = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5) and median 2 min (N = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting. PMID:28316887

  20. Safety Alerts: An Observational Study in Portugal.

    PubMed

    Soares, Sara; Roque, Fátima; Teixeira Rodrigues, António; Figueiras, Adolfo; Herdeiro, Maria Teresa

    2015-09-01

    The information that is available when marketing authorizations are approved is limited. Pharmacovigilance has an important role during the postauthorization period, and alerts published by national authorities allow health care professionals to be informed about new data on safety profiles. This study therefore sought to analyze all safety alerts published by the Portuguese National Authority of Medicines and Health Products I.P. (INFARMED). We conducted an observational study of all alerts published on the INFARMED website from January 2002 through December 2014. From the data included in the alerts, the following information was abstracted: active substance name (and trade name), event that led to the alert, and the resulting safety measures. Active substances were classified according to the Anatomical Therapeutic Chemical (ATC) code. A total of 562 alerts were published, and 304 were eligible for inclusion. The musculoskeletal system was the ATC code with more alerts (n = 53), followed by the nervous system (n = 42). Communication of the information and recommendations to the health care professionals and the public in general was the most frequent safety measure (n = 128), followed by changes in the Summary of the Product Characteristics and package information leaflet (n = 66). During the study period, 26 marketing authorizations were temporarily suspended and 10 were revoked. The knowledge of the alerts published during the postmarketing period is very useful to the health care professionals for improving prescription and use of medicines and to the scientific community for the development of new researches. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  1. The Zwicky Transient Facility Public Alert Stream

    NASA Astrophysics Data System (ADS)

    Masci, F.; Kulkarni, S. R.; Graham, M.; Prince, T.; Helou, G.

    2018-06-01

    The Zwicky Transient Facility (ZTF; ATel #11266) announces the start of public alerts. These alerts will originate from the ZTF public surveys (Bellm & Kulkarni 2017; Nature Astronomy 1, 71) as described at www.ztf.caltech.edu/page/msip Alerts are generated by the ZTF Science Data System housed at IPAC-Caltech (www.ipac.caltech.edu) using a realtime image-subtraction pipeline (Masci et al. 2018; www.ztf.caltech.edu/page/technical).

  2. Evaluation of Helmet Mounted Display Alerting Symbology

    NASA Technical Reports Server (NTRS)

    DeMaio, Joe; Rutkowski, Michael (Technical Monitor)

    2000-01-01

    Proposed helicopter helmet mounted displays will be used to alert the pilot to a variety of conditions, from threats to equipment problems. The present research was performed under the NASA Safe All-weather Flight Operations Research (SAFOR) program supported by a joint Army/NASA research agreement. The purpose of the research was to examine ways to optimize the alerting effectiveness of helmet display symbology. The research used two approaches to increasing the effectiveness of alerts. One was to increase the ability of the alert to attract attention by using the entire display surface. The other was to include information about the required response in the alert itself. The investigation was conducted using the NASA Ames Research Center's six-degree-of-freedom vertical motion simulator (VMS) with a rotorcraft cockpit. Helmet display symbology was based on the AH-64's pilot night vision system (PNVS), cruise mode symbology. A standardized mission was developed, that consisted of 11 legs. The mission included four tasks, which allowed variation in the frequency of alerts. The general trend in the data points to a small benefit from both the full-screen alert and the partial information alert.

  3. CHEMICAL SAFETY ALERTS-

    EPA Science Inventory

    Chemical Safety Alerts are short publications which explain specific hazards that have become evident through chemical accident investigation efforts. EPA has produced over a dozen Alerts to date. This year's Alert: Managing Chemical Reactivity Hazards

  4. V-Alert: Description and Validation of a Vulnerable Road User Alert System in the Framework of a Smart City

    PubMed Central

    Hernandez-Jayo, Unai; De-la-Iglesia, Idoia; Perez, Jagoba

    2015-01-01

    V-Alert is a cooperative application to be deployed in the frame of Smart Cities with the aim of reducing the probability of accidents involving Vulnerable Road Users (VRU) and vehicles. The architecture of V-Alert combines short- and long-range communication technologies in order to provide more time to the drivers and VRU to take the appropriate maneuver and avoid a possible collision. The information generated by mobile sensors (vehicles and cyclists) is sent over this heterogeneous communication architecture and processed in a central server, the Drivers Cloud, which is in charge of generating the messages that are shown on the drivers’ and cyclists’ Human Machine Interface (HMI). First of all, V-Alert has been tested in a simulated scenario to check the communications architecture in a complex scenario and, once it was validated, all the elements of V-Alert have been moved to a real scenario to check the application reliability. All the results are shown along the length of this paper. PMID:26230695

  5. V-Alert: Description and Validation of a Vulnerable Road User Alert System in the Framework of a Smart City.

    PubMed

    Hernandez-Jayo, Unai; De-la-Iglesia, Idoia; Perez, Jagoba

    2015-07-29

    V-Alert is a cooperative application to be deployed in the frame of Smart Cities with the aim of reducing the probability of accidents involving Vulnerable Road Users (VRU) and vehicles. The architecture of V-Alert combines short- and long-range communication technologies in order to provide more time to the drivers and VRU to take the appropriate maneuver and avoid a possible collision. The information generated by mobile sensors (vehicles and cyclists) is sent over this heterogeneous communication architecture and processed in a central server, the Drivers Cloud, which is in charge of generating the messages that are shown on the drivers' and cyclists' Human Machine Interface (HMI). First of all, V-Alert has been tested in a simulated scenario to check the communications architecture in a complex scenario and, once it was validated, all the elements of V-Alert have been moved to a real scenario to check the application reliability. All the results are shown along the length of this paper.

  6. Conditional Outlier Detection for Clinical Alerting

    PubMed Central

    Hauskrecht, Milos; Valko, Michal; Batal, Iyad; Clermont, Gilles; Visweswaran, Shyam; Cooper, Gregory F.

    2010-01-01

    We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates. PMID:21346986

  7. Wireless Emergency Alerts (WEA) Cybersecurity Risk Management Strategy for Alert Originators

    DTIC Science & Technology

    2014-03-01

    formerly known as the Commercial Mobile Alert Service ( CMAS ) RDT&E program, is a collaborative partnership that includes the cellular industry, the...Examples illustrate a STRIDE analysis of the generic mission 1 The CMAS Alerting Pipeline Taxonomy describes in detail a hierarchical classification...SEI-2013-SR-018 | 1 1 Introduction The Wireless Emergency Alerts (WEA) service, formerly known as the Commercial Mobile Alert Service ( CMAS ), is a

  8. A framework for evaluating the appropriateness of clinical decision support alerts and responses

    PubMed Central

    Waitman, Lemuel R; Lewis, Julia B; Wright, Julie A; Choma, David P; Miller, Randolph A; Peterson, Josh F

    2011-01-01

    Objective Alerting systems, a type of clinical decision support, are increasingly prevalent in healthcare, yet few studies have concurrently measured the appropriateness of alerts with provider responses to alerts. Recent reports of suboptimal alert system design and implementation highlight the need for better evaluation to inform future designs. The authors present a comprehensive framework for evaluating the clinical appropriateness of synchronous, interruptive medication safety alerts. Methods Through literature review and iterative testing, metrics were developed that describe successes, justifiable overrides, provider non-adherence, and unintended adverse consequences of clinical decision support alerts. The framework was validated by applying it to a medication alerting system for patients with acute kidney injury (AKI). Results Through expert review, the framework assesses each alert episode for appropriateness of the alert display and the necessity and urgency of a clinical response. Primary outcomes of the framework include the false positive alert rate, alert override rate, provider non-adherence rate, and rate of provider response appropriateness. Application of the framework to evaluate an existing AKI medication alerting system provided a more complete understanding of the process outcomes measured in the AKI medication alerting system. The authors confirmed that previous alerts and provider responses were most often appropriate. Conclusion The new evaluation model offers a potentially effective method for assessing the clinical appropriateness of synchronous interruptive medication alerts prior to evaluating patient outcomes in a comparative trial. More work can determine the generalizability of the framework for use in other settings and other alert types. PMID:21849334

  9. Managing the Alert Process at NewYork-Presbyterian Hospital

    PubMed Central

    Kuperman, Gilad J; Diamente, Rosanna; Khatu, Vrinda; Chan-Kraushar, Terri; Stetson, Pete; Boyer, Aurelia; Cooper, Mary

    2005-01-01

    Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources. PMID:16779073

  10. Successful ShakeAlert Performance for the Napa Quake

    NASA Astrophysics Data System (ADS)

    Allen, R. M.; Given, D. D.; Heaton, T. H.; Vidale, J. E.

    2014-12-01

    ShakeAlert, the demonstration earthquake early warning system, developed by the USGS, UC Berkeley, Caltech, ETH, and the University of Washington, functioned as expected for the August 24, 2014, M6.0 Napa earthquake. The first ShakeAlert was generated by the ElarmS algorithm 5.1 sec after the origin time of the earthquake, and 3.3 sec after the P-wave arrived at the closest station 6.5 km from the epicenter. This initial alert, based on P-wave triggers from four stations, estimated the magnitude to be 5.7. The warning was received at the UC Berkeley Seismological Laboratory 5 seconds before the S-wave and about 10 sec prior to the onset of the strongest shaking. ShakeAlert beta-testers across the San Francisco Bay Area simultaneously received the alert, including the San Francisco 911 center with 8 sec warning, and the BART train system. BART has implemented an automated train-stopping system that was activated (although no trains were running at 3:20 am). With the available network geometry and communications, the blind zone of the first alert had a radius of 16 km. The four stations that contributed to the first alert all encapsulate data into 1-second packets, but the latency in transmitting data to the processing center ranged from 0.27 to 2.62 seconds. If all the stations were to deliver data in 0.27 seconds, then the alert would have been available 2.3 sec sooner and the blind zone would be reduced to about 8 km. This would also mean that the city of Napa would have received about 1 second of warning. The magnitude estimate and event location were accurate from the initial alert onwards. The magnitude estimate did first increase to 5.8 and then dip to 5.4 2.6 sec after the initial alert, stayed at that level for 2 sec, and then returned to 5.7. The final magnitude estimate was 6.0, consistent with the ANSS catalog.

  11. A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety.

    PubMed

    Page, N; Baysari, M T; Westbrook, J I

    2017-09-01

    To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness. Twenty-three studies describing 32 alerts classified into 11 alert categories were identified. The most common alert categories studied were drug-condition interaction (n=6), drug-drug interaction alerts (n=6) and corollary order alerts (n=6). All 23 papers investigated the effect of the intervention alert on at least one outcome measure of prescriber behavior. Just over half of the studies (53%, n=17) reported a statistically significant beneficial effect from the intervention alert; 34% (n=11) reported no statistically significant effect, and 6% (n=2) reported a significant detrimental effect. Two studies also evaluated the effect of alerts on patient outcome measures; neither finding that patient outcomes significantly improved following alert implementation (6%, n=2). The greatest volume of evidence relates to three alert categories: drug-condition, drug-drug and corollary order alerts. Of these, drug-condition alerts had the greatest number of studies reporting positive effects (five out of six studies). Only two of six studies of drug-drug interaction and one of six of corollary alerts reported positive benefits. The current evidence-base does not show a clear indication that particular categories of alerts are more effective than others. While the majority of alert categories were shown to improve outcomes in some studies, there were also many cases where outcomes did not improve. This lack of evidence hinders decisions

  12. Perceptual evaluation of visual alerts in surveillance videos

    NASA Astrophysics Data System (ADS)

    Rogowitz, Bernice E.; Topkara, Mercan; Pfeiffer, William; Hampapur, Arun

    2015-03-01

    Visual alerts are commonly used in video monitoring and surveillance systems to mark events, presumably making them more salient to human observers. Surprisingly, the effectiveness of computer-generated alerts in improving human performance has not been widely studied. To address this gap, we have developed a tool for simulating different alert parameters in a realistic visual monitoring situation, and have measured human detection performance under conditions that emulated different set-points in a surveillance algorithm. In the High-Sensitivity condition, the simulated alerts identified 100% of the events with many false alarms. In the Lower-Sensitivity condition, the simulated alerts correctly identified 70% of the targets, with fewer false alarms. In the control condition, no simulated alerts were provided. To explore the effects of learning, subjects performed these tasks in three sessions, on separate days, in a counterbalanced, within subject design. We explore these results within the context of cognitive models of human attention and learning. We found that human observers were more likely to respond to events when marked by a visual alert. Learning played a major role in the two alert conditions. In the first session, observers generated almost twice as many False Alarms as in the No-Alert condition, as the observers responded pre-attentively to the computer-generated false alarms. However, this rate dropped equally dramatically in later sessions, as observers learned to discount the false cues. Highest observer Precision, Hits/(Hits + False Alarms), was achieved in the High Sensitivity condition, but only after training. The successful evaluation of surveillance systems depends on understanding human attention and performance.

  13. Maximizing Trust in the Wireless Emergency Alerts (WEA) Service

    DTIC Science & Technology

    2014-02-01

    Homeland Security under Contract No. FA8721-05-C-0003 with Carnegie Mellon University for the operation of the Software En - gineering Institute, a...AOs will protect their alert-generating systems from misuse. A compro- mised alert-generating system could overload the IPAWS-OPEN message validation...greater accessibility, such as accessing the WEA service re- motely from the scene of an incident. Although we are currently unaware of any alerting

  14. Implementation of a simple electronic transfusion alert system decreases inappropriate ordering of packed red blood cells and plasma in a multi-hospital health care system.

    PubMed

    Smith, Matthew; Triulzi, Darrell J; Yazer, Mark H; Rollins-Raval, Marian A; Waters, Jonathan H; Raval, Jay S

    2014-12-01

    Prescriber adherence to institutional blood component ordering guidelines can be low. The goal of this study was to decrease red blood cell (RBC) and plasma orders that did not meet institutional transfusion guidelines by using data within the laboratory information system to trigger alerts in the computerized order entry (CPOE) system at the time of order entry. At 10 hospitals within a regional health care system, discernment rules were created for RBC and plasma orders utilizing transfusion triggers of hemoglobin <8 gm/dl and INR >1.6, respectively, with subsequent alert generation that appears within the CPOE system when a prescriber attempts to order RBCs or plasma on a patient whose antecedent laboratory values do not suggest that a transfusion is indicated. Orders and subsequent alerts were tracked for RBCs and plasma over evaluation periods of 15 and 10 months, respectively, along with the hospital credentials of the ordering health care providers (physician or nurse). Alerts triggered which were heeded remained steady and averaged 11.3% for RBCs and 19.6% for plasma over the evaluation periods. Overall, nurses and physicians canceled statistically identical percentages of alerted RBC (10.9% vs. 11.5%; p = 0.78) and plasma (21.3% vs. 18.7%; p = 0.22) orders. Implementing a simple evidence-based transfusion alert system at the time of order entry decreased non-evidence based transfusion orders by both nurse and physician providers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Statistics from the Operation of the Low-Level Wind Shear Alert System (LLWAS) during the Joint Airport Weather Studies (JAWS) Project.

    DTIC Science & Technology

    1984-12-01

    AD-RI59 367 STATISTICS FROM THE OPERATION OF THE LOW-LEVEL WIND I/i SHEAR ALERT SYSTEM (L..(U) NATIONAL CENTER FOR ATOMSPHERIC RESEARCH BOULDER CO...NATIONAL BUREAU OF STANDARDS-1963A % % Oh b DOT/FAAIPM-84132 Statistics from the Operation of the Program Engineering Low-Level Wind Shear Alert System and...The Operation of The Low-Level Wind December 1984 Shear Alert System (LLWAS) During The JAWS Project: 6. Performing Organization Code An Interim Report

  16. Prescription order risk factors for pediatric dosing alerts.

    PubMed

    Stultz, J S; Porter, K; Nahata, M C

    2015-02-01

    To determine dosing alert rates based on prescription order characteristics and identify prescription order risk factors for the occurrence of dosing alerts. A retrospective analysis of inpatient medication orders and dosing alerts occurring during October 2011 and January, April, and July 2012 at a pediatric institution. Prescription orders and alerts were categorized by: medication class, patient age, route of administration, and month of the year. There were 228,259 orders during the studied period, with 11,072 alerted orders (4.9%). The most frequently alerted medication class was the non-analgesic central nervous system agent class (14% of alerts). Age, route, medication class, and month all independently affected dosing alert rates. The alert rate was highest for immunosuppressive agents (54%), neonates (6.7%), and orders for rectal administration (9.5%). The alert rate was higher in adult patients receiving their care at a pediatric institution (5.7%) compared to children (4.7%), but after multivariate analysis, pediatric orders had higher odds for an alert (OR 1.1, 95% CI 1.05-1.16). Mercaptopurine had the highest alert rate when categorized by active ingredient (73.9%). Albuterol 2.5mg/mL continuous aerosol and heparin 1000 units in 0.9% sodium chloride injection solution were the unique medications with the highest alert rates (100.0% and 97.7%, respectively). Certain types of prescription orders have a higher risk for causing dosing alerts than others. Patient age, medication class, route of administration, and the month of year can affect dosing alert rates. Design and customization efforts should focus on these medications and prescription order characteristics that increase the risk for dosing alerts. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Pilot Non-Conformance to Alerting System Commands During Closely Spaced Parallel Approaches

    NASA Technical Reports Server (NTRS)

    Pritchett, Amy R.; Hansman, R. John

    1997-01-01

    Pilot non-conformance to alerting system commands has been noted in general and to a TCAS-like collision avoidance system in a previous experiment. This paper details two experiments studying collision avoidance during closely-spaced parallel approaches in instrument meteorological conditions (IMC), and specifically examining possible causal factors of, and design solutions to, pilot non-conformance.

  18. Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project.

    PubMed

    Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R

    2017-01-01

    Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors' system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers' mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.

  19. Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project

    PubMed Central

    Boriani, Elena; Esposito, Roberto; Frazzoli, Chiara; Fantke, Peter; Hald, Tine; Rüegg, Simon R.

    2017-01-01

    Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required. PMID:28804707

  20. A Novel Free Flap Monitoring System Using Tissue Oximetry with Text Message Alerts.

    PubMed

    Ricci, Joseph A; Vargas, Christina R; Lin, Samuel J; Tobias, Adam M; Taghinia, Amir H; Lee, Bernard T

    2016-06-01

    Background The time to detection of vascular compromise is a significant predictor of free flap salvage outcomes as early reexploration improves salvage rates. Continuous transcutaneous near-infrared tissue oximetry is an objective, quantitative method of detecting flap vascular compromise and has been shown to allow earlier reexploration and higher salvage rates than clinical assessment alone. We designed a novel text messaging system to improve communication using tissue oximetry monitoring. Methods A retrospective review was performed of a prospectively collected database of all microsurgical breast reconstructions from 2008 to 2015. A novel text messaging system was introduced in 2013 and programmed to send text messages alert when the tissue oximetry readings suggested potential flap compromise based on established thresholds. Patient demographics and complications, including rate of reexploration and flap loss were assessed. Results There were 900 autologous microsurgical breast free flaps during the study period: 614 were monitored with standard clinical monitoring and tissue oximetry compared with 286 flaps with the additional text messaging system. There were 27 unplanned returns to the operating room in the tissue oximetry group and 5 in the text messaging group with 1 complete flap loss in each group. Reexploration occurred sooner as a result of these text message alerts (17.5 vs. 26.6 hours postoperatively), however, it did not achieve statistical significance. Conclusions We were able to demonstrate the use of a novel text messaging system for tissue oximetry. This alert system shows promise in identifying impending flap loss with rapid notification of the surgical team. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors

    PubMed Central

    Shah, Priya; Wyatt, Jeremy C; Makubate, Boikanyo; Cross, Frank W

    2011-01-01

    Objective Expert authorities recommend clinical decision support systems to reduce prescribing error rates, yet large numbers of insignificant on-screen alerts presented in modal dialog boxes persistently interrupt clinicians, limiting the effectiveness of these systems. This study compared the impact of modal and non-modal electronic (e-) prescribing alerts on prescribing error rates, to help inform the design of clinical decision support systems. Design A randomized study of 24 junior doctors each performing 30 simulated prescribing tasks in random order with a prototype e-prescribing system. Using a within-participant design, doctors were randomized to be shown one of three types of e-prescribing alert (modal, non-modal, no alert) during each prescribing task. Measurements The main outcome measure was prescribing error rate. Structured interviews were performed to elicit participants' preferences for the prescribing alerts and their views on clinical decision support systems. Results Participants exposed to modal alerts were 11.6 times less likely to make a prescribing error than those not shown an alert (OR 11.56, 95% CI 6.00 to 22.26). Those shown a non-modal alert were 3.2 times less likely to make a prescribing error (OR 3.18, 95% CI 1.91 to 5.30) than those not shown an alert. The error rate with non-modal alerts was 3.6 times higher than with modal alerts (95% CI 1.88 to 7.04). Conclusions Both kinds of e-prescribing alerts significantly reduced prescribing error rates, but modal alerts were over three times more effective than non-modal alerts. This study provides new evidence about the relative effects of modal and non-modal alerts on prescribing outcomes. PMID:21836158

  2. Optimizing the response to surveillance alerts in automated surveillance systems.

    PubMed

    Izadi, Masoumeh; Buckeridge, David L

    2011-02-28

    Although much research effort has been directed toward refining algorithms for disease outbreak alerting, considerably less attention has been given to the response to alerts generated from statistical detection algorithms. Given the inherent inaccuracy in alerting, it is imperative to develop methods that help public health personnel identify optimal policies in response to alerts. This study evaluates the application of dynamic decision making models to the problem of responding to outbreak detection methods, using anthrax surveillance as an example. Adaptive optimization through approximate dynamic programming is used to generate a policy for decision making following outbreak detection. We investigate the degree to which the model can tolerate noise theoretically, in order to keep near optimal behavior. We also evaluate the policy from our model empirically and compare it with current approaches in routine public health practice for investigating alerts. Timeliness of outbreak confirmation and total costs associated with the decisions made are used as performance measures. Using our approach, on average, 80 per cent of outbreaks were confirmed prior to the fifth day of post-attack with considerably less cost compared to response strategies currently in use. Experimental results are also provided to illustrate the robustness of the adaptive optimization approach and to show the realization of the derived error bounds in practice. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

    PubMed

    Caputo, Maria Luce; Muschietti, Sandro; Burkart, Roman; Benvenuti, Claudio; Conte, Giulio; Regoli, François; Mauri, Romano; Klersy, Catherine; Moccetti, Tiziano; Auricchio, Angelo

    2017-05-01

    We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP). The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mobile APP. Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was significantly reduced by the APP-based system (3.5 [2.8-5.2]) compared to the SMS-based system (5.6 [4.2-8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, p<0.01) with the APP. Earlier arrival of a first responder or of a lay responder determined a higher survival rate. The mobile APP system is highly efficient in the recruitment of first responders, significantly reducing the time to the initiation of CPR thus increasing survival rates. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Foodborne Norovirus State of Affairs in the EU Rapid Alert System for Food and Feed

    PubMed Central

    Papapanagiotou, Elias P.

    2017-01-01

    The European Union Rapid Alert System for Food and Feed (EU RASFF) database is an invaluable instrument for analyzing notifications involving norovirus in food. The aim of this work was to carry out a thorough research of the alert and border rejection notifications submitted in the RASFF database from its onset until 31 August 2017. Some conclusions of interest were: (i) Denmark, France, Italy, the Netherlands and Norway have contributed the majority of alert notifications as notifying countries, (ii) France and Serbia have been cited more often in alert notifications as countries of origin, (iii) Italy and Spain have submitted the majority of border rejection notifications, (iv) Third Countries implicated more frequently in border rejection notifications for norovirus in bivalve molluscs were Vietnam and Tunisia, whereas in fruits and vegetables were China and Serbia, (v) “risk dispersion” from norovirus-contaminated food was narrow since, in just over half of all alert notifications and all of the border rejection notifications, only up to three countries were involved, and (vi) both raw (oysters and berries) and cooked (mussels) food products can present a health risk to consumers. The information retrieved from the RASFF database on norovirus-contaminated food could prove helpful in the planning of future norovirus risk analysis endeavors. PMID:29186840

  5. A fresh look at runway incursions: onboard surface movement awareness and alerting system based on SVS

    NASA Astrophysics Data System (ADS)

    Vernaleken, Christoph; Mihalic, Lamir; Güttler, Mathias; Klingauf, Uwe

    2006-05-01

    Increasing traffic density on the aerodrome surface due to the continuous worldwide growth in the number of flight operations does not only cause capacity and efficiency problems, but also increases the risk of serious incidents and accidents on the airport movement area. Of these, Runway Incursions are the by far most safety-critical. In fact, the worst-ever accident in civil aviation, the collision of two Boeing B747s on Tenerife in 1977 with 583 fatalities, was caused by a Runway Incursion. Therefore, various Runway Safety programs have recently been initiated around the globe, often focusing on ground-based measures such as improved surveillance. However, as a lack of flight crew situational awareness is a key causal factor in many Runway Incursion incidents and accidents, there is a strong need for an onboard solution, which should be capable of interacting cooperatively with ground-based ATM systems, such as A-SMGCS where available. This paper defines the concept of preventive and reactive Runway Incursion avoidance and describes a Surface Movement Awareness & Alerting System (SMAAS) designed to alert the flight crew if they are at risk of infringing a runway. Both the SVS flight deck displays and the corresponding alerting algorithms utilize an ED 99A/RTCA DO-272A compliant aerodrome database, as well as airport operational, traffic and clearance data received via ADS-B or other data links, respectively. The displays provide the crew with enhanced positional, operational, clearance and traffic awareness, and they are used to visualize alerts. A future enhancement of the system will provide intelligent alerting for conflicts caused by surrounding traffic.

  6. Emergency vehicle alert system (EVAS)

    NASA Technical Reports Server (NTRS)

    Reed, Bill; Crump, Roger; Harper, Warren; Myneni, Krishna

    1995-01-01

    The Emergency Vehicle Alert System (EVAS) program is sponsored by the NASA/MSFC Technology Utilization (TU) office. The program was conceived to support the needs of hearing impaired drivers. The objective of the program is to develop a low-cost, small device which can be located in a personal vehicle and warn the driver, via a visual means, of the approach of an emergency vehicle. Many different technologies might be developed for this purpose and each has its own advantages and drawbacks. The requirements for an acoustic detection system, appear to be pretty stringent and may not allow the development of a reliable, low-cost device in the near future. The problems include variations in the sirens between various types of emergency vehicles, distortions due to wind and surrounding objects, competing background noise, sophisticated signal processing requirements, and omni-directional coverage requirements. Another approach is to use a Radio Frequency (RF) signal between the Emergency Vehicle (EV) and the Personal Vehicle (PV). This approach requires a transmitter on each EV and a receiver in each PV, however it is virtually assured that a system can be developed which works. With this approach, the real technology issue is how to make a system work as inexpensively as possible. This report gives a brief summary of the EVAS program from its inception and concentrates on describing the activities that occurred during Phase 4. References 1-3 describe activities under Phases 1-3. In the fourth phase of the program, the major effort to be expended was in development of the microcontroller system for the PV, refinement of some system elements and packaging for demonstration purposes. An EVAS system was developed and demonstrated which used standard spread spectrum modems with minor modifications.

  7. Hypoglycemic Accuracy and Improved Low Glucose Alerts of the Latest Dexcom G4 Platinum Continuous Glucose Monitoring System.

    PubMed

    Peyser, Thomas A; Nakamura, Katherine; Price, David; Bohnett, Lucas C; Hirsch, Irl B; Balo, Andrew

    2015-08-01

    Accuracy of continuous glucose monitoring (CGM) devices in hypoglycemia has been a widely reported shortcoming of this technology. We report the accuracy in hypoglycemia of a new version of the Dexcom (San Diego, CA) G4 Platinum CGM system (software 505) and present results regarding the optimum setting of CGM hypoglycemic alerts. CGM values were compared with YSI analyzer (YSI Life Sciences, Yellow Springs, OH) measurements every 15 min. We reviewed the accuracy of the CGM system in the hypoglycemic range using standard metrics. We analyzed the time required for the CGM system to detect biochemical hypoglycemia (70 mg/dL) compared with the YSI with alert settings at 70 mg/dL and 80 mg/dL. We also analyzed the time between the YSI value crossing 55 mg/dL, defined as the threshold for cognitive impairment due to hypoglycemia, and when the CGM system alerted for hypoglycemia. The mean absolute difference for a glucose level of less than 70 mg/dL was 6 mg/dL. Ninety-six percent of CGM values were within 20 mg/dL of the YSI values between 40 and 80 mg/dL. When the CGM hypoglycemic alert was set at 80 mg/dL, the device provided an alert for biochemical hypoglycemia within 10 min in 95% of instances and at least a 10-min advance warning before the cognitive impairment threshold in 91% of instances in the study. Use of an 80 mg/dL threshold setting for hypoglycemic alerts on the G4 Platinum (software 505) may provide patients with timely warning of hypoglycemia before the onset of cognitive impairment, enabling them to treat themselves for hypoglycemia with fast-acting carbohydrates and prevent neuroglycopenia associated with very low glucose levels.

  8. Diagnostic accuracy and effectiveness of automated electronic sepsis alert systems: A systematic review.

    PubMed

    Makam, Anil N; Nguyen, Oanh K; Auerbach, Andrew D

    2015-06-01

    Although timely treatment of sepsis improves outcomes, delays in administering evidence-based therapies are common. To determine whether automated real-time electronic sepsis alerts can: (1) accurately identify sepsis and (2) improve process measures and outcomes. We systematically searched MEDLINE, Embase, The Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature from database inception through June 27, 2014. Included studies that empirically evaluated 1 or both of the prespecified objectives. Two independent reviewers extracted data and assessed the risk of bias. Diagnostic accuracy of sepsis identification was measured by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio (LR). Effectiveness was assessed by changes in sepsis care process measures and outcomes. Of 1293 citations, 8 studies met inclusion criteria, 5 for the identification of sepsis (n = 35,423) and 5 for the effectiveness of sepsis alerts (n = 6894). Though definition of sepsis alert thresholds varied, most included systemic inflammatory response syndrome criteria ± evidence of shock. Diagnostic accuracy varied greatly, with PPV ranging from 20.5% to 53.8%, NPV 76.5% to 99.7%, LR+ 1.2 to 145.8, and LR- 0.06 to 0.86. There was modest evidence for improvement in process measures (ie, antibiotic escalation), but only among patients in non-critical care settings; there were no corresponding improvements in mortality or length of stay. Minimal data were reported on potential harms due to false positive alerts. Automated sepsis alerts derived from electronic health data may improve care processes but tend to have poor PPV and do not improve mortality or length of stay. © 2015 Society of Hospital Medicine.

  9. Diagnostic Accuracy and Effectiveness of Automated Electronic Sepsis Alert Systems: A Systematic Review

    PubMed Central

    Makam, Anil N.; Nguyen, Oanh K.; Auerbach, Andrew D.

    2015-01-01

    Background Although timely treatment of sepsis improves outcomes, delays in administering evidence-based therapies are common. Purpose To determine whether automated real-time electronic sepsis alerts can: 1) accurately identify sepsis, and 2) improve process measures and outcomes. Data Sources We systematically searched MEDLINE, Embase, The Cochrane Library, and CINAHL from database inception through June 27, 2014. Study Selection Included studies that empirically evaluated one or both of the prespecified objectives. Data Extraction Two independent reviewers extracted data and assessed the risk of bias. Diagnostic accuracy of sepsis identification was measured by sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and likelihood ratios (LR). Effectiveness was assessed by changes in sepsis care process measures and outcomes. Data Synthesis Of 1,293 citations, 8 studies met inclusion criteria, 5 for the identification of sepsis (n=35,423) and 5 for the effectiveness of sepsis alerts (n=6,894). Though definition of sepsis alert thresholds varied, most included systemic inflammatory response syndrome criteria ± evidence of shock. Diagnostic accuracy varied greatly, with PPV ranging from 20.5-53.8%, NPV 76.5-99.7%; LR+ 1.2-145.8; and LR- 0.06-0.86. There was modest evidence for improvement in process measures (i.e., antibiotic escalation), but only among patients in non-critical care settings; there were no corresponding improvements in mortality or length of stay. Minimal data were reported on potential harms due to false positive alerts. Conclusions Automated sepsis alerts derived from electronic health data may improve care processes but tend to have poor positive predictive value and do not improve mortality or length of stay. PMID:25758641

  10. Important imaging finding e-mail alert system: experience after 3 years of implementation.

    PubMed

    Abujudeh, Hani H; Kaewlai, Rathachai; Choy, Garry; Whelton, Dianne G; Rosenthal, Daniel I

    2009-09-01

    To evaluate the effectiveness of an important finding alert (IFA) system that uses e-mail technology to alert referring physicians to an important but nonurgent imaging finding. The institutional review board approved the study; the requirement for informed consent was waived. The authors retrospectively reviewed the radiology reports generated from January 2005 to December 2007 to determine how many reports contained an IFA statement, how many IFA messages were sent, and how many such messages were viewed by referring physicians. They reviewed 1000 randomly selected radiology reports that contained the IFA statement to identify the imaging modalities and findings that triggered the radiologists' use of the IFA system. A total of 1540254 radiology reports were generated during the 3-year period. A total of 56 691 (3.7%) reports contained the IFA statement. IFA e-mail messages were sent for 52 883 (93.3%) of the 56 691 reports, and 42 285 (74.6%) of the 56 691 reports were viewed by the referring physicians. The most common important but nonurgent findings were definitive (449 [44.9%] of 1000 reports) and indeterminate (260 [26.0%] of 1000 reports) abnormalities. More than half (n = 503) of the alerts were related to computed tomographic examinations, and the majority (n = 677, 67.7%) of them were initiated by thoracic and abdominal radiologists. The IFA system is a potentially useful method of communicating nonurgent but important imaging findings with use of e-mail technology.

  11. Wireless clinical alerts and patient outcomes in the surgical intensive care unit.

    PubMed

    Major, Kevin; Shabot, M Michael; Cunneen, Scott

    2002-12-01

    Errors in medicine have gained public interest since the Institute of Medicine published its 1999 report on this subject. Although errors of commission are frequently cited, errors of omission can be equally serious. A computerized surgical intensive care unit (SICU) information system when coupled to an event-driven alerting engine has the potential to reduce errors of omission for critical intensive care unit events. Automated alerts and patient outcomes were prospectively collected for all patients admitted to a tertiary-care SICU for a 2-year period. During the study period 3,973 patients were admitted to the SICU and received 13,608 days of care. A total of 15,066 alert pages were sent including alerts for physiologic condition (6,163), laboratory data (4,951), blood gas (3,774), drug allergy (130), and toxic drug levels (48). Admission Simplified Acute Physiology Score and Acute Physiology and Chronic Health Evaluation II score, SICU lengths of stay, and overall mortality rates were significantly higher in patients who triggered the alerting system. Patients triggering the alert paging system were 49.4 times more likely to die in the SICU compared with patients who did not generate an alert. Even after transfer to floor care the patients who triggered the alerting system were 5.7 times more likely to die in the hospital. An alert page identifies patients who will stay in the SICU longer and have a significantly higher chance of death compared with patients who do not trigger the alerting system.

  12. The effect of phasic auditory alerting on visual perception.

    PubMed

    Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus; Vangkilde, Signe; Habekost, Thomas

    2017-08-01

    Phasic alertness refers to a short-lived change in the preparatory state of the cognitive system following an alerting signal. In the present study, we examined the effect of phasic auditory alerting on distinct perceptual processes, unconfounded by motor components. We combined an alerting/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen's Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects visual perception by increasing the visual processing speed and lowering the threshold of conscious perception (Experiment 1). By manipulating the intensity of the alerting cue, we further observed a positive relationship between alerting intensity and processing speed, which was not seen for the threshold of conscious perception (Experiment 2). This was replicated in a third experiment, in which pupil size was measured as a physiological marker of alertness. Results revealed that the increase in processing speed was accompanied by an increase in pupil size, substantiating the link between alertness and processing speed (Experiment 3). The implications of these results are discussed in relation to a newly developed mathematical model of the relationship between levels of alertness and the speed with which humans process visual information. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

    PubMed

    Sagah Zadeh, Rana; Shepley, Mardelle; Sadatsafavi, Hessam; Owora, Arthur Hamie; Krieger, Ana C

    2018-04-01

    This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety. Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries. We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively. In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p < .05). By optimizing the physical environment and organizational policies and providing education programs, we have an opportunity to support healthcare professionals in managing sleepiness and maintaining alertness at work. In addition, such system level interventions may reduce unhealthy choices such as frequent caffeine intake to keep alert. The development of multidisciplinary evidence-based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

  14. Improving the health forecasting alert system for cold weather and heat-waves in England: a case-study approach using temperature-mortality relationships

    NASA Astrophysics Data System (ADS)

    Masato, Giacomo; Cavany, Sean; Charlton-Perez, Andrew; Dacre, Helen; Bone, Angie; Carmicheal, Katie; Murray, Virginia; Danker, Rutger; Neal, Rob; Sarran, Christophe

    2015-04-01

    The health forecasting alert system for cold weather and heatwaves currently in use in the Cold Weather and Heatwave plans for England is based on 5 alert levels, with levels 2 and 3 dependent on a forecast or actual single temperature action trigger. Epidemiological evidence indicates that for both heat and cold, the impact on human health is gradual, with worsening impact for more extreme temperatures. The 60% risk of heat and cold forecasts used by the alerts is a rather crude probabilistic measure, which could be substantially improved thanks to the state-of-the-art forecast techniques. In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater

  15. Physicians’ response to computerised alerts for psychotropic drugs in older persons: a multilevel analysis of the associated alert, patient and physician characteristics

    PubMed Central

    Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

    2012-01-01

    Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID

  16. Public Release of Estimated Impact-Based Earthquake Alerts - An Update to the U.S. Geological Survey PAGER System

    NASA Astrophysics Data System (ADS)

    Wald, D. J.; Jaiswal, K. S.; Marano, K.; Hearne, M.; Earle, P. S.; So, E.; Garcia, D.; Hayes, G. P.; Mathias, S.; Applegate, D.; Bausch, D.

    2010-12-01

    The U.S. Geological Survey (USGS) has begun publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses. These estimates should significantly enhance the utility of the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) system that has been providing estimated ShakeMaps and computing population exposures to specific shaking intensities since 2007. Quantifying earthquake impacts and communicating loss estimates (and their uncertainties) to the public has been the culmination of several important new and evolving components of the system. First, the operational PAGER system now relies on empirically-based loss models that account for estimated shaking hazard, population exposure, and employ country-specific fatality and economic loss functions derived using analyses of losses due to recent and past earthquakes. In some countries, our empirical loss models are informed in part by PAGER’s semi-empirical and analytical loss models, and building exposure and vulnerability data sets, all of which are being developed in parallel to the empirical approach. Second, human and economic loss information is now portrayed as a supplement to existing intensity/exposure content on both PAGER summary alert (available via cell phone/email) messages and web pages. Loss calculations also include estimates of the economic impact with respect to the country’s gross domestic product. Third, in order to facilitate rapid and appropriate earthquake responses based on our probable loss estimates, in early 2010 we proposed a four-level Earthquake Impact Scale (EIS). Instead of simply issuing median estimates for losses—which can be easily misunderstood and misused—this scale provides ranges of losses from which potential responders can gauge expected overall impact from strong shaking. EIS is based on two complementary criteria: the estimated cost of damage, which is most suitable for U

  17. Revocation of Academic Degrees by Colleges and Universities.

    ERIC Educational Resources Information Center

    Reams, Bernard D., Jr.

    1987-01-01

    Legal issues in an institution's revocation of a previously-awarded academic degree because of plagiarism or academic dishonesty are examined in light of the public-private sector dichotomy, and the legal processes to which an institution must be alert when seeking degree revocation are discussed. (MSE)

  18. Project ALERT: Forging New Partnerships to Improve Earth System Science Education for Pre-Service and In-Service Teachers

    NASA Astrophysics Data System (ADS)

    Metzger, E. P.; Ambos, E. L.; Ng, E. W.; Skiles, J.; Simila, G.; Garfield, N.

    2002-05-01

    Project ALERT (Augmented Learning Environment and Renewable Teaching) was founded in 1998, with funding from NASA and the California State University (CSU), to improve earth system science education for pre-service teachers. Project ALERT has formed linkages between ten campuses of the CSU, which prepares about 60 percent of California's teachers, and two NASA centers, Ames Research Center and the Jet Propulsion Laboratory. ALERT has also fostered alliances between earth science and science education faculty. The combined expertise of Project ALERT's diverse partners has led to a wide array of activities and products, including: 1) incorporation in university classrooms of NASA-developed imagery, data, and educational resources; 2) creation and/or enhancement of several courses that bring earth systems science to pre-service teachers; 3) fellowships for CSU faculty to participate in collaborative research and education projects at the NASA Centers; 4) development of teaching modules on such varied topics as volcanoes, landslides, and paleoclimate; and 5) a central web site that highlights resources for teaching introductory Earth system science. An outgrowth of Project ALERT is the increased interest on the part of CSU earth scientists in education issues. This has catalyzed their participation in other projects, including NASA's Project NOVA, Earth System Science Education Alliance, and Sun-Earth Connection Education Forum, the Digital Library for Earth System Science Education, and the California Science Project. Project ALERT has also expanded to provide professional development opportunities for in-service teachers, as exemplified by its support of the Bay Area Earth Science Institute (BAESI) at San Jose State University. Each year, BAESI offers 10-15 full-day workshops that supply teachers and teachers-to-be with a blend of science concepts and classroom activities, free instructional materials, and the opportunity to earn inexpensive university credit. These

  19. A new method for determining a sector alert

    DOT National Transportation Integrated Search

    2008-09-29

    The Traffic Flow Management System (TFMS) currently declares an alert for any 15-minute interval in which the predicted demand exceeds the Monitor/Alert Parameter (MAP) for any airport, sector, or fix. For a sector, TFMS predicts the demand for each ...

  20. Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

    PubMed

    Kim, Julia M; Rivera, Maria; Persing, Nichole; Bundy, David G; Psoter, Kevin J; Ghazarian, Sharon R; Miller, Marlene R; Solomon, Barry S

    2017-08-01

    The impact of electronic health record (EHR) immunization clinical alert systems on the delivery of other preventive services remains unknown. We assessed for spillover effects of an EHR immunization alert on delivery of 6 other preventive services, in children 18 to 30 months of age needing immunizations. We conducted a secondary data analysis, with additional primary data collection, of a randomized, historically controlled trial to improve immunization rates with EHR alerts, in an urban, primary care clinic. No significant differences were found in screening for anemia, lead, development, nutrition, and injury prevention counseling in children prompting EHR immunization alerts (n = 129), compared with controls (n = 135). Significant increases in oral health screening in patients prompting EHR alerts (odds ratio = 4.8, 95% CI = 1.8-13.0) were likely due to practice changes over time. An EHR clinical alert system targeting immunizations did not have a spillover effect on the delivery of other preventive services.

  1. Black Box Testing: Experiments with Runway Incursion Advisory Alerting System

    NASA Technical Reports Server (NTRS)

    Mukkamala, Ravi

    2005-01-01

    This report summarizes our research findings on the Black box testing of Runway Incursion Advisory Alerting System (RIAAS) and Runway Safety Monitor (RSM) system. Developing automated testing software for such systems has been a problem because of the extensive information that has to be processed. Customized software solutions have been proposed. However, they are time consuming to develop. Here, we present a less expensive, and a more general test platform that is capable of performing complete black box testing. The technique is based on the classification of the anomalies that arise during Monte Carlo simulations. In addition, we also discuss a generalized testing tool (prototype) that we have developed.

  2. Development of the Runway Incursion Advisory and Alerting System (RIAAS): Research Summary

    NASA Technical Reports Server (NTRS)

    Jones, Denise R. (Technical Monitor); Cassell, Rick

    2005-01-01

    This report summarizes research conducted on an aircraft based Runway Incursion Advisory and Alerting System (RIAAS) developed under a cooperative agreement between Rannoch Corporation and the NASA Langley Research Center. A summary of RIAAS is presented along with results from simulation and flight testing, safety benefits, and key technical issues.

  3. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Provider alert gateway requirements. 10.320 Section 10.320 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM... that each Participating Commercial Mobile Service provider is required to support and perform at its...

  4. Alerts in mobile healthcare applications: requirements and pilot study.

    PubMed

    Kafeza, Eleanna; Chiu, Dickson K W; Cheung, S C; Kafeza, Marina

    2004-06-01

    Recent advances in mobile technologies have greatly extended traditional communication technologies to mobile devices. At the same time, healthcare environments are by nature "mobile" where doctors and nurses do not have fixed workspaces. Irregular and exceptional events are generated in daily hospital routines, such as operations rescheduling, laboratory/examination results, and adverse drug events. These events may create requests that should be delivered to the appropriate person at the appropriate time. Those requests that are classified as urgent are referred to as alerts. Efficient routing and monitoring of alerts are keys to quality and cost-effective healthcare services. Presently, these are generally handled in an ad hoc manner. In this paper, we propose the use of a healthcare alert management system to handle these alert messages systematically. We develop a model for specifying alerts that are associated with medical tasks and a set of parameters for their routing. We design an alert monitor that matches medical staff and their mobile devices to receive alerts, based on the requirements of these alerts. We also propose a mechanism to handle and reroute, if necessary, an alert message when it has not been acknowledged within a specific deadline.

  5. 47 CFR 11.56 - EAS Participants receive CAP-formatted alerts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false EAS Participants receive CAP-formatted alerts... SYSTEM (EAS) Emergency Operations § 11.56 EAS Participants receive CAP-formatted alerts. Notwithstanding anything herein to the contrary, all EAS Participants must be able to receive CAP-formatted EAS alerts no...

  6. Real Time Flood Alert System (RTFAS) for Puerto Rico

    USGS Publications Warehouse

    Lopez-Trujillo, Dianne

    2010-01-01

    The Real Time Flood Alert System is a web-based computer program, developed as a data integration tool, and designed to increase the ability of emergency managers to rapidly and accurately predict flooding conditions of streams in Puerto Rico. The system includes software and a relational database to determine the spatial and temporal distribution of rainfall, water levels in streams and reservoirs, and associated storms to determine hazardous and potential flood conditions. The computer program was developed as part of a cooperative agreement between the U.S. Geological Survey Caribbean Water Science Center and the Puerto Rico Emergency Management Agency, and integrates information collected and processed by these two agencies and the National Weather Service.

  7. Optimization of drug-drug interaction alert rules in a pediatric hospital's electronic health record system using a visual analytics dashboard.

    PubMed

    Simpao, Allan F; Ahumada, Luis M; Desai, Bimal R; Bonafide, Christopher P; Gálvez, Jorge A; Rehman, Mohamed A; Jawad, Abbas F; Palma, Krisha L; Shelov, Eric D

    2015-03-01

    To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrelevant drug-drug interaction (DDI) alert rules. We analyzed the impact of the interventions on care providers' and pharmacists' alert and override rates using an interrupted time series framework with piecewise regression. We evaluated 2 391 880 medication alerts between January 31, 2011 and January 26, 2014. For pharmacists, the median alert rate prior to the first DDI deactivation was 58.74 alerts/100 orders (IQR 54.98-60.48) and 25.11 alerts/100 orders (IQR 23.45-26.57) following the three interventions (p<0.001). For providers, baseline median alert rate prior to the first round of DDI deactivation was 19.73 alerts/100 orders (IQR 18.66-20.24) and 15.11 alerts/100 orders (IQR 14.44-15.49) following the three interventions (p<0.001). In a subgroup analysis, we observed a decrease in pharmacists' override rates for DDI alerts that were not modified in the system from a median of 93.06 overrides/100 alerts (IQR 91.96-94.33) to 85.68 overrides/100 alerts (IQR 84.29-87.15, p<0.001). The medication serious safety event rate decreased during the study period, and there were no serious safety events reported in association with the deactivated alert rules. An alert dashboard facilitated safe rapid-cycle reductions in alert burden that were temporally associated with lower pharmacist override rates in a subgroup of DDIs not directly affected by the interventions; meanwhile, the pharmacists' frequency of selecting the 'cancel' option increased. We hypothesize that reducing the alert burden enabled pharmacists to devote more attention to clinically relevant alerts. © The Author 2014. Published by

  8. Stimulated reporting: the impact of US food and drug administration-issued alerts on the adverse event reporting system (FAERS).

    PubMed

    Hoffman, Keith B; Demakas, Andrea R; Dimbil, Mo; Tatonetti, Nicholas P; Erdman, Colin B

    2014-11-01

    The US Food and Drug Administration (FDA) uses the Adverse Event Reporting System (FAERS) to support post-marketing safety surveillance programs. Currently, almost one million case reports are submitted to FAERS each year, making it a vast repository of drug safety information. Sometimes cited as a limitation of FAERS, however, is the assumption that "stimulated reporting" of adverse events (AEs) occurs in response to warnings, alerts, and label changes that are issued by the FDA. To determine the extent of "stimulated reporting" in the modern-day FAERS database. One hundred drugs approved by the FDA between 2001 and 2010 were included in this analysis. FDA alerts were obtained by a comprehensive search of the FDA's MedWatch and main websites. Publicly available FAERS data were used to assess the "primary suspect" AE reporting pattern for up to four quarters before, and after, the issuance of an FDA alert. A few drugs did demonstrate "stimulated reporting" trends. A majority of the drugs, however, showed little evidence for significant reporting changes associated with the issuance of alerts. When we compared the percentage changes in reporting after an FDA alert with those after a sham "control alert", the overall reporting trends appeared to be quite similar. Of 100 drugs analyzed for short-term reporting trends, 21 real alerts and 25 sham alerts demonstrated an increase (greater than or equal to 1 %) in reporting. The long-term analysis of 91 drugs showed that 24 real alerts and 28 sham alerts demonstrated a greater than or equal to 1 % increase. Our results suggest that most of modern day FAERS reporting is not significantly affected by the issuance of FDA alerts.

  9. Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

    NASA Technical Reports Server (NTRS)

    Winder, Lee F.; Kuchar, James K.

    2000-01-01

    The goal of the research was to develop formal guidelines for the design of hazard avoidance systems. An alerting system is automation designed to reduce the likelihood of undesirable outcomes that are due to rare failures in a human-controlled system. It accomplishes this by monitoring the system, and issuing warning messages to the human operators when thought necessary to head off a problem. On examination of existing and recently proposed logics for alerting it appears that few commonly accepted principles guide the design process. Different logics intended to address the same hazards may take disparate forms and emphasize different aspects of performance, because each reflects the intuitive priorities of a different designer. Because performance must be satisfactory to all users of an alerting system (implying a universal meaning of acceptable performance) and not just one designer, a proposed logic often undergoes significant piecemeal modification before gamma general acceptance. This report is an initial attempt to clarify the common performance goals by which an alerting system is ultimately judged. A better understanding of these goals will hopefully allow designers to reach the final logic in a quicker, more direct and repeatable manner. As a case study, this report compares three alerting logics for collision prevention during independent approaches to parallel runways, and outlines a fourth alternative incorporating elements of the first three, but satisfying stated requirements. Three existing logics for parallel approach alerting are described. Each follows from different intuitive principles. The logics are presented as examples of three "philosophies" of alerting system design.

  10. Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

    PubMed

    Lacson, Ronilda; O'Connor, Stacy D; Sahni, V Anik; Roy, Christopher; Dalal, Anuj; Desai, Sonali; Khorasani, Ramin

    2016-07-01

    Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (p<0.0001, Cochran-Armitage trend test). The proportion of provider-communicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  11. Passive pavement-mounted acoustical linguistic drive alert system and method

    DOEpatents

    Kisner, Roger A.; Anderson, Richard L.; Carnal, Charles L.; Hylton, James O.; Stevens, Samuel S.

    2001-01-01

    Systems and methods are described for passive pavement-mounted acoustical alert of the occupants of a vehicle. A method of notifying a vehicle occupant includes providing a driving medium upon which a vehicle is to be driven; and texturing a portion of the driving medium such that the textured portion interacts with the vehicle to produce audible signals, the textured portion pattern such that a linguistic message is encoded into the audible signals. The systems and methods provide advantages because information can be conveyed to the occupants of the vehicle based on the location of the vehicle relative to the textured surface.

  12. Implementation of an alert and response system in Haiti during the early stage of the response to the cholera epidemic.

    PubMed

    Santa-Olalla, Patricia; Gayer, Michelle; Magloire, Roc; Barrais, Robert; Valenciano, Marta; Aramburu, Carmen; Poncelet, Jean Luc; Gustavo Alonso, Juan Carlos; Van Alphen, Dana; Heuschen, Florence; Andraghetti, Roberta; Lee, Robert; Drury, Patrick; Aldighieri, Sylvain

    2013-10-01

    The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and

  13. Implementation of an Alert and Response System in Haiti during the Early Stage of the Response to the Cholera Epidemic

    PubMed Central

    Santa-Olalla, Patricia; Gayer, Michelle; Magloire, Roc; Barrais, Robert; Valenciano, Marta; Aramburu, Carmen; Poncelet, Jean Luc; Gustavo Alonso, Juan Carlos; Van Alphen, Dana; Heuschen, Florence; Andraghetti, Roberta; Lee, Robert; Drury, Patrick; Aldighieri, Sylvain

    2013-01-01

    The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and

  14. Real-time Seismic Alert System of NIED

    NASA Astrophysics Data System (ADS)

    Horiuchi, S.; Fujinawa, Y.; Negishi, H.; Matsumoto, T.; Fujiwara, H.; Kunugi, T.; Hayashi, Y.

    2001-12-01

    An extensive seismic network has been constructed nationwide composed of hi-sensitivity seismographic network, broadband seismographic network and strong motion seismographic network. All these data from some 3,000 sites belonging to NIED, JMA and universities are to be accumulated and distributed through NIED to any scientists and engineering through INTERNET under the coordination of the National Seismic Research Committee of MEXT. As a practical application of those data we are now developing a real-time seismic alert information system for the purpose of providing short-term warning of imminent strong grounds motions from major earthquakes from several seconds to a few days. The contents of information are seismic focal parameters (several seconds), seismic fault plane solutions (some 10 seconds), after-shock activities (several minutes-a few days ). The fundamental fault parameters are used to build specific information at sites for particular users for use of triggering automated and /or half-automated responses. The most important application is an immediate estimate of expected shaking distribution and damages in a district using synthetic database and site effects for local governments to initial proper measures of hazard mitigation. Another application is estimation of arrival time and shaking strength at any individual site for human lives to be safeguarded. The system could also start an automatic electrical isolation and protection of computer systems, protection of hazardous chronic systems, transportation systems and so on. The information are corrected successively as seismic ground motion are received at a larger number of sites in time with the result that more accurate and more sophisticated earthquake information is transmitted to any user. Besides the rapid determination of seismic parameters, one of essential items in this alert system is the data transmission means. The data transmission is chosen to assure negligibly small delay of data

  15. Mexican Seismic Alert System's SAS-I algorithm review considering strong earthquakes felt in Mexico City since 1985

    NASA Astrophysics Data System (ADS)

    Cuellar Martinez, A.; Espinosa Aranda, J.; Suarez, G.; Ibarrola Alvarez, G.; Ramos Perez, S.; Camarillo Barranco, L.

    2013-05-01

    The Seismic Alert System of Mexico (SASMEX) uses three algorithms for alert activation that involve the distance between the seismic sensing field station (FS) and the city to be alerted; and the forecast for earthquake early warning activation in the cities integrated to the system, for example in Mexico City, the earthquakes occurred with the highest accelerations, were originated in the Pacific Ocean coast, whose distance this seismic region and the city, favors the use of algorithm called Algorithm SAS-I. This algorithm, without significant changes since its beginning in 1991, employs the data that generate one or more FS during P wave detection until S wave detection plus a period equal to the time employed to detect these phases; that is the double S-P time, called 2*(S-P). In this interval, the algorithm performs an integration process of quadratic samples from FS which uses a triaxial accelerometer to get two parameters: amplitude and growth rate measured until 2*(S-P) time. The parameters in SAS-I are used in a Magnitude classifier model, which was made from Guerrero Coast earthquakes time series, with reference to Mb magnitude mainly. This algorithm activates a Public or Preventive Alert if the model predicts whether Strong or Moderate earthquake. The SAS-I algorithm has been operating for over 23 years in the subduction zone of the Pacific Coast of Mexico, initially in Guerrero and followed by Oaxaca; and since March 2012 in the seismic region of Pacific covering the coasts among Jalisco, Colima, Michoacan, Guerrero and Oaxaca, where this algorithm has issued 16 Public Alert and 62 Preventive Alerts to the Mexico City where its soil conditions increase damages by earthquake such as the occurred in September 1985. This work shows the review of the SAS-I algorithm and possible alerts that it could generate from major earthquakes recordings detected by FS or seismometers near the earthquakes, coming from Pacific Ocean Coast whose have been felt in Mexico

  16. Building a Communication, Education, an Outreach Program for the ShakeAlert National Earthquake Early Warning Program

    NASA Astrophysics Data System (ADS)

    DeGroot, R. M.; Strauss, J. A.; Given, D. D.; Cochran, E. S.; Burkett, E. R.; Long, K.

    2016-12-01

    Earthquake Early Warning (EEW) systems can provide as much as tens of seconds of warning to people and automated systems before strong shaking arrives. The United States Geological Survey (USGS) and its partners are developing an EEW system for the West Coast of the United States. To be an integral part of successful implementation, EEW engagement programs and materials must integrate with and leverage broader earthquake risk programs. New methods and products for dissemination must be multidisciplinary, cost effective, and consistent with existing hazards education efforts. Our presentation outlines how the USGS and its partners will approach this effort in the context of the EEW system through the work of a multistate and multiagency committee that participates in the design, implementation, and evaluation of a portfolio of programs and products. This committee, referred to as the ShakeAlert Joint Committee for Communication, Education, and Outreach (ShakeAlert CEO), is working to identify, develop, and cultivate partnerships with EEW stakeholders including Federal, State, academic partners, private companies, policy makers, and local organizations. Efforts include developing materials, methods for delivery, and reaching stakeholders with information on EEW, earthquake preparedness, and emergency protective actions. It is essential to develop standards to ensure information communicated via the EEW alerts is consistent across the public and private sector and achieving a common understanding of what actions users take when they receive an EEW warning. The USGS and the participating states and agencies acknowledge that the implementation of EEW is a collective effort requiring the participation of hundreds of stakeholders committed to ensuring public accessibility.

  17. Volcanic Alert System (VAS) developed during the (2011-2013) El Hierro (Canary Islands) volcanic process

    NASA Astrophysics Data System (ADS)

    Ortiz, Ramon; Berrocoso, Manuel; Marrero, Jose Manuel; Fernandez-Ros, Alberto; Prates, Gonçalo; De la Cruz-Reyna, Servando; Garcia, Alicia

    2014-05-01

    In volcanic areas with long repose periods (as El Hierro), recently installed monitoring networks offer no instrumental record of past eruptions nor experience in handling a volcanic crisis. Both conditions, uncertainty and inexperience, contribute to make the communication of hazard more difficult. In fact, in the initial phases of the unrest at El Hierro, the perception of volcanic risk was somewhat distorted, as even relatively low volcanic hazards caused a high political impact. The need of a Volcanic Alert System became then evident. In general, the Volcanic Alert System is comprised of the monitoring network, the software tools for the analysis of the observables, the management of the Volcanic Activity Level, and the assessment of the threat. The Volcanic Alert System presented here places special emphasis on phenomena associated to moderate eruptions, as well as on volcano-tectonic earthquakes and landslides, which in some cases, as in El Hierro, may be more destructive than an eruption itself. As part of the Volcanic Alert System, we introduce here the Volcanic Activity Level which continuously applies a routine analysis of monitoring data (particularly seismic and deformation data) to detect data trend changes or monitoring network failures. The data trend changes are quantified according to the Failure Forecast Method (FFM). When data changes and/or malfunctions are detected, by an automated watchdog, warnings are automatically issued to the Monitoring Scientific Team. Changes in the data patterns are then translated by the Monitoring Scientific Team into a simple Volcanic Activity Level, that is easy to use and understand by the scientists and technicians in charge for the technical management of the unrest. The main feature of the Volcanic Activity Level is its objectivity, as it does not depend on expert opinions, which are left to the Scientific Committee, and its capabilities for early detection of precursors. As a consequence of the El Hierro

  18. Using Heuristic Evaluation to Improve Sepsis Alert Usability.

    PubMed

    Pertiwi, Ariani Arista Putri; Fraczkowski, Dan; Stogis, Sheryl L; Lopez, Karen Dunn

    2018-06-01

    Sepsis, life-threatening organ dysfunction in response to infection, is an alarmingly common and aggressive illness in US hospitals, especially for intensive care patients. Preventing sepsis deaths rests on the clinicians' ability to promptly recognize and treat sepsis. To aid early recognition, many organizations have employed clinician-facing electronic sepsis alert systems. However, the effectiveness of the alert relies on heavily on the visual interface, textual information, and overall usability. This article reports a usability inspection of a sepsis alert system. The authors found violations in 12 of the 14 usability principles and promote use of this method in practice to systematically identify usability problems. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Prototype Conflict Alerting Logic for Free Flight

    NASA Technical Reports Server (NTRS)

    Yang, Lee C.; Kuchar, James K.

    1997-01-01

    This paper discusses the development of a prototype alerting system for a conceptual Free Flight environment. The concept assumes that datalink between aircraft is available and that conflicts are primarily resolved on the flight deck. Four alert stages are generated depending on the likelihood of a conflict. If the conflict is not resolved by the flight crews, Air Traffic Control is notified to take over separation authority. The alerting logic is based on probabilistic analysis through modeling of aircraft sensor and trajectory uncertainties. Monte Carlo simulations were used over a range of encounter situations to determine conflict probability. The four alert stages were then defined based on probability of conflict and on the number of avoidance maneuvers available to the flight crew. Preliminary results from numerical evaluations and from a piloted simulator study at NASA Ames Research Center are summarized.

  20. Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

    PubMed Central

    Staes, Catherine J.; Evans, R. Scott; Rocha, Beatriz H.S.C.; Sorensen, John B.; Huff, Stanley M.; Arata, Joan; Narus, Scott P.

    2008-01-01

    Authors evaluated the impact of computerized alerts on the quality of outpatient laboratory monitoring for transplant patients. For 356 outpatient liver transplant patients managed at LDS Hospital, Salt Lake City, this observational study compared traditional laboratory result reporting, using faxes and printouts, to computerized alerts implemented in 2004. Study alerts within the electronic health record notified clinicians of new results and overdue new orders for creatinine tests and immunosuppression drug levels. After implementing alerts, completeness of reporting increased from 66 to >99 %, as did positive predictive value that a report included new information (from 46 to >99 %). Timeliness of reporting and clinicians' responses improved after implementing alerts (p <0.001): median times for clinicians to receive and complete actions decreased to 9 hours from 33 hours using the prior traditional reporting system. Computerized alerts led to more efficient, complete, and timely management of laboratory information. PMID:18308982

  1. Evaluation of negative results of BacT/Alert 3D automated blood culture system.

    PubMed

    Kocoglu, M Esra; Bayram, Aysen; Balci, Iclal

    2005-06-01

    Although automated continuous-monitoring blood culture systems are both rapid and sensitive, false-positive and false-negative results still occur. The objective of this study, then, was to evaluate negative results occurring with BacT/Alert 3D blood culture systems. A total of 1032 samples were cultured with the BacT/Alert 3D automated blood culture system, using both aerobic (FA) and anaerobic (FN) [corrected] media, and 128 of these samples yielded positive results. A total of 904 negative blood samples were then subcultured in 5% sheep blood agar, eosin methylene blue, chocolate agar, and sabouraud-dextrose agar. Organisms growing on these subcultures were subsequently identified using both Vitek32 (bioMerieux, Durham, NC) and conventional methods. Twenty four (2.6%) of the 904 subcultures grew on the subculture media. The majority (83.3%) of these were determined to be gram-positive microorganisms. Fourteen (58.3%) were coagulase-negative staphylococci, two (8.3%) were Bacillus spp., one (4.2%) was Staphylococcus aureus, and one (4.2%) was identified as Enterococcus faecium. Streptococcus pneumoniae and Neisseria spp. were isolated together in two (8.3%) vials. Gram-negative microorganisms comprised 12.5% of the subcultures, of which two (8.3%) were found to be Pseudomonas aeruginosa, and one (4.2%) was Pseudomonas fluorescens. The other isolate (4.2%) was identified as Candida albicans. We conclude that the subculture of negative results is valuable in the BacT/Alert 3D system, especially in situations in which only one set of blood cultures is taken.

  2. Alert status of nuclear weapons

    NASA Astrophysics Data System (ADS)

    Kristensen, Hans M.

    2017-11-01

    Nuclear Alert Forces. Four nuclear-armed states deploy nuclear warheads on alert, ready to be used on relatively short notice: United States, Russia, France and Britain. Combined, the four countries deploy an estimated 1,869 nuclear alert warheads. Russia and the United States deploy 1,749 alert warheads combined, or 94% of all alert warheads. Despite some debate about possible need to increase readiness of nuclear forces (China, Pakistan), the five other nuclear-armed states (China, Pakistan, India, Israel and North Korea) are thought to store their warheads separate from launchers under normal circumstances. The overall number of alert warheads has remained relatively stable during the past five years.

  3. Divers Alert Network

    MedlinePlus

    ... is Your Dive Safety Association Divers Alert Network DAN is Divers Alert Network, the diving industry’s largest ... Serving scuba divers for more than 30 years, DAN provides emergency assistance, medical information resources, educational opportunities ...

  4. Improving the Health Forecasting Alert System for Cold Weather and Heat-Waves In England: A Proof-of-Concept Using Temperature-Mortality Relationships.

    PubMed

    Masato, Giacomo; Bone, Angie; Charlton-Perez, Andrew; Cavany, Sean; Neal, Robert; Dankers, Rutger; Dacre, Helen; Carmichael, Katie; Murray, Virginia

    2015-01-01

    In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office's (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. The prototype health forecasting alert system introduces an "impact vs likelihood matrix" for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use.

  5. Implications of resolved hypoxemia on the utility of desaturation alerts sent from an anesthesia decision support system to supervising anesthesiologists.

    PubMed

    Epstein, Richard H; Dexter, Franklin

    2012-10-01

    Hypoxemia (oxygen saturation <90%) lasting 2 or more minutes occurs in 6.8% of adult patients undergoing noncardiac anesthesia in operating room settings. Alarm management functionality can be added to decision support systems (DSS) to send text alerts about vital signs outside specified thresholds, using data in anesthesia information management systems. We considered enhancing our DSS to send hypoxemia alerts to the text pagers of supervising anesthesiologists. As part of a voluntary application for an investigative device exemption from our IRB to implement such functionality, we evaluated the maximum potential utility of such an alert system. Pulse oximetry values (Spo(2)) were extracted from our anesthesia information management systems for all cases performed in our main operating rooms and ambulatory surgical center between September 1, 2011, and February 4, 2012 (n = 16,870). Hypoxemic episodes (Spo(2) < 90%) were characterized as either (a) lasting one or more minutes or (b) lasting 2 or more minutes. A single simulated "alert" was modeled as having been sent at the timestamp of the first (a) or the second (b) hypoxemic value. The hypoxemic episode was considered resolved at 1, 3, or 5 minutes after the time of the alert if the Spo(2) value was no longer below the 90% threshold. Two-sided 99% conservative confidence limits were calculated for the percentage of unresolved alerts at the 3 evaluation intervals and compared with 70%, the lower limit of an acceptable true alarm rate for clinical utility. There was at least 1 hypoxemic episode lasting 1 minute or longer in 23% of cases, and at least 1 episode lasting 2 minutes or longer in 8% of cases. Only 7% (99% confidence interval [CI] 6% to 8%) of the 1-minute hypoxemic episodes were unresolved after 3 minutes, and only 8% (99% CI 6%to 9%) of 2-minute episodes after 5 minutes (both P < 10(-6) in comparison with 70% minimum reliability rate). Low utility should be expected for a DSS sending hypoxemia alerts

  6. CISN ShakeAlert: Using early warnings for earthquakes in California

    NASA Astrophysics Data System (ADS)

    Vinci, M.; Hellweg, M.; Jones, L. M.; Khainovski, O.; Schwartz, K.; Lehrer, D.; Allen, R. M.; Neuhauser, D. S.

    2009-12-01

    Educated users who have developed response plans and procedures are just as important for an earthquake early warning (EEW) system as are the algorithms and computers that process the data and produce the warnings. In Japan, for example, the implementation of the EEW system which now provides advanced alerts of ground shaking included intense outreach efforts to both institutional and individual recipients. Alerts are now used in automatic control systems that stop trains, place sensitive equipment in safe mode and isolate hazards while the public takes cover. In California, the California Integrated Seismic Network (CISN) is now developing and implementing components of a prototype system for EEW, ShakeAlert. As this processing system is developed, we invite a suite of perspective users from critical industries and institutions throughout California to partner with us in developing useful ShakeAlert products and procedures. At the same time, we will support their efforts to determine and implement appropriate responses to an early warning of earthquake shaking. As a first step, in a collaboration with BART, we have developed a basic system allowing BART’s operation center to receive realtime ground shaking information from more than 150 seismic stations operating in the San Francisco Bay Area. BART engineers are implementing a display system for this information. Later phases will include the development of improved response procedures utilizing this information. We plan to continue this collaboration to include more sophisticated information from the prototype CISN ShakeAlert system.

  7. [Materials and articles intended to come into contact with food: evaluation of the rapid alert system for food and feed (RASFF) 2008-2010].

    PubMed

    Baiguini, Alessandro; Colletta, Stefano; Rebella, Valentina

    2011-01-01

    For some time, packaging materials and articles intended to come into contact with food are included in the system of controls, early warnings and risk communication provided by the European Commission (EU) regulation 178/2002. Data analysis of the EU rapid alert system for food allows one to define a specific risk profile and to establish an effective plan for official control of materials intended to come into contact with food. In the 2008-2010 period the rapid alert system has ratified alert notifications, mostly related to plastic materials of Chinese origin.

  8. Investigating the association of alerts from a national mortality surveillance system with subsequent hospital mortality in England: an interrupted time series analysis.

    PubMed

    Cecil, Elizabeth; Bottle, Alex; Esmail, Aneez; Wilkinson, Samantha; Vincent, Charles; Aylin, Paul P

    2018-05-04

    To investigate the association between alerts from a national hospital mortality surveillance system and subsequent trends in relative risk of mortality. There is increasing interest in performance monitoring in the NHS. Since 2007, Imperial College London has generated monthly mortality alerts, based on statistical process control charts and using routinely collected hospital administrative data, for all English acute NHS hospital trusts. The impact of this system has not yet been studied. We investigated alerts sent to Acute National Health Service hospital trusts in England in 2011-2013. We examined risk-adjusted mortality (relative risk) for all monitored diagnosis and procedure groups at a hospital trust level for 12 months prior to an alert and 23 months post alert. We used an interrupted time series design with a 9-month lag to estimate a trend prior to a mortality alert and the change in trend after, using generalised estimating equations. On average there was a 5% monthly increase in relative risk of mortality during the 12 months prior to an alert (95% CI 4% to 5%). Mortality risk fell, on average by 61% (95% CI 56% to 65%), during the 9-month period immediately following an alert, then levelled to a slow decline, reaching on average the level of expected mortality within 18 months of the alert. Our results suggest an association between an alert notification and a reduction in the risk of mortality, although with less lag time than expected. It is difficult to determine any causal association. A proportion of alerts may be triggered by random variation alone and subsequent falls could simply reflect regression to the mean. Findings could also indicate that some hospitals are monitoring their own mortality statistics or other performance information, taking action prior to alert notification. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless

  9. Self-Alert Training: Volitional Modulation of Autonomic Arousal Improves Sustained Attention

    ERIC Educational Resources Information Center

    O'Connell, Redmond G.; Bellgrove, Mark A.; Dockree, Paul M.; Lau, Adam; Fitzgerald, Michael; Robertson, Ian H.

    2008-01-01

    The present study examines a new alertness training strategy (Self-Alert Training, SAT) designed to explore the relationship between the top-down control processes governing arousal and sustained attention. In order to maximally target frontal control systems SAT combines a previously validated behavioural self-alerting technique [Robertson, I.…

  10. Closing the Loop in ICU Decision Support: Physiologic Event Detection, Alerts, and Documentation

    PubMed Central

    Norris, Patrick R.; Dawant, Benoit M.

    2002-01-01

    Automated physiologic event detection and alerting is a challenging task in the ICU. Ideally care providers should be alerted only when events are clinically significant and there is opportunity for corrective action. However, the concepts of clinical significance and opportunity are difficult to define in automated systems, and effectiveness of alerting algorithms is difficult to measure. This paper describes recent efforts on the Simon project to capture information from ICU care providers about patient state and therapy in response to alerts, in order to assess the value of event definitions and progressively refine alerting algorithms. Event definitions for intracranial pressure and cerebral perfusion pressure were studied by implementing a reliable system to automatically deliver alerts to clinical users’ alphanumeric pagers, and to capture associated documentation about patient state and therapy when the alerts occurred. During a 6-month test period in the trauma ICU at Vanderbilt University Medical Center, 530 alerts were detected in 2280 hours of data spanning 14 patients. Clinical users electronically documented 81% of these alerts as they occurred. Retrospectively classifying documentation based on therapeutic actions taken, or reasons why actions were not taken, provided useful information about ways to potentially improve event definitions and enhance system utility.

  11. Closing the loop in ICU decision support: physiologic event detection, alerts, and documentation.

    PubMed Central

    Norris, P. R.; Dawant, B. M.

    2001-01-01

    Automated physiologic event detection and alerting is a challenging task in the ICU. Ideally care providers should be alerted only when events are clinically significant and there is opportunity for corrective action. However, the concepts of clinical significance and opportunity are difficult to define in automated systems, and effectiveness of alerting algorithms is difficult to measure. This paper describes recent efforts on the Simon project to capture information from ICU care providers about patient state and therapy in response to alerts, in order to assess the value of event definitions and progressively refine alerting algorithms. Event definitions for intracranial pressure and cerebral perfusion pressure were studied by implementing a reliable system to automatically deliver alerts to clinical users alphanumeric pagers, and to capture associated documentation about patient state and therapy when the alerts occurred. During a 6-month test period in the trauma ICU at Vanderbilt University Medical Center, 530 alerts were detected in 2280 hours of data spanning 14 patients. Clinical users electronically documented 81% of these alerts as they occurred. Retrospectively classifying documentation based on therapeutic actions taken, or reasons why actions were not taken, provided useful information about ways to potentially improve event definitions and enhance system utility. PMID:11825238

  12. Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit.

    PubMed

    Klumpner, Thomas T; Kountanis, Joanna A; Langen, Elizabeth S; Smith, Roger D; Tremper, Kevin K

    2018-06-26

    Maternal early warning systems reduce maternal morbidity. We developed an electronic maternal surveillance system capable of visually summarizing the labor and delivery census and identifying changes in clinical status. Automatic page alerts to clinical providers, using an algorithm developed at our institution, were incorporated in an effort to improve early detection of maternal morbidity. We report the frequency of pages generated by the system. To our knowledge, this is the first time such a system has been used in peripartum care. Alert criteria were developed after review of maternal early warning systems, including the Maternal Early Warning Criteria (MEWC). Careful consideration was given to the frequency of pages generated by the surveillance system. MEWC notification criteria were liberalized and a paging algorithm was created that triggered paging alerts to first responders (nurses) and then managing services due to the assumption that paging all clinicians for each vital sign triggering MEWC would generate an inordinate number of pages. For preliminary analysis, to determine the effect of our automated paging algorithm on alerting frequency, the paging frequency of this system was compared to the frequency of vital signs meeting the Maternal Early Warning Criteria (MEWC). This retrospective analysis was limited to a sample of 34 patient rooms uniquely capable of storing every vital sign reported by the bedside monitor. Over a 91-day period, from April 1 to July 1, 2017, surveillance was conducted from 64 monitored beds, and the obstetrics service received one automated page every 2.3 h. The most common triggers for alerts were for hypertension and tachycardia. For the subset of 34 patient rooms uniquely capable of real-time recording, one vital sign met the MEWC every 9.6 to 10.3 min. Anecdotally, the system was well-received. This novel electronic maternal surveillance system is designed to reduce cognitive bias and improve timely clinical

  13. Maintained effectiveness of an electronic alert system to prevent venous thromboembolism among hospitalized patients.

    PubMed

    Lecumberri, Ramón; Marqués, Margarita; Díaz-Navarlaz, María Teresa; Panizo, Elena; Toledo, Jon; García-Mouriz, Alberto; Páramo, José A

    2008-10-01

    Despite current guidelines, venous thromboembolism (VTE) prophylaxis is underused. Computerized programs to encourage physicians to apply thromboprophylaxis have been shown to be effective in selected populations. Our aim was to analyze the impact of the implementation of a computer-alert system for VTE risk in all hospitalized patients of a teaching hospital. A computer program linked to the clinical record database was developed to assess all hospitalized patients' VTE risk daily. The physician responsible for patients at high risk was alerted, but remained free to order or withhold prophylaxis. Over 19,000 hospitalized, medical and surgical, adult patients between January to June 2005 (pre-intervention phase), January to June 2006 and January to June 2007 (post-intervention phase), were included. During the first semesters of 2006 and 2007, an electronic alert was sent to 32.8% and 32.2% of all hospitalized patients, respectively. Appropriate prophylaxis among alerted patients was ordered in 89.7% (2006) and 88.5% (2007) of surgical patients, and in 49.2% (2006) and 64.4% (2007) of medical patients. A sustained reduction of VTE during hospitalization was achieved, Odds ratio (OR): 0.53, 95% confidence interval (CI) (0.25-1.10) and OR: 0.51, 95%CI (0.24-1.05) during the first semesters of 2006 and 2007 respectively, the impact being significant (p < 0.05) among medical patients in 2007, OR: 0.36, 95%CI (0.12-0.98). The implementation of a computer-alert program helps physicians to assess each patient's thrombotic risk, leading to a better use of thromboprophylaxis, and a reduction in the incidence of VTE among hospitalized patients. For the first time, an intervention aimed to improve VTE prophylaxis shows maintained effectiveness over time.

  14. Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients

    PubMed Central

    Stultz, Jeremy S; Porter, Kyle; Nahata, Milap C

    2014-01-01

    Objectives To determine the sensitivity and specificity of a dosing alert system for dosing errors and to compare the sensitivity of a proprietary system with and without institutional customization at a pediatric hospital. Methods A retrospective analysis of medication orders, orders causing dosing alerts, reported adverse drug events, and dosing errors during July, 2011 was conducted. Dosing errors with and without alerts were identified and the sensitivity of the system with and without customization was compared. Results There were 47 181 inpatient pediatric orders during the studied period; 257 dosing errors were identified (0.54%). The sensitivity of the system for identifying dosing errors was 54.1% (95% CI 47.8% to 60.3%) if customization had not occurred and increased to 60.3% (CI 54.0% to 66.3%) with customization (p=0.02). The sensitivity of the system for underdoses was 49.6% without customization and 60.3% with customization (p=0.01). Specificity of the customized system for dosing errors was 96.2% (CI 96.0% to 96.3%) with a positive predictive value of 8.0% (CI 6.8% to 9.3). All dosing errors had an alert over-ridden by the prescriber and 40.6% of dosing errors with alerts were administered to the patient. The lack of indication-specific dose ranges was the most common reason why an alert did not occur for a dosing error. Discussion Advances in dosing alert systems should aim to improve the sensitivity and positive predictive value of the system for dosing errors. Conclusions The dosing alert system had a low sensitivity and positive predictive value for dosing errors, but might have prevented dosing errors from reaching patients. Customization increased the sensitivity of the system for dosing errors. PMID:24496386

  15. Glucose alert system improves health professional responses to adverse glycaemia and reduces the number of hyperglycaemic episodes in non-critical care inpatients.

    PubMed

    Kyi, M; Wraight, P R; Rowan, L M; Marley, K A; Colman, P G; Fourlanos, S

    2018-06-01

    To investigate the effect of a novel glucose alert system, comprising the Melbourne Glucose Alert Pathway and glucose-alert-capable networked blood glucose meters, on nursing and hospital medical officer responses to adverse glycaemia. A prospective, pre- and post-observational study was undertaken in non-critical care wards of a tertiary hospital over 4 months (n=148 or 660 patient-days). The intervention consisted of two components designed to promote a consistent staff response to blood glucose measurements: (1) a clinical escalation pathway, the Melbourne Glucose Alert Pathway, and (2) networked blood glucose meters, which provide a visual alert for out-of-range blood glucose measurement. All consecutive inpatients with diabetes were assessed for diabetes management and capillary blood glucose. The primary outcome was documented nursing and medical staff action in response to episodes of adverse glycaemia (blood glucose >15 mmol/l or <4 mmol/l). Secondary outcomes consisted of glycaemic measures. In response to episodes of adverse glycaemia, nursing action increased (proportion with nursing action: 45% to 73%; P<0.001), and medical action increased (proportion with medical action: 49% to 67%; P=0.011) with the glucose alert system in place. Patient-days with hyperglycaemia (any blood glucose value >15 mmol/l: 24% vs 16%; P=0.012) and patient-days with mean blood glucose >15 mmol/l (7.4% vs 2.6%; P=0.005) decreased. There was no difference in hypoglycaemia incidence. Use of a novel glucose alert system improved health professional responses to adverse glycaemia and decreased hyperglycaemia in the hospital setting. © 2018 Diabetes UK.

  16. Development of an "Alert Framework" Based on the Practices in the Medical Front.

    PubMed

    Sakata, Takuya; Araki, Kenji; Yamazaki, Tomoyoshi; Kawano, Koichi; Maeda, Minoru; Kushima, Muneo; Araki, Sanae

    2018-05-09

    At the University of Miyazaki Hospital (UMH), we have accumulated and semantically structured a vast amount of medical information since the activation of the electronic health record system approximately 10 years ago. With this medical information, we have decided to develop an alert system for aiding in medical treatment. The purpose of this investigation is to not only to integrate an alert framework into the electronic heath record system, but also to formulate a modeling method of this knowledge. A trial alert framework was developed for the staff in various occupational categories at the UMH. Based on findings of subsequent interviews, a more detailed and upgraded alert framework was constructed, resulting in the final model. Based on our current findings, an alert framework was developed with four major items. Based on the analysis of the medical practices from the trial model, it has been concluded that there are four major risk patterns that trigger the alert. Furthermore, the current alert framework contains detailed definitions which are easily substituted into the database, leading to easy implementation of the electronic health records.

  17. Clinical Decision Support Alert Appropriateness: A Review and Proposal for Improvement

    PubMed Central

    McCoy, Allison B.; Thomas, Eric J.; Krousel-Wood, Marie; Sittig, Dean F.

    2014-01-01

    Background Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when clinicians do not follow the guidance presented by the alert, can hinder improved patient outcomes. Methods We present a review of CDS alerts and describe a proposal to develop novel methods for evaluating and improving CDS alerts that builds upon traditional informatics approaches. Our proposal incorporates previously described models for predicting alert overrides that utilize retrospective chart review to determine which alerts are clinically relevant and which overrides are justifiable. Results Despite increasing implementations of CDS alerts, detailed evaluations rarely occur because of the extensive labor involved in manual chart reviews to determine alert and response appropriateness. Further, most studies have solely evaluated alert overrides that are appropriate or justifiable. Our proposal expands the use of web-based monitoring tools with an interactive dashboard for evaluating CDS alert and response appropriateness that incorporates the predictive models. The dashboard provides 2 views, an alert detail view and a patient detail view, to provide a full history of alerts and help put the patient's events in context. Conclusion The proposed research introduces several innovations to address the challenges and gaps in alert evaluations. This research can transform alert evaluation processes across healthcare settings, leading to improved CDS, reduced alert fatigue, and increased patient safety. PMID:24940129

  18. Improving the Health Forecasting Alert System for Cold Weather and Heat-Waves In England: A Proof-of-Concept Using Temperature-Mortality Relationships

    PubMed Central

    Masato, Giacomo; Bone, Angie; Charlton-Perez, Andrew; Cavany, Sean; Neal, Robert; Dankers, Rutger; Dacre, Helen; Carmichael, Katie; Murray, Virginia

    2015-01-01

    Objectives In this study a prototype of a new health forecasting alert system is developed, which is aligned to the approach used in the Met Office’s (MO) National Severe Weather Warning Service (NSWWS). This is in order to improve information available to responders in the health and social care system by linking temperatures more directly to risks of mortality, and developing a system more coherent with other weather alerts. The prototype is compared to the current system in the Cold Weather and Heatwave plans via a case-study approach to verify its potential advantages and shortcomings. Method The prototype health forecasting alert system introduces an “impact vs likelihood matrix” for the health impacts of hot and cold temperatures which is similar to those used operationally for other weather hazards as part of the NSWWS. The impact axis of this matrix is based on existing epidemiological evidence, which shows an increasing relative risk of death at extremes of outdoor temperature beyond a threshold which can be identified epidemiologically. The likelihood axis is based on a probability measure associated with the temperature forecast. The new method is tested for two case studies (one during summer 2013, one during winter 2013), and compared to the performance of the current alert system. Conclusions The prototype shows some clear improvements over the current alert system. It allows for a much greater degree of flexibility, provides more detailed regional information about the health risks associated with periods of extreme temperatures, and is more coherent with other weather alerts which may make it easier for front line responders to use. It will require validation and engagement with stakeholders before it can be considered for use. PMID:26431427

  19. Real-time monitoring of the human alertness level

    NASA Astrophysics Data System (ADS)

    Alvarez, Robin; del Pozo, Francisco; Hernando, Elena; Gomez, Eduardo; Jimenez, Antonio

    2003-04-01

    Many accidents are associated with a driver or machine operator's alertness level. Drowsiness often develops as a result of repetitive or monotonous tasks, uninterrupted by external stimuli. In order to enhance safety levels, it would be most desirable to monitor the individual's level of attention. In this work, changes in the power spectrum of the electroencephalographic signal (EEG) are associated with the subject's level of attention. This study reports on the initial research carried out in order to answer the following important questions: (i) Does a trend exist in the shape of the power spectrum, which will indicate the state of a subject's alertness state (drowsy, relaxed or alert)? (ii) What points on the cortex are most suitable to detect drowsiness and/or high alertness? (iii) What parameters in the power spectrum are most suitable to establish a workable alertness classification in human subjects? In this work, we answer these questions and combine power spectrum estimation and artificial neural network techniques to create a non-invasive and real - time system able to classify EEG into three levels of attention: High, Relaxed and Drowsiness. The classification is made every 10 seconds o more, a suitable time span for giving an alarm signal if the individual is with insufficient level of alertness. This time span is set by the user. The system was tested on twenty subjects. High and relaxed attention levels were measured in randomise hours of the day and drowsiness attention level was measured in the morning after one night of sleep deprivation.

  20. The effect of automated alerts on preoperative anemia management.

    PubMed

    Dilla, Andrew; Wisniewski, Mary Kay; Waters, Jonathan H; Triulzi, Darrell J; Yazer, Mark H

    2015-04-01

    This study evaluated the role of an automated anemia notification system that alerted providers about anemic pre-operative patients. After scheduling surgery, the alert program continuously searched the patient's laboratory data for hemoglobin value(s) in the medical record. When an anemic patient according to the World Health Oganization's criteria was identified, an email was sent to the patient's surgeon, and/or assistant, and/or patient's primary care physician suggesting that the anemia be managed before surgery. Thirteen surgeons participated in this pilot study. In 11 months, there were 70 pre-surgery anemia alerts generated on 69 patients. The surgeries were 60 orthopedic, 7 thoracic, 2 general surgery, and 1 urological. The alerts were sent 15 ± 10 days before surgery. No pre-operative anemia treatment could be found in 37 of 69 (54%) patients. Some form of anemia management was found in 32 of 69 (46%) patients. Of the 23 patients who received iron, only 3 of 23 (13%) of these patients started iron shortly after the alert was generated. The alert likely resulted in the postponement of one surgery for anemia correction. Although anemia diagnosis and management can be complex, it was hoped that receipt of the alert would lead to the management of all anemic patients. Alerts are only effective if they are received and read by a healthcare provider empowered to treat the patient or to make an appropriate referral. Automated preoperative alerts alone are not likely to alter surgeons' anemia management practices. These alerts need to be part of a comprehensive anemia management strategy.

  1. 49 CFR 229.140 - Alerters.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... alerters shall provide an audio alarm upon expiration of the timing cycle interval. An alerter on a... indication to the operator at least five seconds prior to an audio alarm. The visual indication on an alerter...

  2. Delivering Alert Messages to Members of a Work Force

    NASA Technical Reports Server (NTRS)

    Loftis, Julia; Nickens, Stephanie; Pell, Melissa; Pell, Vince

    2008-01-01

    Global Alert Resolution Network (GARNET) is a software system for delivering emergency alerts as well as less-urgent messages to members of the Goddard Space Flight Center work force via an intranet or the Internet, and can be adapted to similar use in other large organizations.

  3. 47 CFR 80.1113 - Transmission of a distress alert.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating...-shore distress alerts are used to alert Rescue Coordination Centers via coast stations or coast earth... (from a ship earth station or a satellite EPIRB) and terrestrial services (from ship stations and EPIRBs...

  4. 47 CFR 80.1113 - Transmission of a distress alert.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating...-shore distress alerts are used to alert Rescue Coordination Centers via coast stations or coast earth... (from a ship earth station or a satellite EPIRB) and terrestrial services (from ship stations and EPIRBs...

  5. 47 CFR 80.1113 - Transmission of a distress alert.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating...-shore distress alerts are used to alert Rescue Coordination Centers via coast stations or coast earth... (from a ship earth station or a satellite EPIRB) and terrestrial services (from ship stations and EPIRBs...

  6. Factors influencing alert acceptance: a novel approach for predicting the success of clinical decision support

    PubMed Central

    Seidling, Hanna M; Phansalkar, Shobha; Seger, Diane L; Paterno, Marilyn D; Shaykevich, Shimon; Haefeli, Walter E

    2011-01-01

    Background Clinical decision support systems can prevent knowledge-based prescription errors and improve patient outcomes. The clinical effectiveness of these systems, however, is substantially limited by poor user acceptance of presented warnings. To enhance alert acceptance it may be useful to quantify the impact of potential modulators of acceptance. Methods We built a logistic regression model to predict alert acceptance of drug–drug interaction (DDI) alerts in three different settings. Ten variables from the clinical and human factors literature were evaluated as potential modulators of provider alert acceptance. ORs were calculated for the impact of knowledge quality, alert display, textual information, prioritization, setting, patient age, dose-dependent toxicity, alert frequency, alert level, and required acknowledgment on acceptance of the DDI alert. Results 50 788 DDI alerts were analyzed. Providers accepted only 1.4% of non-interruptive alerts. For interruptive alerts, user acceptance positively correlated with frequency of the alert (OR 1.30, 95% CI 1.23 to 1.38), quality of display (4.75, 3.87 to 5.84), and alert level (1.74, 1.63 to 1.86). Alert acceptance was higher in inpatients (2.63, 2.32 to 2.97) and for drugs with dose-dependent toxicity (1.13, 1.07 to 1.21). The textual information influenced the mode of reaction and providers were more likely to modify the prescription if the message contained detailed advice on how to manage the DDI. Conclusion We evaluated potential modulators of alert acceptance by assessing content and human factors issues, and quantified the impact of a number of specific factors which influence alert acceptance. This information may help improve clinical decision support systems design. PMID:21571746

  7. AmberAlert / DPS / DHSEM / AAB

    Science.gov Websites

    cooperative public service alert to aid in the safe recovery of abducted children. The Alaska AMBER Alert children to aid in their safe return. AMBER Alert Hotline: 866-AKAMBER - (866-252-6237) State of Alaska

  8. Multicenter Clinical Evaluation of BacT/Alert Virtuo Blood Culture System.

    PubMed

    Jacobs, Michael R; Mazzulli, Tony; Hazen, Kevin C; Good, Caryn E; Abdelhamed, Ayman M; Lo, Pauline; Shum, Bianche; Roman, Katharine P; Robinson, Danielle C

    2017-08-01

    BacT/Alert Virtuo is an advanced, automated blood culture system incorporating improved automation and an enhanced detection algorithm to shorten time to detection. A multicenter study of the investigational Virtuo system (bioMérieux, Inc., Durham, NC) compared to BacT/Alert 3D (BTA3D) for detection of bacteremia/fungemia in four bottle types, SA and FA Plus (aerobic) and SN and FN Plus (anaerobic), was performed in a clinical setting with patient samples in a matched system design clinical trial. Blood was added to paired aerobic or anaerobic bottles, with the volume in each bottle in each pair required to be ≤10 ml and with the volumes required to be within 30% of each other. Of 5,709 bottle sets (52.5% aerobic pairs and 47.5% anaerobic pairs), 430 (7.5%) were positive for bacterial or fungal growth, with 342 (6.0%) clinically significant and 83 (1.5%) contaminated. A total of 3,539 sets (62.0%) were volume compliant, with 203 sets (5.7%) clinically significant. The positivity rates for volume-compliant bottle pairs determined by the two systems were comparable, with 68.7% of clinically significant isolates detected by both instruments, 15.7% by Virtuo only, and 15.7% by BTA3D only. Virtuo detected microbial growth nearly 2 h sooner overall than BTA3D (mean, 15.9 h versus 17.7 h). Shorter time to detection by Virtuo was related to organism group, with the time to detection being significantly shorter for enteric Gram-negative bacilli and enterococci (means, 3.6 h and 2.3 h shorter, respectively). This large clinical study demonstrated that the Virtuo blood culture system produced results comparable to those seen with the long-established BTA3D system, with significantly shorter time to detection. Copyright © 2017 Jacobs et al.

  9. Use of Circadian Lighting System to improve night shift alertness and performance of NRC Headquarters Operations Officers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Baker, T.L.; Morisseau, D.; Murphy, N.M.

    1995-04-01

    The Nuclear Regulatory Commission`s (NRC) Headquarters Operations Officers (HOOs) receive and respond to events reported in the nuclear industry on a 24-hour basis. The HOOs have reported reduced alertness on the night shift, leading to a potential deterioration in their on-shift cognitive performance during the early morning hours. For some HOOs, maladaptation to the night shift was also reported to be the principal cause of: (a) reduced alertness during the commute to and from work, (b) poor sleep quality, and (c) personal lifestyle problems. ShiftWork Systems, Inc. (SWS) designed and installed a Circadian Lighting System (CLS) at both the Bethesdamore » and Rockville HOO stations with the goal of facilitating the HOOs physiological adjustment to their night shift schedules. The data indicate the following findings: less subjective fatigue on night shifts; improved night shift alertness and mental performance; higher HOO confidence in their ability to assess event reports; longer, deeper and more restorative day sleep after night duty shifts; swifter adaptation to night work; and a safer commute, particularly for those with extensive drives.« less

  10. Dual-task performance consequences of imperfect alerting associated with a cockpit display of traffic information.

    PubMed

    Wickens, Christopher; Colcombe, Angela

    2007-10-01

    Performance consequences related to integrating an imperfect alert within a complex task domain were examined in two experiments. Cockpit displays of traffic information (CDTIs) are being designed for use in airplane cockpits as responsibility for safe separation becomes shared between pilots and controllers. Of interest in this work is how characteristics of the alarm system such as threshold, modality, and number of alert levels impact concurrent task (flight control) performance and response to potential conflicts. Student pilots performed a tracking task analogous to flight control while simultaneously monitoring for air traffic conflicts with the aid of a CDTI alert as the threshold, modality, and level of alert was varied. As the alerting system became more prone to false alerts, pilot compliance decreased and concurrent performance improved. There was some evidence of auditory preemption with auditory alerts as the false alarm rate increased. Finally, there was no benefit to a three-level system over a two-level system. There is justification for increased false alarm rates, as miss-prone systems appear to be costly. The 4:1 false alarm to miss ratio employed here improved accuracy and concurrent task performance. More research needs to address the potential benefits of likelihood alerting. The issues addressed in this research can be applied to any imperfect alerting system such as in aviation, driving, or air traffic control. It is crucial to understand the performance consequences of new technology and the efficacy of potential mitigating design features within the specific context desired.

  11. Alarms based on real-time sensor glucose values alert patients to hypo- and hyperglycemia: the guardian continuous monitoring system.

    PubMed

    Bode, Bruce; Gross, Kenneth; Rikalo, Nancy; Schwartz, Sherwyn; Wahl, Timothy; Page, Casey; Gross, Todd; Mastrototaro, John

    2004-04-01

    The purposes of this study were to demonstrate the accuracy and effectiveness of the Guardian Continuous Monitoring System (Medtronic MiniMed, Northridge, California) and to demonstrate that the application of real-time alarms to continuous monitoring alerts users to hypo and hyperglycemia and reduces excursions in people with diabetes. A total of 71 subjects with type 1 diabetes, mean hemoglobin A1c of 7.6 +/- 1.1%, age 44.0 +/- 11.4 years, and duration of diabetes 23.6 +/- 10.6 years were enrolled in this two-period, randomized, multicenter study. Subjects were randomized into either an Alert group or a Control group. The accuracy of the Guardian was evaluated by treating the study data as a single-sample correlational design. Effectiveness of the Guardian alerts was evaluated by comparing the Alert group with the Control group. The mean (median) absolute relative error between home blood glucose meter readings and sensor values was 21.3% (17.3%), and the Guardian, on average, read 12.8 mg/dL below the concurrent home blood glucose meter readings. The hypoglycemia alert was able to distinguished glucose values < or =70 mg/dL with 67% sensitivity, 90% specificity, and 47% false alerts. The hyperglycemia alert showed a similar ability to detect sensor values > or =250 mg/dL with 63% sensitivity, 97% specificity, and 19% false alerts. The Alert group demonstrated a median decrease in the duration of hypoglycemic excursions (-27.8 min) that was significantly greater than the median decrease in the duration of hypoglycemic excursions in the Control group (-4.5 min) (P = 0.03). A marginally significant increase in the frequency of hyperglycemic excursions (P = 0.07) between Period 1 and Period 2 was accompanied by a decrease of 9.6 min in the duration of hyperglycemic excursions in the Alert group. Glucose measurements differ between blood samples taken from the finger and interstitial fluid, especially when levels are changing rapidly; however, these results

  12. U.S. Geological Survey's Alert Notification System for Volcanic Activity

    USGS Publications Warehouse

    Gardner, Cynthia A.; Guffanti, Marianne C.

    2006-01-01

    The United States and its territories have about 170 volcanoes that have been active during the past 10,000 years, and most could erupt again in the future. In the past 500 years, 80 U.S. volcanoes have erupted one or more times. About 50 of these recently active volcanoes are monitored, although not all to the same degree. Through its five volcano observatories, the U.S. Geological Survey (USGS) issues information and warnings to the public about volcanic activity. For clarity of warnings during volcanic crises, the USGS has now standardized the alert-notification system used at its observatories.

  13. Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

    PubMed Central

    Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

    2016-01-01

    Objective To assess whether integrating critical result management software—Alert Notification of Critical Results (ANCR)—with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). Materials and Methods This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts (“alerts”) within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Results Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Conclusions Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. PMID:26335982

  14. Alarms about structural alerts.

    PubMed

    Alves, Vinicius; Muratov, Eugene; Capuzzi, Stephen; Politi, Regina; Low, Yen; Braga, Rodolpho; Zakharov, Alexey V; Sedykh, Alexander; Mokshyna, Elena; Farag, Sherif; Andrade, Carolina; Kuz'min, Victor; Fourches, Denis; Tropsha, Alexander

    2016-08-21

    Structural alerts are widely accepted in chemical toxicology and regulatory decision support as a simple and transparent means to flag potential chemical hazards or group compounds into categories for read-across. However, there has been a growing concern that alerts disproportionally flag too many chemicals as toxic, which questions their reliability as toxicity markers. Conversely, the rigorously developed and properly validated statistical QSAR models can accurately and reliably predict the toxicity of a chemical; however, their use in regulatory toxicology has been hampered by the lack of transparency and interpretability. We demonstrate that contrary to the common perception of QSAR models as "black boxes" they can be used to identify statistically significant chemical substructures (QSAR-based alerts) that influence toxicity. We show through several case studies, however, that the mere presence of structural alerts in a chemical, irrespective of the derivation method (expert-based or QSAR-based), should be perceived only as hypotheses of possible toxicological effect. We propose a new approach that synergistically integrates structural alerts and rigorously validated QSAR models for a more transparent and accurate safety assessment of new chemicals.

  15. A radar-based regional extreme rainfall analysis to derive the thresholds for a novel automatic alert system in Switzerland

    NASA Astrophysics Data System (ADS)

    Panziera, Luca; Gabella, Marco; Zanini, Stefano; Hering, Alessandro; Germann, Urs; Berne, Alexis

    2016-06-01

    This paper presents a regional extreme rainfall analysis based on 10 years of radar data for the 159 regions adopted for official natural hazard warnings in Switzerland. Moreover, a nowcasting tool aimed at issuing heavy precipitation regional alerts is introduced. The two topics are closely related, since the extreme rainfall analysis provides the thresholds used by the nowcasting system for the alerts. Warm and cold seasons' monthly maxima of several statistical quantities describing regional rainfall are fitted to a generalized extreme value distribution in order to derive the precipitation amounts corresponding to sub-annual return periods for durations of 1, 3, 6, 12, 24 and 48 h. It is shown that regional return levels exhibit a large spatial variability in Switzerland, and that their spatial distribution strongly depends on the duration of the aggregation period: for accumulations of 3 h and shorter, the largest return levels are found over the northerly alpine slopes, whereas for longer durations the southern Alps exhibit the largest values. The inner alpine chain shows the lowest values, in agreement with previous rainfall climatologies. The nowcasting system presented here is aimed to issue heavy rainfall alerts for a large variety of end users, who are interested in different precipitation characteristics and regions, such as, for example, small urban areas, remote alpine catchments or administrative districts. The alerts are issued not only if the rainfall measured in the immediate past or forecast in the near future exceeds some predefined thresholds but also as soon as the sum of past and forecast precipitation is larger than threshold values. This precipitation total, in fact, has primary importance in applications for which antecedent rainfall is as important as predicted one, such as urban floods early warning systems. The rainfall fields, the statistical quantity representing regional rainfall and the frequency of alerts issued in case of

  16. Sensor Alerting Capability

    NASA Astrophysics Data System (ADS)

    Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

    2013-04-01

    There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

  17. Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

    PubMed Central

    Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

    2017-01-01

    Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each

  18. Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

    PubMed

    Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

    2016-12-01

    To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Transient Alerts in LSST

    NASA Astrophysics Data System (ADS)

    Kantor, J.

    During LSST observing, transient events will be detected and alerts generated at the LSST Archive Center at NCSA in Champaign-Illinois. As a very high rate of alerts is expected, approaching ˜ 10 million per night, we plan for VOEvent-compliant Distributor/Brokers (http://voevent.org) to be the primary end-points of the full LSST alert streams. End users will then use these Distributor/Brokers to classify and filter events on the stream for those fitting their science goals. These Distributor/Brokers are envisioned to be operated as a community service by third parties who will have signed MOUs with LSST. The exact identification of Distributor/Brokers to receive alerts will be determined as LSST approaches full operations and may change over time, but it is in our interest to identify and coordinate with them as early as possible. LSST will also operate a limited Distributor/Broker with a filtering capability at the Archive Center, to allow alerts to be sent directly to a limited number of entities that for some reason need to have a more direct connection to LSST. This might include, for example, observatories with significant follow-up capabilities whose observing may temporarily be more directly tied to LSST observing. It will let astronomers create simple filters that limit what alerts are ultimately forwarded to them. These user defined filters will be possible to specify using an SQL-like declarative language, or short snippets of (likely Python) code. We emphasize that this LSST-provided capability will be limited, and is not intended to satisfy the wide variety of use cases that a full-fledged public Event Distributor/Broker could. End users will not be able to subscribe to full, unfiltered, alert streams coming directly from LSST. In this session, we will discuss anticipated LSST data rates, and capabilities for alert processing and distribution/brokering. We will clarify what the LSST Observatory will provide versus what we anticipate will be a

  20. Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

    PubMed

    O'Connor, Stacy D; Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

    2016-03-01

    To assess whether integrating critical result management software--Alert Notification of Critical Results (ANCR)--with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Medical alert bracelet (image)

    MedlinePlus

    People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ... People with diabetes should always wear a medical alert bracelet or necklace that emergency medical workers will ...

  2. With Free Google Alert Services

    ERIC Educational Resources Information Center

    Gunn, Holly

    2005-01-01

    Alert services are a great way of keeping abreast of topics that interest you. Rather than searching the Web regularly to find new content about your areas of interest, an alert service keeps you informed by sending you notices when new material is added to the Web that matches your registered search criteria. Alert services are examples of push…

  3. EU alerting and reporting systems for potential chemical public health threats and hazards.

    PubMed

    Orford, R; Crabbe, H; Hague, C; Schaper, A; Duarte-Davidson, R

    2014-11-01

    A number of European and international IT platforms are used to notify competent authorities of new potential chemical exposures. Recently the European Parliament and the Council of European Union adopted new legislation that aims to improve the co-ordinated response to cross border health threats (Decision 1082/2013/EU). The Decision, inter alia, sets provisions on notification, ad hoc monitoring and coordination of public health measures following serious cross border threats to health from biological, chemical and environmental events as well as events that have an unknown origin. The legal instrument applies to all European Union Member States and is comparable to the International Health Regulations in its content, requirements and adoption of a multiple hazards approach. An inter-sectoral and multidisciplinary response to events with potentially dangerous cross border exposure pathways is often required. For example, European Poisons Centres may be aware of cases of toxic exposure to a product and, in parallel, trading standards may be aware of the same product due to a breach of consumer product standards. Whilst both cases would have been recorded for separate purposes in different alerting systems, they relate to the same exposure pathway; therefore a process for linking these records would allow a more robust approach to risk assessment and risk mitigation. The Decision seeks to reconcile this issue for serious threats by linking relevant platforms into one overarching higher level risk management IT platform called the Early Warning Response System (EWRS). This system will serve to link other sectors within the European Commission (EC) to public health (e.g. medicines), as well as other EU agencies and international bodies via co-notification features. Other European alert systems will be linked to EWRS to facilitate information sharing at both the assessment and management levels. This paper provides a timely overview of the main systems run by the EC

  4. A new approach to monitoring and alerting congestion in airspace sectors

    DOT National Transportation Integrated Search

    2014-09-28

    The Federal Aviation Administration (FAA) Traffic Flow Management System (TFMS)currently declares an alert for any 15 minute interval in which the predicted demand exceeds the Monitor/Alert Parameter (MAP)for any airport, sector, or fix. For airports...

  5. Adherence to drug-drug interaction alerts in high-risk patients: a trial of context-enhanced alerting.

    PubMed

    Duke, Jon D; Li, Xiaochun; Dexter, Paul

    2013-05-01

    Drug-drug interaction (DDI) alerting is an important form of clinical decision support, yet physicians often fail to attend to critical DDI warnings due to alert fatigue. We previously described a model for highlighting patients at high risk of a DDI by enhancing alerts with relevant laboratory data. We sought to evaluate the effect of this model on alert adherence in high-risk patients. A 6-month randomized controlled trial involving 1029 outpatient physicians was performed. The target interactions were all DDIs known to cause hyperkalemia. Alerts in the intervention group were enhanced with the patient's most recent potassium and creatinine levels. The control group received unmodified alerts. High -risk patients were those with baseline potassium >5.0 mEq/l and/or creatinine ≥1.5 mg/dl (132 μmol/l). We found no significant difference in alert adherence in high-risk patients between the intervention group (15.3%) and the control group (16.8%) (p=0.71). Adherence in normal risk patients was significantly lower in the intervention group (14.6%) than in the control group (18.6%) (p<0.01). In neither group did physicians increase adherence in patients at high risk. Physicians adhere poorly to hyperkalemia-associated DDI alerts even in patients with risk factors for a clinically significant interaction, and the display of relevant laboratory data in these alerts did not improve adherence levels in the outpatient setting. Further research is necessary to determine optimal strategies for conveying patient-specific DDI risk.

  6. Randomized Trial of Intelligent Sensor System for Early Illness Alerts in Senior Housing.

    PubMed

    Rantz, Marilyn; Phillips, Lorraine J; Galambos, Colleen; Lane, Kari; Alexander, Gregory L; Despins, Laurel; Koopman, Richelle J; Skubic, Marjorie; Hicks, Lanis; Miller, Steven; Craver, Andy; Harris, Bradford H; Deroche, Chelsea B

    2017-10-01

    Measure the clinical effectiveness and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. This sensor system has demonstrated in pilot studies to detect changes in function and in chronic diseases or acute illnesses on average 10 days to 2 weeks before usual assessment methods or self-reports of illness. Prospective intervention study in 13 assisted living (AL) communities of 171 residents randomly assigned to intervention (n=86) or comparison group (n=85) receiving usual care. Intervention participants lived with the sensor system an average of one year. Continuous data collected 24 hours/7 days a week from motion sensors to measure overall activity, an under mattress bed sensor to capture respiration, pulse, and restlessness as people sleep, and a gait sensor that continuously measures gait speed, stride length and time, and automatically assess for increasing fall risk as the person walks around the apartment. Continuously running computer algorithms are applied to the sensor data and send health alerts to staff when there are changes in sensor data patterns. The randomized comparison group functionally declined more rapidly than the intervention group. Walking speed and several measures from GaitRite, velocity, step length left and right, stride length left and right, and the fall risk measure of functional ambulation profile (FAP) all had clinically significant changes. The walking speed increase (worse) and velocity decline (worse) of 0.073 m/s for comparison group exceeded 0.05 m/s, a value considered to be a minimum clinically important difference. No differences were measured in health care costs. These findings demonstrate that sensor data with health alerts and fall alerts sent to AL nursing staff can be an effective strategy to detect and intervene in early signs of illness or functional decline. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published

  7. Alerts of forest disturbance from MODIS imagery

    NASA Astrophysics Data System (ADS)

    Hammer, Dan; Kraft, Robin; Wheeler, David

    2014-12-01

    This paper reports the methodology and computational strategy for a forest cover disturbance alerting system. Analytical techniques from time series econometrics are applied to imagery from the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor to detect temporal instability in vegetation indices. The characteristics from each MODIS pixel's spectral history are extracted and compared against historical data on forest cover loss to develop a geographically localized classification rule that can be applied across the humid tropical biome. The final output is a probability of forest disturbance for each 500 m pixel that is updated every 16 days. The primary objective is to provide high-confidence alerts of forest disturbance, while minimizing false positives. We find that the alerts serve this purpose exceedingly well in Pará, Brazil, with high probability alerts garnering a user accuracy of 98 percent over the training period and 93 percent after the training period (2000-2005) when compared against the PRODES deforestation data set, which is used to assess spatial accuracy. Implemented in Clojure and Java on the Hadoop distributed data processing platform, the algorithm is a fast, automated, and open source system for detecting forest disturbance. It is intended to be used in conjunction with higher-resolution imagery and data products that cannot be updated as quickly as MODIS-based data products. By highlighting hotspots of change, the algorithm and associated output can focus high-resolution data acquisition and aid in efforts to enforce local forest conservation efforts.

  8. Effects of conflict alerting system reliability and task difficulty on pilots' conflict detection with cockpit display of traffic information.

    PubMed

    Xu, Xidong; Wickens, Christopher D; Rantanen, Esa M

    2007-01-15

    A total of 24 pilots viewed dynamic encounters between their own aircraft and an intruder aircraft on a 2-D cockpit display of traffic information (CDTI) and estimated the point and time of closest approach. A three-level alerting system provided a correct categorical estimate of the projected miss distance on 83% of the trials. The remaining 17% of alerts were equally divided between misses and false alarms, of large and small magnitude. Roughly half the pilots depended on automation to improve estimation of miss distance relative to the baseline pilots, who viewed identical trials without the aid of automated alerts. Moreover, they did so more on the more difficult traffic trials resulting in improved performance on the 83% correct automation trials without causing harm on the 17% automation-error trials, compared to the baseline group. The automated alerts appeared to lead pilots to inspect the raw data more closely. While assisting the accurate prediction of miss distance, the automation led to an underestimate of the time remaining until the point of closest approach. The results point to the benefits of even imperfect automation in the strategic alerts characteristic of the CDTI, at least as long as this reliability remains high (above 80%).

  9. Prioritizing earthquake and tsunami alerting efforts

    NASA Astrophysics Data System (ADS)

    Allen, R. M.; Allen, S.; Aranha, M. A.; Chung, A. I.; Hellweg, M.; Henson, I. H.; Melgar, D.; Neuhauser, D. S.; Nof, R. N.; Strauss, J. A.

    2015-12-01

    The timeline of hazards associated with earthquakes ranges from seconds for the strong shaking at the epicenter, to minutes for strong shaking at more distant locations in big quakes, to tens of minutes for a local tsunami. Earthquake and tsunami warning systems must therefore include very fast initial alerts, while also taking advantage of available time in bigger and tsunami-generating quakes. At the UC Berkeley Seismological Laboratory we are developing a suite of algorithms to provide the fullest possible information about earthquake shaking and tsunami inundation from seconds to minutes after a quake. The E-larmS algorithm uses the P-wave to rapidly detect an earthquake and issue a warning. It is currently issuing alerts to test users in as little as 3 sec after the origin time. Development of a new waveform detector may lead to even faster alerts. G-larmS uses permanent deformation estimates from GNSS stations to estimate the geometry and extent of rupture underway providing more accurate ground shaking estimates in big (M>~7) earthquakes. It performed well in the M6.0 2014 Napa earthquake. T-larmS is a new algorithm designed to extend alert capabilities to tsunami inundation. Rapid estimates of source characteristics for subduction zones event can not only be used to warn of the shaking hazard, but also the local tsunami inundation hazard. These algorithms are being developed, implemented and tested with a focus on the western US, but are also now being tested in other parts of the world including Israel, Turkey, Korea and Chile. Beta users in the Bay Area are receiving the alerts and beginning to implement automated actions. They also provide feedback on users needs, which has led to the development of the MyEEW smartphone app. This app allows beta users to receive the alerts on their cell phones. All these efforts feed into our ongoing assessment of directions and priorities for future development and implementation efforts.

  10. PubMedAlertMe - Standalone Windows-based PubMed SDI Software Application

    PubMed Central

    Ma’ayan, Avi

    2008-01-01

    PubMedAlertMe is a Windows-based software system for automatically receiving e-mail alert messages about recent publications listed on PubMed. The e-mail messages contain links to newly available abstracts listed on PubMed describing publications that were selectively returned from a specified list of queries. Links are also provided to directly export citations to EndNote, and links are provided to directly forward articles to colleagues. The program is standalone. Thus, it does not require a remote mail server or user registration. PubMedAlertMe is free software, and can be downloaded from: http://amp.pharm.mssm.edu/PubMedAlertMe/PubMedAlertMe_setup.zip PMID:18402930

  11. For whom the bell tolls: Silver Alerts raise concerns regarding individual rights and governmental interests.

    PubMed

    Wasser, Tobias D; Fox, Patrick K

    2013-01-01

    The Silver Alert system was initially created to help protect missing persons who have cognitive impairments, particularly the elderly. The Silver Alert is modeled after the Amber Alert, created to help locate and safeguard missing children. Unlike the Amber Alert, however, in most states the Silver Alert applies to the elderly, adults with a mental impairment, or both, depending on the state. The goal of the Silver Alert system is the quick dissemination of information about missing persons to law enforcement personnel as well as to the general public. Previously, states notified law enforcement personnel of missing persons through teletype to other public safety jurisdictions to enlist their assistance in the retrieval of the missing person. Silver Alert programs substantially expand the notification to include the general public, who receive information through radio and television broadcasts as well as highway billboards. The programs serve a legitimate governmental interest by protecting a vulnerable population from possible harm. Yet, the implementation of these alerts can have unintended consequences, including the possible violation of an individual's right to privacy. Such consequences require careful consideration.

  12. Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

    PubMed

    Epstein, Richard H; Dexter, Franklin; Patel, Neil

    2015-09-01

    In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system

  13. Time-to-detection of bacteria and yeast with the BACTEC FX versus BacT/Alert Virtuo blood culture systems.

    PubMed

    Somily, Ali Mohammed; Habib, Hanan Ahmed; Torchyan, Armen Albert; Sayyed, Samina B; Absar, Muhammed; Al-Aqeel, Rima; Binkhamis, A Khalifa

    2018-01-01

    Bloodstream infections are associated with high rates of morbidity and mortality. Rapid detection of bloodstream infections is important in achieving better patient outcomes. Compare the time-to-detection (TTD) of the new BacT/Alert Virtuo and the BACTEC FX automated blood culture systems. Prospective simulated comparison of two instruments using seeded samples. Medical microbiology laboratory. Blood culture bottles were seeded in triplicate with each of the standard ATCC strains of aerobes, anaerobes and yeast. TTD was calculated as the length of time from the beginning of culture incubation to the detection of bacterial growth. TTD for the various tested organisms on the two microbial detection systems. The 99 bottles of seeded blood cultures incubated in each of the blood culture systems included 21 anaerobic, 39 aerobic and 39 pediatric bottles. The BacT/Alert Virtuo system exhibited significantly shorter TTD for 72.7 % of the tested organisms compared to BACTEC FX system with a median difference in mean TTD of 2.1 hours (interquartile range: 1.5-3.5 hours). The BACTEC FX system was faster in 15.2% (5/33) of microorganisms, with a median difference in mean TTD of 25.9 hours (IQR: 9.1-29.2 hours). TTD was significantly shorter for most of the microorganisms tested on the new BacT/Alert Virtuo system compared to the BACTEC FX system. Use of simulated cultures to assess TTD may not precisely represent clinical blood cultures. None.

  14. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  15. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  16. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  17. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  18. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  19. Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015.

    PubMed

    Lee, Christopher T; Bulterys, Marc; Martel, Lise D; Dahl, Benjamin A

    2016-03-11

    The epidemic of Ebola virus disease (Ebola) in West Africa began in Guinea in late 2013 (1), and on August 8, 2014, the World Health Organization (WHO) declared the epidemic a Public Health Emergency of International Concern (2). Guinea was declared Ebola-free on December 29, 2015, and is under a 90 day period of enhanced surveillance, following 3,351 confirmed and 453 probable cases of Ebola and 2,536 deaths (3). Passive surveillance for Ebola in Guinea has been conducted principally through the use of a telephone alert system. Community members and health facilities report deaths and suspected Ebola cases to local alert numbers operated by prefecture health departments or to a national toll-free call center. The national call center additionally functions as a source of public health information by responding to questions from the public about Ebola. To evaluate the sensitivity of the two systems and compare the sensitivity of the national call center with the local alerts system, the CDC country team performed probabilistic record linkage of the combined prefecture alerts database, as well as the national call center database, with the national viral hemorrhagic fever (VHF) database; the VHF database contains records of all known confirmed Ebola cases. Among 17,309 alert calls analyzed from the national call center, 71 were linked to 1,838 confirmed Ebola cases in the VHF database, yielding a sensitivity of 3.9%. The sensitivity of the national call center was highest in the capital city of Conakry (11.4%) and lower in other prefectures. In comparison, the local alerts system had a sensitivity of 51.1%. Local public health infrastructure plays an important role in surveillance in an epidemic setting.

  20. Work zone intrusion alert technologies : assessment and practical guidance : final report.

    DOT National Transportation Integrated Search

    2017-06-01

    A work zone intrusion alert technology is a type of safety system that is used in a roadway work zone to alert field workers and secure time for them to escape when errant vehicles intrude into the work zone. Although such technologies have potential...

  1. The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock.

    PubMed

    Arabi, Yaseen M; Al-Dorzi, Hasan M; Alamry, Ahmed; Hijazi, Ra'ed; Alsolamy, Sami; Al Salamah, Majid; Tamim, Hani M; Al-Qahtani, Saad; Al-Dawood, Abdulaziz; Marini, Abdellatif M; Al Ehnidi, Fatimah H; Mundekkadan, Shihab; Matroud, Amal; Mohamed, Mohamed S; Taher, Saadi

    2017-12-01

    Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department. This was a pre-post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011-September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012-March 03, 2013) and intervention phase II when SRT was added (March 04, 2013-October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital. After implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58-0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37-0.55, p < 0.0001) and reduction in ICU LOS and hospital LOS for all patients as well as ICU LOS for survivors. Implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.

  2. Preventing dispensing errors by alerting for drug confusions in the pharmacy information system—A survey of users

    PubMed Central

    Campmans, Zizi; van Rhijn, Arianne; Dull, René M.; Santen-Reestman, Jacqueline; Taxis, Katja

    2018-01-01

    Introduction Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. Objective To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. Methods In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Results Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. ‘Alert fatigue’ was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Conclusion Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue. PMID:29813099

  3. Sounding the Alert: Designing an Effective Voice for Earthquake Early Warning

    NASA Astrophysics Data System (ADS)

    Burkett, E. R.; Given, D. D.

    2015-12-01

    The USGS is working with partners to develop the ShakeAlert Earthquake Early Warning (EEW) system (http://pubs.usgs.gov/fs/2014/3083/) to protect life and property along the U.S. West Coast, where the highest national seismic hazard is concentrated. EEW sends an alert that shaking from an earthquake is on its way (in seconds to tens of seconds) to allow recipients or automated systems to take appropriate actions at their location to protect themselves and/or sensitive equipment. ShakeAlert is transitioning toward a production prototype phase in which test users might begin testing applications of the technology. While a subset of uses will be automated (e.g., opening fire house doors), other applications will alert individuals by radio or cellphone notifications and require behavioral decisions to protect themselves (e.g., "Drop, Cover, Hold On"). The project needs to select and move forward with a consistent alert sound to be widely and quickly recognized as an earthquake alert. In this study we combine EEW science and capabilities with an understanding of human behavior from the social and psychological sciences to provide insight toward the design of effective sounds to help best motivate proper action by alert recipients. We present a review of existing research and literature, compiled as considerations and recommendations for alert sound characteristics optimized for EEW. We do not yet address wording of an audible message about the earthquake (e.g., intensity and timing until arrival of shaking or possible actions), although it will be a future component to accompany the sound. We consider pitch(es), loudness, rhythm, tempo, duration, and harmony. Important behavioral responses to sound to take into account include that people respond to discordant sounds with anxiety, can be calmed by harmony and softness, and are innately alerted by loud and abrupt sounds, although levels high enough to be auditory stressors can negatively impact human judgment.

  4. ECG Holter monitor with alert system and mobile application

    NASA Astrophysics Data System (ADS)

    Teron, Abigail C.; Rivera, Pedro A.; Goenaga, Miguel A.

    2016-05-01

    This paper proposes a new approach on the Holter monitor by creating a portable Electrocardiogram (ECG) Holter monitor that will alert the user by detecting abnormal heart beats using a digital signal processing software. The alarm will be triggered when the patient experiences arrhythmias such as bradycardia and tachycardia. The equipment is simple, comfortable and small in size that fit in the hand. It can be used at any time and any moment by placing three leads to the person's chest which is connected to an electronic circuit. The ECG data will be transmitted via Bluetooth to the memory of a selected mobile phone using an application that will store the collected data for up to 24 hrs. The arrhythmia is identified by comparing the reference signals with the user's signal. The diagnostic results demonstrate that the ECG Holter monitor alerts the user when an arrhythmia is detected thru the Holter monitor and mobile application.

  5. Dynamic malware containment under an epidemic model with alert

    NASA Astrophysics Data System (ADS)

    Zhang, Tianrui; Yang, Lu-Xing; Yang, Xiaofan; Wu, Yingbo; Tang, Yuan Yan

    2017-03-01

    Alerting at the early stage of malware invasion turns out to be an important complement to malware detection and elimination. This paper addresses the issue of how to dynamically contain the prevalence of malware at a lower cost, provided alerting is feasible. A controlled epidemic model with alert is established, and an optimal control problem based on the epidemic model is formulated. The optimality system for the optimal control problem is derived. The structure of an optimal control for the proposed optimal control problem is characterized under some conditions. Numerical examples show that the cost-efficiency of an optimal control strategy can be enhanced by adjusting the upper and lower bounds on admissible controls.

  6. 75 FR 26269 - Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ...] Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's... from construction- related actions taken under the Integrated Public Alert and Warning Program (IPAWS... Order 13407, Public Alert and Warning System, by providing robust and survivable power generation, fuel...

  7. 77 FR 16688 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-22

    ... the approximately three and one half-year window it is providing for intermediary device users is..., including the originator, event, location and the valid time period of the EAS message, from the CAP text... event, which it believes would provide more visual information to alert message viewers. The Commission...

  8. Evaluation of medication alerts in electronic health records for compliance with human factors principles

    PubMed Central

    Phansalkar, Shobha; Zachariah, Marianne; Seidling, Hanna M; Mendes, Chantal; Volk, Lynn; Bates, David W

    2014-01-01

    Introduction Increasing the adoption of electronic health records (EHRs) with integrated clinical decision support (CDS) is a key initiative of the current US healthcare administration. High over-ride rates of CDS alerts strongly limit these potential benefits. As a result, EHR designers aspire to improve alert design to achieve better acceptance rates. In this study, we evaluated drug–drug interaction (DDI) alerts generated in EHRs and compared them for compliance with human factors principles. Methods We utilized a previously validated questionnaire, the I-MeDeSA, to assess compliance with nine human factors principles of DDI alerts generated in 14 EHRs. Two reviewers independently assigned scores evaluating the human factors characteristics of each EHR. Rankings were assigned based on these scores and recommendations for appropriate alert design were derived. Results The 14 EHRs evaluated in this study received scores ranging from 8 to 18.33, with a maximum possible score of 26. Cohen's κ (κ=0.86) reflected excellent agreement among reviewers. The six vendor products tied for second and third place rankings, while the top system and bottom five systems were home-grown products. The most common weaknesses included the absence of characteristics such as alert prioritization, clear and concise alert messages indicating interacting drugs, actions for clinical management, and a statement indicating the consequences of over-riding the alert. Conclusions We provided detailed analyses of the human factors principles which were assessed and described our recommendations for effective alert design. Future studies should assess whether adherence to these recommendations can improve alert acceptance. PMID:24780721

  9. Developing Network Situational Awareness through Visualizations of Fused Intrusion Detection System Alerts

    DTIC Science & Technology

    2008-06-01

    Phishing with Plug and Play Exploit. In this attack, the at- tacker sets up a website offering the visitor free “ porn ” if they sign up. The user is allowed... porn alert so its unclear at the moment if 100.20.3.127 is compromised and if so, how it is compromised because there are no other alerts at this time...unauthorized porn website. The investigation would conclude that the attacker at 51.251.22.183 used the information gained from the website to open an

  10. Medication-related clinical decision support alert overrides in inpatients.

    PubMed

    Nanji, Karen C; Seger, Diane L; Slight, Sarah P; Amato, Mary G; Beeler, Patrick E; Her, Qoua L; Dalleur, Olivia; Eguale, Tewodros; Wong, Adrian; Silvers, Elizabeth R; Swerdloff, Michael; Hussain, Salman T; Maniam, Nivethietha; Fiskio, Julie M; Dykes, Patricia C; Bates, David W

    2018-05-01

    To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.

  11. The results of the Seismic Alert System of Mexico SASMEX, during the earthquakes of 7 and 19 of September 2017

    NASA Astrophysics Data System (ADS)

    Espinosa Aranda, J. M., Sr.; Cuellar Martinez, A.

    2017-12-01

    The Seismic Alert System of Mexico, SASMEX began in 1991, is integrated by the seismic alert system of Mexico City and the seismic alert system of Oaxaca. SASMEX has 97 seismic sensors which are distributed in the seismic regions of the Pacific coast and the South of the Trans-Mexican Volcanic Belt of states of Jalisco, Colima, Michoacán, Guerrero, Oaxaca and Puebla. The alert dissemination covers the cities of: Acapulco, Chilpancingo, Morelia, Puebla, Oaxaca, Toluca and Mexico City, reaching the earthquake warnings to more than 25 millions of people. SASMEX has detected correctly more than 5600 earthquakes and warned 156. Mexico City has different alert dissemination systems like several Radio and Tv commercial broadcasters, dedicated radio receivers, EAS-SAME-SARMEX radio receivers and more tha 6700 public loud speakers. The other cities have only some of those systems. The Mw 8.2 Chiapas earthquake on September 7, despite the epicentral distance far of the first seismic detections (more than 180 km) and the low amplitudes of the P waves, the earthquake warning time gave more than 90 seconds to Mexico City before the arrivals of S waves with minor damages to the city in contrast with high damages in towns in the coast. This earthquake offered an opportunity to show the developments and lacks to reduce the risk, such as the need to increase the seismic detection coverage and the earthquake warning dissemination in towns with high seismic vulnerability. The Mw 7.1 Morelos earthquake on September 19 caused thousands of damages and hundreds of deaths and injuries in Mexico City, this earthquake is the second with the most damages after the Mw 8.1 Michoacán earthquake of September 19 on 1985. The earthquake early warning gave 11 seconds after the arrivals of S waves, however the activation occurred few seconds after the P waves arrives to Mexico City, and due to the seismic focus was near to the city, the P waves were felt for the people. The Accelerographic Network

  12. Automated health alerts from Kinect-based in-home gait measurements.

    PubMed

    Stone, Erik E; Skubic, Marjorie; Back, Jessica

    2014-01-01

    A method for automatically generating alerts to clinicians in response to changes in in-home gait parameters is investigated. Kinect-based gait measurement systems were installed in apartments in a senior living facility. The systems continuously monitored the walking speed, stride time, and stride length of apartment residents. A framework for modeling uncertainty in the residents' gait parameter estimates, which is critical for robust change detection, is developed; along with an algorithm for detecting changes that may be clinically relevant. Three retrospective case studies, of individuals who had their gait monitored for periods ranging from 12 to 29 months, are presented to illustrate use of the alert method. Evidence suggests that clinicians could be alerted to health changes at an early stage, while they are still small and interventions may be most successful. Additional potential uses are also discussed.

  13. 75 FR 67201 - Flightcrew Alerting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... airplanes concerning flightcrew alerting. These standards update definitions, prioritization, color... addressed regulations regarding definitions, prioritization, color requirements, and performance for... proposal: Reserving and limiting the use of alerting colors red, amber, or yellow on the flight deck...

  14. Gamified Android Based Academic Information System

    ERIC Educational Resources Information Center

    Setiana, Henry; Hansun, Seng

    2017-01-01

    Student is often lazy when it comes to studying, and how to motivate student was one of the problem in the educational world. To overcome the matters, we will implement the gamification method into an Academic Information System. Academic Information System is a software used for providing information and arranging administration which connected…

  15. Feature Selection Using Information Gain for Improved Structural-Based Alert Correlation

    PubMed Central

    Siraj, Maheyzah Md; Zainal, Anazida; Elshoush, Huwaida Tagelsir; Elhaj, Fatin

    2016-01-01

    Grouping and clustering alerts for intrusion detection based on the similarity of features is referred to as structurally base alert correlation and can discover a list of attack steps. Previous researchers selected different features and data sources manually based on their knowledge and experience, which lead to the less accurate identification of attack steps and inconsistent performance of clustering accuracy. Furthermore, the existing alert correlation systems deal with a huge amount of data that contains null values, incomplete information, and irrelevant features causing the analysis of the alerts to be tedious, time-consuming and error-prone. Therefore, this paper focuses on selecting accurate and significant features of alerts that are appropriate to represent the attack steps, thus, enhancing the structural-based alert correlation model. A two-tier feature selection method is proposed to obtain the significant features. The first tier aims at ranking the subset of features based on high information gain entropy in decreasing order. The‏ second tier extends additional features with a better discriminative ability than the initially ranked features. Performance analysis results show the significance of the selected features in terms of the clustering accuracy using 2000 DARPA intrusion detection scenario-specific dataset. PMID:27893821

  16. The Simplified Aircraft-Based Paired Approach With the ALAS Alerting Algorithm

    NASA Technical Reports Server (NTRS)

    Perry, Raleigh B.; Madden, Michael M.; Torres-Pomales, Wilfredo; Butler, Ricky W.

    2013-01-01

    This paper presents the results of an investigation of a proposed concept for closely spaced parallel runways called the Simplified Aircraft-based Paired Approach (SAPA). This procedure depends upon a new alerting algorithm called the Adjacent Landing Alerting System (ALAS). This study used both low fidelity and high fidelity simulations to validate the SAPA procedure and test the performance of the new alerting algorithm. The low fidelity simulation enabled a determination of minimum approach distance for the worst case over millions of scenarios. The high fidelity simulation enabled an accurate determination of timings and minimum approach distance in the presence of realistic trajectories, communication latencies, and total system error for 108 test cases. The SAPA procedure and the ALAS alerting algorithm were applied to the 750-ft parallel spacing (e.g., SFO 28L/28R) approach problem. With the SAPA procedure as defined in this paper, this study concludes that a 750-ft application does not appear to be feasible, but preliminary results for 1000-ft parallel runways look promising.

  17. Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

    PubMed

    Wright, Adam; Aaron, Skye; Seger, Diane L; Samal, Lipika; Schiff, Gordon D; Bates, David W

    2018-05-15

    Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P < 0.001). After disabling the least severe alerts, total DDI alert burden fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

  18. For Emergency Alerts, Some Colleges Try Sirens

    ERIC Educational Resources Information Center

    Young, Jeffrey R.

    2008-01-01

    Colleges and universities, ever more mindful of campus safety, are installing outdoor sirens. The systems can blast spoken messages or tone alerts of danger--and one of the preset messages on many of the public-address systems warns: "There is a shooter on campus. Seek shelter immediately." As college officials reviewed their…

  19. Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

    PubMed

    Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

    2017-09-01

    An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

  20. How to Present Evidence-Based Usability Design Principles Dedicated to Medication-Related Alerting Systems to Designers and Evaluators? Results from a Workshop.

    PubMed

    Marcilly, Romaric; Monkman, Helen; Villumsen, Sidsel; Kaufman, David; Beuscart-Zephir, Marie-Catherine

    2016-01-01

    Medication alerting system use errors and lack of adoption are often attributed to usability issues. Previous work has used evidence from the literature to reveal usability principles specific to medication alerting systems and identify potential consequences of violating these principles. The current study sought to explore how best to convey these principles to designers and evaluators of these systems to facilitate their work. To this aim, a workshop with 19 participants was used to generate ideas and opinions on how to deliver these topic-specific design principles in a way that would be most helpful for them. Participants generated ideas for how (e.g., a collaborative, continuously updated forum) and what (e.g., illustrations, checklists, evidence sources and strength, consequences of violations) information is most useful to disseminate usability principles for medication alerting systems. Participants, especially designers, expressed desire to use these principles in practice and avoid previously documented mistakes and therefore make design and evaluation of these systems more effective and efficient. Those insights are discussed in terms of feasibility and logistical challenges to developing the proposed documentation). To move this work forward, a more collaborative approach of Human Factors specialists in medical informatics is necessary.

  1. Using electronic health record alerts to provide public health situational awareness to clinicians

    PubMed Central

    Lurio, Joseph; Pichardo, Michelle; Berg, Rachel; Buck, Michael D; Wu, Winfred; Kitson, Kwame; Mostashari, Farzad; Calman, Neil

    2010-01-01

    Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations. PMID:20190067

  2. Using electronic health record alerts to provide public health situational awareness to clinicians.

    PubMed

    Lurio, Joseph; Morrison, Frances P; Pichardo, Michelle; Berg, Rachel; Buck, Michael D; Wu, Winfred; Kitson, Kwame; Mostashari, Farzad; Calman, Neil

    2010-01-01

    Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations.

  3. Alertness and cognitive control: Toward a spatial grouping hypothesis.

    PubMed

    Schneider, Darryl W

    2018-05-01

    A puzzling interaction involving alertness and cognitive control is indicated by the finding of faster performance but larger congruency effects on alert trials (on which alerting cues are presented before the task stimuli) than on no-alert trials in selective attention tasks. In the present study, the author conducted four experiments to test hypotheses about the interaction. Manipulation of stimulus spacing revealed a difference in congruency effects between alert and no-alert trials for narrowly spaced stimuli but not for widely spaced stimuli, inconsistent with the hypothesis that increased alertness is associated with more diffuse attention. Manipulation of color grouping revealed similar differences in congruency effects between alert and no-alert trials for same-color and different-color groupings of targets and distractors, inconsistent with the general hypothesis that increased alertness is associated with more perceptual grouping. To explain the results, the author proposes that increased alertness is associated specifically with more spatial grouping of stimuli, possibly by modulating the threshold for parsing stimulus displays into distinct objects.

  4. 76 FR 35810 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... Plan that provides for delivery of such alerts. 3. The Third FNPRM builds on that effort by seeking...)(3) of the Commission's rules should be modified to include a requirement for a single Ethernet port... distribution should be delineated in terms of how the EAN is distributed from the PEP/NP to the PN/NN stations...

  5. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. ...

  6. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. ...

  7. Regulatory alerts for dietary supplements in Canada and the United States, 2005-13.

    PubMed

    Abe, Andrew M; Hein, Darren J; Gregory, Philip J

    2015-06-01

    Dietary supplement regulatory alerts published by the Food and Drug Administration (FDA) and Health Canada were evaluated and characterized. FDA MedWatch and Health Canada websites were reviewed to identify regulatory alerts regarding dietary supplements from January 1, 2005, through December 31, 2013. Alerts were analyzed to identify product characteristics that may be predictive of product quality issues and potential patient harm. A total of 1560 dietary supplement-related regulatory alerts were identified. Of those, 1287 (83%) were identified through Health Canada, and 273 (18%) were identified through FDA MedWatch. The country of origin of dietary supplements associated with regulatory alerts was not provided in most regulatory alerts; however, when their origin was provided, the United States was the most common. Dietary supplements intended for sexual enhancement were the subject of 33% of all regulatory alerts identified. Products purchased online were the most likely to be associated with a regulatory alert. Dietary supplements intended for sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical such as a phosphodiesterase-5 inhibitor or sibutramine. Analysis of Canadian and U.S. regulatory alerts concerning dietary supplements revealed that more than 80% of the composite alerts were issued by Health Canada. The most common intended uses of supplements for which alerts were issued were sexual enhancement, weight loss, and bodybuilding or athletic performance. The most common reason for alerts was the presence of a pharmaceutical contaminant. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  8. Usability flaws of medication-related alerting functions: A systematic qualitative review.

    PubMed

    Marcilly, Romaric; Ammenwerth, Elske; Vasseur, Francis; Roehrer, Erin; Beuscart-Zéphir, Marie-Catherine

    2015-06-01

    Medication-related alerting functions may include usability flaws that limit their optimal use. A first step on the way to preventing usability flaws is to understand the characteristics of these usability flaws. This systematic qualitative review aims to analyze the type of usability flaws found in medication-related alerting functions. Papers were searched via PubMed, Scopus and Ergonomics Abstracts databases, along with references lists. Paper selection, data extraction and data analysis was performed by two to three Human Factors experts. Meaningful semantic units representing instances of usability flaws were the main data extracted. They were analyzed through qualitative methods: categorization following general usability heuristics and through an inductive process for the flaws specific to medication-related alerting functions. From the 6380 papers initially identified, 26 met all eligibility criteria. The analysis of the papers identified a total of 168 instances of usability flaws that could be classified into 13 categories of usability flaws representing either violations of general usability principles (i.e. they could be found in any system, e.g. guidance and workload issues) or infractions specific to medication-related alerting functions. The latter refer to issues of low signal-to-noise ratio, incomplete content of alerts, transparency, presentation mode and timing, missing alert features, tasks and control distribution. The list of 168 instances of usability flaws of medication-related alerting functions provides a source of knowledge for checking the usability of medication-related alerting functions during their design and evaluation process and ultimately constructs evidence-based usability design principles for these functions. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. (b) [Reserved] ...

  10. 21 CFR Appendix E to Subpart A of... - Elements To Be Considered in Developing a Two-Way Alert System

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... hazards evaluation and classification —Language of communication and transmission of information 2. Crisis Management System —Crisis analysis and communication mechanisms —Establishment of contact points —Reporting... Considered in Developing a Two-Way Alert System 1. Documentation —Definition of a crisis/emergency and under...

  11. Wireless Sensor Node for Autonomous Monitoring and Alerts in Remote Environments

    NASA Technical Reports Server (NTRS)

    Panangadan, Anand V. (Inventor); Monacos, Steve P. (Inventor)

    2015-01-01

    A method, apparatus, system, and computer program products provides personal alert and tracking capabilities using one or more nodes. Each node includes radio transceiver chips operating at different frequency ranges, a power amplifier, sensors, a display, and embedded software. The chips enable the node to operate as either a mobile sensor node or a relay base station node while providing a long distance relay link between nodes. The power amplifier enables a line-of-sight communication between the one or more nodes. The sensors provide a GPS signal, temperature, and accelerometer information (used to trigger an alert condition). The embedded software captures and processes the sensor information, provides a multi-hop packet routing protocol to relay the sensor information to and receive alert information from a command center, and to display the alert information on the display.

  12. 34 CFR 200.3 - Designing State Academic Assessment Systems.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... State Academic Assessment Systems. (a)(1) For each grade and subject assessed, a State's academic assessment system must— (i) Address the depth and breadth of the State's academic content standards under... terms of the State's student academic achievement standards; and (iv) Be designed to provide a coherent...

  13. 34 CFR 200.3 - Designing State Academic Assessment Systems.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Designing State Academic Assessment Systems. 200.3... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... State Academic Assessment Systems. (a)(1) For each grade and subject assessed, a State's academic...

  14. 34 CFR 200.3 - Designing State Academic Assessment Systems.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Designing State Academic Assessment Systems. 200.3... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... State Academic Assessment Systems. (a)(1) For each grade and subject assessed, a State's academic...

  15. 34 CFR 200.3 - Designing State Academic Assessment Systems.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Designing State Academic Assessment Systems. 200.3... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... State Academic Assessment Systems. (a)(1) For each grade and subject assessed, a State's academic...

  16. 34 CFR 200.3 - Designing State Academic Assessment Systems.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Designing State Academic Assessment Systems. 200.3... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED... State Academic Assessment Systems. (a)(1) For each grade and subject assessed, a State's academic...

  17. Climatological Study to Determine the Impact of Icing on the Low Level Windshear Alert System. Volume II. Statistics.

    DOT National Transportation Integrated Search

    1989-01-01

    The climatological study was performed to determine the impact of icing on the performance of the Low Level Winshear Alert System (LLWAS). : This report Presents the Icing Statisctical profile in the form of data tables and histograms of 106 LLWAS si...

  18. Climatological Study to Determine the Impact of Icing on the Low Level Windshear Alert System. Volume I. Analysis.

    DOT National Transportation Integrated Search

    1989-09-01

    The climatological study was performed to determine the impact of icing on the performance of Low Level Windshear Alert System (LLWAS). : This report presents the icing statistical profile in the form of data tables and histograms of 106 LLWAS sites....

  19. Generating Artificial Snort Alerts and Implementing SELK: The Snort-Elasticsearch-Logstash-Kibana Stack

    DTIC Science & Technology

    2017-09-01

    analyzing Snort alerts. The first section covers the Snort alert-generation program, the methodology involved in developing it, and how it accelerates...guide on system setup. The methodologies described can be translated to the setup and use of the ELK stack for storing and visualizing any data...Figures iv List of Tables iv 1. Introduction 1 2. Methodology 2 2.1. Snort Alert Generation 2 2.2 The SELK Stack 8 3. Discussion and Conclusion 11

  20. A dramatic increase in the positive blood culture rates of Helicobacter cinaedi: the evidence of differential detection abilities between the Bactec and BacT/Alert systems.

    PubMed

    Miyake, Noriko; Chong, Yong; Nishida, Ruriko; Nagasaki, Yoji; Kibe, Yasushi; Kiyosuke, Makiko; Shimomura, Takeshi; Shimono, Nobuyuki; Shimoda, Shinji; Akashi, Koichi

    2015-11-01

    In our hospital, positive blood culture rates of Helicobacter cinaedi dramatically increased after introducing the Bactec system. A simulated culture model of H. cinaedi bacteremia demonstrated no positive signals using the BacT/Alert system, despite efficient growth in bottles. Clinically suspected H. cinaedi bacteremia should be monitored more closely when using the BacT/Alert system, preferably with subcultivation after 7days of incubation. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Sleep, alertness and alertness management among commercial airline pilots on short-haul and long-haul flights.

    PubMed

    Sallinen, Mikael; Sihvola, Maria; Puttonen, Sampsa; Ketola, Kimmo; Tuori, Antti; Härmä, Mikko; Kecklund, Göran; Åkerstedt, Torbjörn

    2017-01-01

    Airline pilots' sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain their alertness while being on duty is scarce. To address these gaps in research knowledge, we conducted a field study on a representative sample of the airline pilots of a medium-sized airline. The sample consisted of 90 pilots, of whom 30 flew long-haul (LH) routes, 30 short-haul (SH) routes, and 30 flew both. A total of 86 pilots completed the measurements that lasted for almost two months per pilot. The measurements resulted in a total of 965 flight duty periods (FDPs) including SH flights and 627 FDPs including LH flights. During the measurement periods, sleep was measured by a diary and actigraphs, on-duty alertness by the Karolinska Sleepiness Scale (KSS) in all flight phases, and on-duty alertness management strategies by the diary. Results showed that SH and LH FDPs covering the whole domicile night (00:00-06:00 at home base) were most consistently associated with reduced sleep-wake ratio and subjective alertness. Approximately every 3rd FDP falling into this category involved a reduced sleep-wake ratio (1:3 or lower) and every 2nd a reduced level of subjective alertness (KSS rating 8-9 in at least one flight phase). The corresponding frequencies for the SH and LH FDPs that partly covered the domicile night were every 10th and every 5th FDP and for the pure non-night FDPs every 30th and every 36th FDP, respectively. The results also showed that the pilots tended to increase the use of effective on-duty alertness management strategies (consuming alertness-promoting products and taking strategic naps) in connection with the FDPs that overlapped the domicile night. Finally, the results showed that the frequency of

  2. INITIAL EXPLORATION OF NEWLY IMPLEMENTED PUBLIC HEALTH POLICY USING GEOGRAPHIC INFORMATION SYSTEMS: THE CASE OF A U.S. SILVER ALERT PROGRAM.

    PubMed

    Yamashita, Takashi; Carr, Dawn C; Brown, J Scott

    2014-01-01

    Public health policies are designed for specific subsets of the population. Evidence that a policy is effectively designed should be based on whether it effectively addresses its mission. A critical factor is determining whether utilization patterns reflect the mission and the efficacy of public health policies, particularly during early stages of implementation. We assert that utilization patterns can be effectively assessed using geographic information systems (GIS). This paper uses the Silver Alert program, a recently implemented public health policy, as a case for how and why GIS can be used to examine utilization patterns. GIS are employed to visualize and spatially analyze a new health policy--North Carolina's Silver Alert policy. We use visualized data and spatial statistics to assess utilization patterns and mission adherence. Results show disproportionate utilization patterns of the Silver Alert policy. In particular, an outstanding number of Silver Alerts were used in Wake County and its surrounding counties, which are both the political and media center of North Carolina. Other counties, including populous counties, had few if any alerts. Findings suggest that the North Carolina's Silver Alert policy needs to be adjusted to more effectively address its mission. We identify several factors that need further examination prior to a statewide evaluation. From this case study, we propose ways future programs, particularly the introduction of the Affordable Care Act (ACA) in 2014, might use GIS to examine utilization patterns as a means to better understand whether and in what ways the health care needs of the public are being met with such a policy.

  3. Speech Auditory Alerts Promote Memory for Alerted Events in a Video-Simulated Self-Driving Car Ride.

    PubMed

    Nees, Michael A; Helbein, Benji; Porter, Anna

    2016-05-01

    Auditory displays could be essential to helping drivers maintain situation awareness in autonomous vehicles, but to date, few or no studies have examined the effectiveness of different types of auditory displays for this application scenario. Recent advances in the development of autonomous vehicles (i.e., self-driving cars) have suggested that widespread automation of driving may be tenable in the near future. Drivers may be required to monitor the status of automation programs and vehicle conditions as they engage in secondary leisure or work tasks (entertainment, communication, etc.) in autonomous vehicles. An experiment compared memory for alerted events-a component of Level 1 situation awareness-using speech alerts, auditory icons, and a visual control condition during a video-simulated self-driving car ride with a visual secondary task. The alerts gave information about the vehicle's operating status and the driving scenario. Speech alerts resulted in better memory for alerted events. Both auditory display types resulted in less perceived effort devoted toward the study tasks but also greater perceived annoyance with the alerts. Speech auditory displays promoted Level 1 situation awareness during a simulation of a ride in a self-driving vehicle under routine conditions, but annoyance remains a concern with auditory displays. Speech auditory displays showed promise as a means of increasing Level 1 situation awareness of routine scenarios during an autonomous vehicle ride with an unrelated secondary task. © 2016, Human Factors and Ergonomics Society.

  4. Alertness function of thalamus in conflict adaptation.

    PubMed

    Wang, Xiangpeng; Zhao, Xiaoyue; Xue, Gui; Chen, Antao

    2016-05-15

    Conflict adaptation reflects the ability to improve current conflict resolution based on previously experienced conflict, which is crucial for our goal-directed behaviors. In recent years, the roles of alertness are attracting increasing attention when discussing the generation of conflict adaptation. However, due to the difficulty of manipulating alertness, very limited progress has been made in this line. Inspired by that color may affect alertness, we manipulated background color of experimental task and found that conflict adaptation significantly presented in gray and red backgrounds but did not in blue background. Furthermore, behavioral and functional magnetic resonance imaging results revealed that the modulation of color on conflict adaptation was implemented through changing alertness level. In particular, blue background eliminated conflict adaptation by damping the alertness regulating function of thalamus and the functional connectivity between thalamus and inferior frontal gyrus (IFG). In contrast, in gray and red backgrounds where alertness levels are typically high, the thalamus and the right IFG functioned normally and conflict adaptations were significant. Therefore, the alertness function of thalamus is determinant to conflict adaptation, and thalamus and right IFG are crucial nodes of the neural circuit subserving this ability. Present findings provide new insights into the neural mechanisms of conflict adaptation. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The DOPA decarboxylase (DDC) gene is associated with alerting attention.

    PubMed

    Zhu, Bi; Chen, Chuansheng; Moyzis, Robert K; Dong, Qi; Chen, Chunhui; He, Qinghua; Li, Jin; Li, Jun; Lei, Xuemei; Lin, Chongde

    2013-06-03

    DOPA decarboxylase (DDC) is involved in the synthesis of dopamine, norepinephrine and serotonin. It has been suggested that genes involved in the dopamine, norepinephrine, and cholinergic systems play an essential role in the efficiency of human attention networks. Attention refers to the cognitive process of obtaining and maintaining the alert state, orienting to sensory events, and regulating the conflicts of thoughts and behavior. The present study tested seven single nucleotide polymorphisms (SNPs) within the DDC gene for association with attention, which was assessed by the Attention Network Test to detect three networks of attention, including alerting, orienting, and executive attention, in a healthy Han Chinese sample (N=451). Association analysis for individual SNPs indicated that four of the seven SNPs (rs3887825, rs7786398, rs10499695, and rs6969081) were significantly associated with alerting attention. Haplotype-based association analysis revealed that alerting was associated with the haplotype G-A-T for SNPs rs7786398-rs10499695-rs6969081. These associations remained significant after correcting for multiple testing by max(T) permutation. No association was found for orienting and executive attention. This study provides the first evidence for the involvement of the DDC gene in alerting attention. A better understanding of the genetic basis of distinct attention networks would allow us to develop more effective diagnosis, treatment, and prevention of deficient or underdeveloped alerting attention as well as its related prevalent neuropsychiatric disorders. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. 47 CFR 80.1114 - False distress alerts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

  7. 47 CFR 80.1114 - False distress alerts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false False distress alerts. 80.1114 Section 80.1114 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE MARITIME SERVICES Global Maritime Distress and Safety System (GMDSS) Operating Procedures for Distress and...

  8. SC-228 Inclusion of DAA Warning Alert for TCAS Interoperability

    NASA Technical Reports Server (NTRS)

    Fern, Lisa

    2016-01-01

    This white paper summarizes NASA research results that have informed Special Committee 228 (SC-228) discussions and decisions regarding the inclusion of a warning-level alert within the detect and avoid (DAA) alerting structure for unmanned aircraft systems (UAS). For UAS, the removal of the pilot from onboard the aircraft has eliminated the ability of the ground-based pilot in command (PIC) to use out-the-window visual information to make judgments about a potential threat of a loss of well clear with another aircraft. As a result, the DAA traffic display will be the primary source of information that the PIC can use to execute the three primary well clear functions: 1) detect a potential loss of well clear, 2) determine a resolution maneuver, and 3) upload that maneuver to the aircraft via the ground control station (GCS). In addition, pilots are required to coordinate with air traffic control (ATC) prior to maneuvering off of their approved flight plan. In determining an appropriate resolution maneuver to avoid a loss of well clear, the PIC must decide both when and how to maneuver, and both the timeliness and the accuracy (i.e., correctness) of the maneuver are critical to reducing the likelihood and/or severity of a loss of well clear. Alerting information is one of three critical components of the DAA display, along with traffic information elements (e.g., relative heading, speed and altitude) and maneuver guidance. Alerting information and maneuver guidance, in particular, have been found to have a significant impact, both statistically and practically, on pilots' ability to avoid and minimize the severity of losses of well clear While all three display components are key to pilots performing the traffic avoidance task of remaining well clear, in general, alerting information provides crucial information about when a resolution maneuver is required while maneuver guidance assists the pilot in determining how best to maneuver. A fundamental task of the DAA

  9. Joint Seismic-Geodetic Algorithm for Finite-Fault Detection and Slip Inversion in the West Coast ShakeAlert System

    NASA Astrophysics Data System (ADS)

    Smith, D. E.; Felizardo, C.; Minson, S. E.; Boese, M.; Langbein, J. O.; Murray, J. R.

    2016-12-01

    Finite-fault source algorithms can greatly benefit earthquake early warning (EEW) systems. Estimates of finite-fault parameters provide spatial information, which can significantly improve real-time shaking calculations and help with disaster response. In this project, we have focused on integrating a finite-fault seismic-geodetic algorithm into the West Coast ShakeAlert framework. The seismic part is FinDer 2, a C++ version of the algorithm developed by Böse et al. (2012). It interpolates peak ground accelerations and calculates the best fault length and strike from template matching. The geodetic part is a C++ version of BEFORES, the algorithm developed by Minson et al. (2014) that uses a Bayesian methodology to search for the most probable slip distribution on a fault of unknown orientation. Ultimately, these two will be used together where FinDer generates a Bayesian prior for BEFORES via the methodology of Minson et al. (2015), and the joint solution will generate estimates of finite-fault extent, strike, dip, best slip distribution, and magnitude. We have created C++ versions of both FinDer and BEFORES using open source libraries and have developed a C++ Application Protocol Interface (API) for them both. Their APIs allow FinDer and BEFORES to contribute to the ShakeAlert system via an open source messaging system, ActiveMQ. FinDer has been receiving real-time data, detecting earthquakes, and reporting messages on the development system for several months. We are also testing FinDer extensively with Earthworm tankplayer files. BEFORES has been tested with ActiveMQ messaging in the ShakeAlert framework, and works off a FinDer trigger. We are finishing the FinDer-BEFORES connections in this framework, and testing this system via seismic-geodetic tankplayer files. This will include actual and simulated data.

  10. Improving the Quality of Alerts and Predicting Intruder's Next Goal with Hidden Colored Petri-Net

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yu, Dong; Frincke, Deb A.

    2006-06-22

    Intrusion detection systems (IDS) often provide poor quality alerts, which are insufficient to support rapid identification of ongoing attacks or predict an intruder’s next likely goal. In this paper, we propose a novel approach to alert post-processing and correlation, the Hidden Colored Petri-Net (HCPN). Different from most other alert correlation methods, our approach treats the alert correlation problem as an inference problem rather than a filter problem. Our approach assumes that the intruder’s actions are unknown to the IDS and can be inferred only from the alerts generated by the IDS sensors. HCPN can describe the relationship between different stepsmore » carried out by intruders, model observations (alerts) and transitions (actions) separately, and associate each token element (system state) with a probability (or confidence). The model is an extension to Colored Petri-Net (CPN) .It is so called “hidden” because the transitions (actions) are not directly observable but can be inferred by looking through the observations (alerts). These features make HCPN especially suitable for discovering intruders’ actions from their partial observations (alerts,) and predicting intruders’ next goal. Our experiments on DARPA evaluation datasets and the attack scenarios from the Grand Challenge Problem (GCP) show that HCPN has promise as a way to reducing false positives and negatives, predicting intruder’s next possible action, uncovering intruders’ intrusion strategies after the attack scenario has happened, and providing confidence scores.« less

  11. Alertness and cognitive control: Testing the early onset hypothesis.

    PubMed

    Schneider, Darryl W

    2018-05-01

    Previous research has revealed a peculiar interaction between alertness and cognitive control in selective-attention tasks: Congruency effects are larger on alert trials (on which an alerting cue is presented briefly in advance of the imperative stimulus) than on no-alert trials, despite shorter response times (RTs) on alert trials. One explanation for this finding is the early onset hypothesis, which is based on the assumptions that increased alertness shortens stimulus-encoding time and that cognitive control involves gradually focusing attention during a trial. The author tested the hypothesis in 3 experiments by manipulating alertness and stimulus quality (which were intended to shorten and lengthen stimulus-encoding time, respectively) in an arrow-based flanker task involving congruent and incongruent stimuli. Replicating past findings, the alerting manipulation led to shorter RTs but larger congruency effects on alert trials than on no-alert trials. The stimulus-quality manipulation led to longer RTs and larger congruency effects for degraded stimuli than for intact stimuli. These results provide mixed support for the early onset hypothesis, but the author discusses how data and theory might be reconciled if stimulus quality affects stimulus-encoding time and the rate of evidence accumulation in the decision process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  12. Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

    PubMed Central

    Krall, M. A.; Sittig, D. F.

    2001-01-01

    There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use". PMID:11825206

  13. Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

    PubMed

    Krall, M A; Sittig, D F

    2001-01-01

    There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use".

  14. Outlier Detection for Patient Monitoring and Alerting

    PubMed Central

    Hauskrecht, Milos; Batal, Iyad; Valko, Michal; Visweswaran, Shyam; Cooper, Gregory F.; Clermont, Gilles

    2012-01-01

    We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management decisions using past patient cases stored in electronic health records (EHRs). Our hypothesis is that a patient-management decision that is unusual with respect to past patient care may be due to an error and that it is worthwhile to generate an alert if such a decision is encountered. We evaluate this hypothesis using data obtained from EHRs of 4,486 post-cardiac surgical patients and a subset of 222 alerts generated from the data. We base the evaluation on the opinions of a panel of experts. The results of the study support our hypothesis that the outlier-based alerting can lead to promising true alert rates. We observed true alert rates that ranged from 25% to 66% for a variety of patient-management actions, with 66% corresponding to the strongest outliers. PMID:22944172

  15. Clinical decision support alert malfunctions: analysis and empirically derived taxonomy.

    PubMed

    Wright, Adam; Ai, Angela; Ash, Joan; Wiesen, Jane F; Hickman, Thu-Trang T; Aaron, Skye; McEvoy, Dustin; Borkowsky, Shane; Dissanayake, Pavithra I; Embi, Peter; Galanter, William; Harper, Jeremy; Kassakian, Steve Z; Ramoni, Rachel; Schreiber, Richard; Sirajuddin, Anwar; Bates, David W; Sittig, Dean F

    2018-05-01

    To develop an empirically derived taxonomy of clinical decision support (CDS) alert malfunctions. We identified CDS alert malfunctions using a mix of qualitative and quantitative methods: (1) site visits with interviews of chief medical informatics officers, CDS developers, clinical leaders, and CDS end users; (2) surveys of chief medical informatics officers; (3) analysis of CDS firing rates; and (4) analysis of CDS overrides. We used a multi-round, manual, iterative card sort to develop a multi-axial, empirically derived taxonomy of CDS malfunctions. We analyzed 68 CDS alert malfunction cases from 14 sites across the United States with diverse electronic health record systems. Four primary axes emerged: the cause of the malfunction, its mode of discovery, when it began, and how it affected rule firing. Build errors, conceptualization errors, and the introduction of new concepts or terms were the most frequent causes. User reports were the predominant mode of discovery. Many malfunctions within our database caused rules to fire for patients for whom they should not have (false positives), but the reverse (false negatives) was also common. Across organizations and electronic health record systems, similar malfunction patterns recurred. Challenges included updates to code sets and values, software issues at the time of system upgrades, difficulties with migration of CDS content between computing environments, and the challenge of correctly conceptualizing and building CDS. CDS alert malfunctions are frequent. The empirically derived taxonomy formalizes the common recurring issues that cause these malfunctions, helping CDS developers anticipate and prevent CDS malfunctions before they occur or detect and resolve them expediently.

  16. An alert system for triggering different levels of coastal management urgency: Tunisia case study using rapid environmental assessment data.

    PubMed

    Price, A R G; Jaoui, K; Pearson, M P; Jeudy de Grissac, A

    2014-03-15

    Rapid environmental assessment (REA) involves scoring abundances of ecosystems/species groups and magnitude of pressures, concurrently, using the same logarithmic (0-6) assessment scale. We demonstrate the utility of REA data for an alert system identifying different levels of coastal management concern. Thresholds set for abundances/magnitudes, when crossed, trigger proposed responses. Kerkennah, Tunisia, our case study, has significant natural assets (e.g. exceptional seagrass and invertebrate abundances), subjected to varying levels of disturbance and management concern. Using REA thresholds set, fishing, green algae/eutrophication and oil occurred at 'low' levels (scores 0-1): management not (currently) necessary. Construction and wood litter prevailed at 'moderate' levels (scores 2-4): management alerted for (further) monitoring. Solid waste densities were 'high' (scores 5-6): management alerted for action; quantities of rubbish were substantial (20-200 items m⁻¹ beach) but not unprecedented. REA is considered a robust methodology and complementary to other rapid assessment techniques, environmental frameworks and indicators of ecosystem condition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. E-Book Purchasing Best Practices for Academic Libraries

    ERIC Educational Resources Information Center

    Simon, Jason C.

    2014-01-01

    This article alerts academic libraries to some of the methods for purchasing electronic books (e-books) and notes that, while they are similar to the models used for journal-evaluation purposes, there are a number of factors important to consider that are different for e-books. Simon notes that, while theoretically there should be some advantages…

  18. An Approach for Representing Sensor Data to Validate Alerts in Ambient Assisted Living

    PubMed Central

    Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A.

    2012-01-01

    The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations—obtained through an argumentation process—of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert. PMID:22778642

  19. An approach for representing sensor data to validate alerts in Ambient Assisted Living.

    PubMed

    Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A

    2012-01-01

    The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations--obtained through an argumentation process--of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert.

  20. Identification of Patients Expected to Benefit from Electronic Alerts for Acute Kidney Injury.

    PubMed

    Biswas, Aditya; Parikh, Chirag R; Feldman, Harold I; Garg, Amit X; Latham, Stephen; Lin, Haiqun; Palevsky, Paul M; Ugwuowo, Ugochukwu; Wilson, F Perry

    2018-06-07

    Electronic alerts for heterogenous conditions such as AKI may not provide benefit for all eligible patients and can lead to alert fatigue, suggesting that personalized alert targeting may be useful. Uplift-based alert targeting may be superior to purely prognostic-targeting of interventions because uplift models assess marginal treatment effect rather than likelihood of outcome. This is a secondary analysis of a clinical trial of 2278 adult patients with AKI randomized to an automated, electronic alert system versus usual care. We used three uplift algorithms and one purely prognostic algorithm, trained in 70% of the data, and evaluated the effect of targeting alerts to patients with higher scores in the held-out 30% of the data. The performance of the targeting strategy was assessed as the interaction between the model prediction of likelihood to benefit from alerts and randomization status. The outcome of interest was maximum relative change in creatinine from the time of randomization to 3 days after randomization. The three uplift score algorithms all gave rise to a significant interaction term, suggesting that a strategy of targeting individuals with higher uplift scores would lead to a beneficial effect of AKI alerting, in contrast to the null effect seen in the overall study. The prognostic model did not successfully stratify patients with regards to benefit of the intervention. Among individuals in the high uplift group, alerting was associated with a median reduction in change in creatinine of -5.3% ( P =0.03). In the low uplift group, alerting was associated with a median increase in change in creatinine of +5.3% ( P =0.005). Older individuals, women, and those with a lower randomization creatinine were more likely to receive high uplift scores, suggesting that alerts may benefit those with more slowly developing AKI. Uplift modeling, which accounts for treatment effect, can successfully target electronic alerts for AKI to those most likely to benefit

  1. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  2. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  3. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  4. The IceCube realtime alert system

    NASA Astrophysics Data System (ADS)

    Aartsen, M. G.; Ackermann, M.; Adams, J.; Aguilar, J. A.; Ahlers, M.; Ahrens, M.; Altmann, D.; Andeen, K.; Anderson, T.; Ansseau, I.; Anton, G.; Archinger, M.; Argüelles, C.; Auffenberg, J.; Axani, S.; Bai, X.; Barwick, S. W.; Baum, V.; Bay, R.; Beatty, J. J.; Becker Tjus, J.; Becker, K.-H.; BenZvi, S.; Berley, D.; Bernardini, E.; Bernhard, A.; Besson, D. Z.; Binder, G.; Bindig, D.; Bissok, M.; Blaufuss, E.; Blot, S.; Bohm, C.; Börner, M.; Bos, F.; Bose, D.; Böser, S.; Botner, O.; Braun, J.; Brayeur, L.; Bretz, H.-P.; Bron, S.; Burgman, A.; Carver, T.; Casier, M.; Cheung, E.; Chirkin, D.; Christov, A.; Clark, K.; Classen, L.; Coenders, S.; Collin, G. H.; Conrad, J. M.; Cowen, D. F.; Cross, R.; Day, M.; de André, J. P. A. M.; De Clercq, C.; del Pino Rosendo, E.; Dembinski, H.; De Ridder, S.; Desiati, P.; de Vries, K. D.; de Wasseige, G.; de With, M.; DeYoung, T.; Díaz-Vélez, J. C.; di Lorenzo, V.; Dujmovic, H.; Dumm, J. P.; Dunkman, M.; Eberhardt, B.; Ehrhardt, T.; Eichmann, B.; Eller, P.; Euler, S.; Evenson, P. A.; Fahey, S.; Fazely, A. R.; Feintzeig, J.; Felde, J.; Filimonov, K.; Finley, C.; Flis, S.; Fösig, C.-C.; Franckowiak, A.; Friedman, E.; Fuchs, T.; Gaisser, T. K.; Gallagher, J.; Gerhardt, L.; Ghorbani, K.; Giang, W.; Gladstone, L.; Glauch, T.; Glüsenkamp, T.; Goldschmidt, A.; Gonzalez, J. G.; Grant, D.; Griffith, Z.; Haack, C.; Hallgren, A.; Halzen, F.; Hansen, E.; Hansmann, T.; Hanson, K.; Hebecker, D.; Heereman, D.; Helbing, K.; Hellauer, R.; Hickford, S.; Hignight, J.; Hill, G. C.; Hoffman, K. D.; Hoffmann, R.; Hoshina, K.; Huang, F.; Huber, M.; Hultqvist, K.; In, S.; Ishihara, A.; Jacobi, E.; Japaridze, G. S.; Jeong, M.; Jero, K.; Jones, B. J. P.; Kang, W.; Kappes, A.; Karg, T.; Karle, A.; Katz, U.; Kauer, M.; Keivani, A.; Kelley, J. L.; Kheirandish, A.; Kim, J.; Kim, M.; Kintscher, T.; Kiryluk, J.; Kittler, T.; Klein, S. R.; Kohnen, G.; Koirala, R.; Kolanoski, H.; Konietz, R.; Köpke, L.; Kopper, C.; Kopper, S.; Koskinen, D. J.; Kowalski, M.; Krings, K.; Kroll, M.; Krückl, G.; Krüger, C.; Kunnen, J.; Kunwar, S.; Kurahashi, N.; Kuwabara, T.; Labare, M.; Lanfranchi, J. L.; Larson, M. J.; Lauber, F.; Lennarz, D.; Lesiak-Bzdak, M.; Leuermann, M.; Lu, L.; Lünemann, J.; Madsen, J.; Maggi, G.; Mahn, K. B. M.; Mancina, S.; Mandelartz, M.; Maruyama, R.; Mase, K.; Maunu, R.; McNally, F.; Meagher, K.; Medici, M.; Meier, M.; Meli, A.; Menne, T.; Merino, G.; Meures, T.; Miarecki, S.; Montaruli, T.; Moulai, M.; Nahnhauer, R.; Naumann, U.; Neer, G.; Niederhausen, H.; Nowicki, S. C.; Nygren, D. R.; Obertacke Pollmann, A.; Olivas, A.; O'Murchadha, A.; Palczewski, T.; Pandya, H.; Pankova, D. V.; Peiffer, P.; Penek, Ö.; Pepper, J. A.; Pérez de los Heros, C.; Pieloth, D.; Pinat, E.; Price, P. B.; Przybylski, G. T.; Quinnan, M.; Raab, C.; Rädel, L.; Rameez, M.; Rawlins, K.; Reimann, R.; Relethford, B.; Relich, M.; Resconi, E.; Rhode, W.; Richman, M.; Riedel, B.; Robertson, S.; Rongen, M.; Rott, C.; Ruhe, T.; Ryckbosch, D.; Rysewyk, D.; Sabbatini, L.; Sanchez Herrera, S. E.; Sandrock, A.; Sandroos, J.; Sarkar, S.; Satalecka, K.; Schlunder, P.; Schmidt, T.; Schoenen, S.; Schöneberg, S.; Schumacher, L.; Seckel, D.; Seunarine, S.; Soldin, D.; Song, M.; Spiczak, G. M.; Spiering, C.; Stanev, T.; Stasik, A.; Stettner, J.; Steuer, A.; Stezelberger, T.; Stokstad, R. G.; Stößl, A.; Ström, R.; Strotjohann, N. L.; Sullivan, G. W.; Sutherland, M.; Taavola, H.; Taboada, I.; Tatar, J.; Tenholt, F.; Ter-Antonyan, S.; Terliuk, A.; Tešić, G.; Tilav, S.; Toale, P. A.; Tobin, M. N.; Toscano, S.; Tosi, D.; Tselengidou, M.; Turcati, A.; Unger, E.; Usner, M.; Vandenbroucke, J.; van Eijndhoven, N.; Vanheule, S.; van Rossem, M.; van Santen, J.; Vehring, M.; Voge, M.; Vogel, E.; Vraeghe, M.; Walck, C.; Wallace, A.; Wallraff, M.; Wandkowsky, N.; Weaver, Ch.; Weiss, M. J.; Wendt, C.; Westerhoff, S.; Whelan, B. J.; Wickmann, S.; Wiebe, K.; Wiebusch, C. H.; Wille, L.; Williams, D. R.; Wills, L.; Wolf, M.; Wood, T. R.; Woolsey, E.; Woschnagg, K.; Xu, D. L.; Xu, X. W.; Xu, Y.; Yanez, J. P.; Yodh, G.; Yoshida, S.; Zoll, M.

    2017-06-01

    Although high-energy astrophysical neutrinos were discovered in 2013, their origin is still unknown. Aiming for the identification of an electromagnetic counterpart of a rapidly fading source, we have implemented a realtime analysis framework for the IceCube neutrino observatory. Several analyses selecting neutrinos of astrophysical origin are now operating in realtime at the detector site in Antarctica and are producing alerts for the community to enable rapid follow-up observations. The goal of these observations is to locate the astrophysical objects responsible for these neutrino signals. This paper highlights the infrastructure in place both at the South Pole site and at IceCube facilities in the north that have enabled this fast follow-up program to be implemented. Additionally, this paper presents the first realtime analyses to be activated within this framework, highlights their sensitivities to astrophysical neutrinos and background event rates, and presents an outlook for future discoveries.

  5. Finite-Fault and Other New Capabilities of CISN ShakeAlert

    NASA Astrophysics Data System (ADS)

    Boese, M.; Felizardo, C.; Heaton, T. H.; Hudnut, K. W.; Hauksson, E.

    2013-12-01

    Over the past 6 years, scientists at Caltech, UC Berkeley, the Univ. of Southern California, the Univ. of Washington, the US Geological Survey, and ETH Zurich (Switzerland) have developed the 'ShakeAlert' earthquake early warning demonstration system for California and the Pacific Northwest. We have now started to transform this system into a stable end-to-end production system that will be integrated into the daily routine operations of the CISN and PNSN networks. To quickly determine the earthquake magnitude and location, ShakeAlert currently processes and interprets real-time data-streams from several hundred seismic stations within the California Integrated Seismic Network (CISN) and the Pacific Northwest Seismic Network (PNSN). Based on these parameters, the 'UserDisplay' software predicts and displays the arrival and intensity of shaking at a given user site. Real-time ShakeAlert feeds are currently being shared with around 160 individuals, companies, and emergency response organizations to gather feedback about the system performance, to educate potential users about EEW, and to identify needs and applications of EEW in a future operational warning system. To improve the performance during large earthquakes (M>6.5), we have started to develop, implement, and test a number of new algorithms for the ShakeAlert system: the 'FinDer' (Finite Fault Rupture Detector) algorithm provides real-time estimates of locations and extents of finite-fault ruptures from high-frequency seismic data. The 'GPSlip' algorithm estimates the fault slip along these ruptures using high-rate real-time GPS data. And, third, a new type of ground-motion prediction models derived from over 415,000 rupture simulations along active faults in southern California improves MMI intensity predictions for large earthquakes with consideration of finite-fault, rupture directivity, and basin response effects. FinDer and GPSlip are currently being real-time and offline tested in a separate internal

  6. Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician Workarounds.

    PubMed

    Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L

    2011-02-01

    Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes

  7. The Un-Named "Native Informant": A Subjective Academic Narrative

    ERIC Educational Resources Information Center

    Arnold, Josie

    2016-01-01

    In this paper I address educational matters that challenge academic and scholarly "givens" so as to enrich knowledge. This acts in two ways to alert educators to the Eurowestern enculturization of knowledge and to propose some useful insights. Firstly, I make a personal scholarly narrative about the situation of the un-named native…

  8. Automated inhaled nitric oxide alerts for adult extracorporeal membrane oxygenation patient identification.

    PubMed

    Belenkiy, Slava M; Batchinsky, Andriy I; Park, Timothy S; Luellen, David E; Serio-Melvin, Maria L; Cancio, Leopoldo C; Pamplin, Jeremy C; Chung, Kevin K; Salinas, Josè; Cannon, Jeremy W

    2014-09-01

    Recently, automated alerts have been used to identify patients with respiratory failure based on set criteria, which can be gleaned from the electronic medical record (EMR). Such an approach may also be useful for identifying patients with severe adult respiratory distress syndrome (ARDS) who may benefit from extracorporeal membrane oxygenation (ECMO). Inhaled nitric oxide (iNO) is a common rescue therapy for severe ARDS which can be easily tracked in the EMR, and some patients started on iNO may have indications for initiating ECMO. This case series summarizes our experience with using automated electronic alerts for ECMO team activation focused particularly on an alert triggered by the initiation of iNO. After a brief trial evaluation, our Smart Alert system generated an automated page and e-mail alert to ECMO team members whenever a nonzero value for iNO appeared in the respiratory care section of our EMR. If iNO was initiated for severe respiratory failure, a detailed evaluation by the ECMO team determined if ECMO was indicated. For those patients managed with ECMO, we tabulated baseline characteristics, indication for ECMO, and outcomes. From September 2012 to July 2013, 45 iNO alerts were generated on 42 unique patients. Six patients (14%) met criteria for ECMO. Of these, four were identified exclusively by the iNO alert. At the time of the alert, the median PaO₂-to-FIO₂ ratio was 64 mm Hg (range, 55-107 mm Hg), the median age-adjusted oxygenation index was 73 (range, 51-96), and the median Murray score was 3.4 (range, 3-3.75), indicating severe respiratory failure. Median time from iNO alert to ECMO initiation was 81 hours (range, -2-292 hours). Survival to hospital discharge was 83% in those managed with ECMO. Automated alerts may be useful for identifying patients with severe ARDS who may be ECMO candidates. Diagnostic test, level V.

  9. Insider Alert 1.0 Beta Version

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Abbott, Robert

    2004-02-01

    Insider Alert 1.0 Beta Version supports interactive selection and graphical display of data generated by the Sandia Cognitive Framework, which simulates the examination of security data by experts of various specialties. Insider Alert also encompasses the configuration and data files input to the Cognitive Framework for this application. Insider Alert 1.0 Beta Version is a computer program for analyzing data indicative of possible espionage or improper handling of data by employees at Sandia National Laboratories (or other facilities with comparable policies and procedures for managing sensitive information) It prioritizes and displays information for review by security analysts.

  10. Triggering Interventions for Influenza: The ALERT Algorithm

    PubMed Central

    Reich, Nicholas G.; Cummings, Derek A. T.; Lauer, Stephen A.; Zorn, Martha; Robinson, Christine; Nyquist, Ann-Christine; Price, Connie S.; Simberkoff, Michael; Radonovich, Lewis J.; Perl, Trish M.

    2015-01-01

    Background. Early, accurate predictions of the onset of influenza season enable targeted implementation of control efforts. Our objective was to develop a tool to assist public health practitioners, researchers, and clinicians in defining the community-level onset of seasonal influenza epidemics. Methods. Using recent surveillance data on virologically confirmed infections of influenza, we developed the Above Local Elevated Respiratory Illness Threshold (ALERT) algorithm, a method to identify the period of highest seasonal influenza activity. We used data from 2 large hospitals that serve Baltimore, Maryland and Denver, Colorado, and the surrounding geographic areas. The data used by ALERT are routinely collected surveillance data: weekly case counts of laboratory-confirmed influenza A virus. The main outcome is the percentage of prospective seasonal influenza cases identified by the ALERT algorithm. Results. When ALERT thresholds designed to capture 90% of all cases were applied prospectively to the 2011–2012 and 2012–2013 influenza seasons in both hospitals, 71%–91% of all reported cases fell within the ALERT period. Conclusions. The ALERT algorithm provides a simple, robust, and accurate metric for determining the onset of elevated influenza activity at the community level. This new algorithm provides valuable information that can impact infection prevention recommendations, public health practice, and healthcare delivery. PMID:25414260

  11. Influence of infectious disease seasonality on the performance of the outbreak detection algorithm in the China Infectious Disease Automated-alert and Response System

    PubMed Central

    Wang, Ruiping; Jiang, Yonggen; Guo, Xiaoqin; Wu, Yiling; Zhao, Genming

    2017-01-01

    Objective The Chinese Center for Disease Control and Prevention developed the China Infectious Disease Automated-alert and Response System (CIDARS) in 2008. The CIDARS can detect outbreak signals in a timely manner but generates many false-positive signals, especially for diseases with seasonality. We assessed the influence of seasonality on infectious disease outbreak detection performance. Methods Chickenpox surveillance data in Songjiang District, Shanghai were used. The optimized early alert thresholds for chickenpox were selected according to three algorithm evaluation indexes: sensitivity (Se), false alarm rate (FAR), and time to detection (TTD). Performance of selected proper thresholds was assessed by data external to the study period. Results The optimized early alert threshold for chickenpox during the epidemic season was the percentile P65, which demonstrated an Se of 93.33%, FAR of 0%, and TTD of 0 days. The optimized early alert threshold in the nonepidemic season was P50, demonstrating an Se of 100%, FAR of 18.94%, and TTD was 2.5 days. The performance evaluation demonstrated that the use of an optimized threshold adjusted for seasonality could reduce the FAR and shorten the TTD. Conclusions Selection of optimized early alert thresholds based on local infectious disease seasonality could improve the performance of the CIDARS. PMID:28728470

  12. Influence of infectious disease seasonality on the performance of the outbreak detection algorithm in the China Infectious Disease Automated-alert and Response System.

    PubMed

    Wang, Ruiping; Jiang, Yonggen; Guo, Xiaoqin; Wu, Yiling; Zhao, Genming

    2018-01-01

    Objective The Chinese Center for Disease Control and Prevention developed the China Infectious Disease Automated-alert and Response System (CIDARS) in 2008. The CIDARS can detect outbreak signals in a timely manner but generates many false-positive signals, especially for diseases with seasonality. We assessed the influence of seasonality on infectious disease outbreak detection performance. Methods Chickenpox surveillance data in Songjiang District, Shanghai were used. The optimized early alert thresholds for chickenpox were selected according to three algorithm evaluation indexes: sensitivity (Se), false alarm rate (FAR), and time to detection (TTD). Performance of selected proper thresholds was assessed by data external to the study period. Results The optimized early alert threshold for chickenpox during the epidemic season was the percentile P65, which demonstrated an Se of 93.33%, FAR of 0%, and TTD of 0 days. The optimized early alert threshold in the nonepidemic season was P50, demonstrating an Se of 100%, FAR of 18.94%, and TTD was 2.5 days. The performance evaluation demonstrated that the use of an optimized threshold adjusted for seasonality could reduce the FAR and shorten the TTD. Conclusions Selection of optimized early alert thresholds based on local infectious disease seasonality could improve the performance of the CIDARS.

  13. Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

    PubMed

    Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

    2017-06-01

    Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (p<0.05). The results of the ANOVA test also revealed that the educational degree and work experience in the healthcare environment (years) in the academic hospitals have a significant relationship with the mean score related to the hardware challenges, as well, experience with HIS has a significant relationship, with the mean score related to the human challenges (p<0.05). The most important challenges in using the information systems are the factors related to the human environment and the human factors. The

  14. The Impact of Alerting Designs on Air Traffic Controller's Eye Movement Patterns and Situation Awareness.

    PubMed

    Kearney, Peter; Li, Wen-Chin; Yu, Chung-San; Braithwaite, Graham

    2018-06-26

    This research investigated controller' situation awareness by comparing COOPANS's acoustic alerts with newly designed semantic alerts. The results demonstrate that ATCOs' visual scan patterns had significant differences between acoustic and semantic designs. ATCOs established different eye movement patterns on fixations number, fixation duration and saccade velocity. Effective decision support systems require human-centred design with effective stimuli to direct ATCO's attention to critical events. It is necessary to provide ATCOs with specific alerting information to reflect the nature of of the critical situation in order to minimize the side-effects of startle and inattentional deafness. Consequently, the design of a semantic alert can significantly reduce ATCOs' response time, therefore providing valuable extra time in a time-limited situation to formulate and execute resolution strategies in critical air safety events. The findings of this research indicate that the context-specified design of semantic alerts could improve ATCO's situational awareness and significantly reduce response time in the event of Short Term Conflict Alert activation which alerts to two aircraft having less than the required lateral or vertical separation.

  15. Evaluation of BacT/Alert 3D Liquid Culture System for Recovery of Mycobacteria from Clinical Specimens Using Sodium Dodecyl (Lauryl) Sulfate-NaOH Decontamination

    PubMed Central

    Carricajo, A.; Fonsale, N.; Vautrin, A. C.; Aubert, G.

    2001-01-01

    A total of 52 mycobacterial isolates were recovered from 1,197 clinical specimens decontaminated by a sodium dodecyl (lauryl) sulfate (SDS)-NaOH protocol. Of these, 94% were recovered with the BacT/Alert 3D system (Organon Teknika, Durham, N.C.) and 79% were recovered on Löwenstein-Jensen (LJ) medium. Mean times to detection of organisms of the Mycobacterium tuberculosis complex (n = 47) were 22.8 days with LJ medium and 16.2 days with the system. The BacT/Alert 3D system is a rapid and efficient detection system which can be used with an SDS-NaOH decontamination procedure. PMID:11574623

  16. Going for the Gold: Identifying Academic-Quality Internet Resources

    ERIC Educational Resources Information Center

    Axford, Mary; Renfro, Crystal

    2008-01-01

    The purpose of this article is to review some of the key directories of Internet resources, with a special focus on those that announce new academic-quality resources. Significant facets of the directories that will be incorporated in the discussion include scope of coverage, update frequency, identification of any e-mail alerts or RSS feeds…

  17. Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers.

    PubMed

    Gregory, Megan E; Russo, Elise; Singh, Hardeep

    2017-07-05

    Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied. To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload. A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States. Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system. Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

  18. Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert.

    PubMed

    Rolnick, Joshua; Downing, N Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

    2016-01-01

    Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems.

  19. Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert

    PubMed Central

    Downing, N. Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

    2016-01-01

    Summary Bachground Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. Objective To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. Methods The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Results Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. Conclusion We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems. PMID:27437061

  20. Experimental evaluation of candidate graphical microburst alert displays

    NASA Technical Reports Server (NTRS)

    Wanke, Craig; Hansman, R. John

    1992-01-01

    The topics addressed are: (1) experimental evaluation of candidate graphical microburst displays; (2) microburst detection and alerting; (3) previous part-task simulator experiment-comparison of presentation modes; (4) presentation mode comparison-results; (5) advantages of graphical mode of presentation; (6) graphical microburst alert experiment-objectives; and graphical microburst alert experiment-overview; and (7) candidate display design.

  1. Subjective alertness rhythms in elderly people

    NASA Technical Reports Server (NTRS)

    Monk, T. H.; Buysse, D. J.; Reynolds, C. F. 3rd; Kupfer, D. J.; Houck, P. R.

    1996-01-01

    The aim of this study was to evaluate age-related changes in the circadian rhythm of subjective alertness and to explore the circadian mechanisms underlying such changes. Using a visual analogue scale (VAS) instrument, 25 older men and women (71 y and older; 15 female, 10 male) rated their subjective alertness about 7 times per day during 5 baseline days of temporal isolation during which habitual bedtimes and waketimes were enforced. Comparisons were made with 13 middle-aged men (37-52 y) experiencing the same protocol. Advancing age (particularly in the men) resulted in less rhythmic alertness patterns, as indicated by lower amplitudes and less reliability of fitted 24-h sinusoids. This appeared in spite of the absence of any reliable age-related diminution in circadian temperature rhythm amplitude, thus suggesting the effect was not due to SCN weakness per se, but to weakened transduction of SCN output. In a further experiment, involving 36 h of constant wakeful bedrest, differences in the amplitude of the alertness rhythm were observed between 9 older men (79 y+), 7 older women (79 y+), and 17 young controls (9 males, 8 females, 19-28 y) suggesting that with advancing age (particularly in men) there is less rhythmic input into subjective alertness from the endogenous circadian pacemaker. These results may explain some of the nocturnal insomnia and daytime hypersomnia that afflict many elderly people.

  2. Providing accurate near real-time fire alerts for Protected Areas through NASA FIRMS: Opportunities and Challenges

    NASA Astrophysics Data System (ADS)

    Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Wong, M.; Murphy, K. J.

    2013-12-01

    The NASA Fire Information for Resource Management System (FIRMS) is at the forefront of providing global near real-time (NRT) MODIS thermal anomalies / hotspot location data to end-users . FIRMS serves the data via an interactive Web GIS named Web Fire Mapper, downloads of NRT active fire, archive data downloads for MODIS hotspots dating back to 1999 and a hotspot email alert system The FIRMS Email Alerts system has been successfully alerting users of fires in their area of interest in near real-time and/or via daily and weekly email summaries, with an option to receive MODIS hotspot data as a text file (CSV) attachment. Currently, there are more than 7000 email alert subscriptions from more than 100 countries. Specifically, the email alerts system is designed to generate and send an email alert for any region or area on the globe, with a special focus on providing alerts for protected areas worldwide. For many protected areas, email alerts are particularly useful for early fire detection, monitoring on going fires, as well as allocating resources to protect wildlife and natural resources of particular value. For protected areas, FIRMS uses the World Database on Protected Areas (WDPA) supplied by United Nations Environment Program - World Conservation Monitoring Centre (UNEP-WCMC). Maintaining the most up-to-date, accurate boundary geometry for the protected areas for the email alerts is a challenge as the WDPA is continuously updated due to changing boundaries, merging or delisting of certain protected areas. Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database. To maintain the most up-to-date boundary information for protected areas and to be in compliance with the WDPA terms and conditions, FIRMS needs to constantly update its database of protected areas. Currently, FIRMS strives to keep its database up to date by downloading the most recent

  3. Comparison of 'time to detection' values between BacT/ALERT VIRTUO and BacT/ALERT 3D instruments for clinical blood culture samples.

    PubMed

    Congestrì, Francesco; Pedna, Maria Federica; Fantini, Michela; Samuelli, Michela; Schiavone, Pasqua; Torri, Arianna; Bertini, Stefania; Sambri, Vittorio

    2017-09-01

    The early detection of bacteraemia and fungemia is of paramount importance to guide antimicrobial therapy in septic patients. In this study the 'time to detection' (TTD) value for the new blood culture system BacT/ALERT VIRTUO (VIRTUO) was evaluated in 1462 positive clinical bottles and compared with the TTD for 1601 positive clinical bottles incubated in the BacT/ALERT 3D system (BTA-3D). The most representative microorganisms isolated from bottles incubated in both blood culture systems were divided into eight categories (in order of frequency): coagulase-negative staphylococci (CoNS), Escherichia coli, Enterobacteriaceae (other than E. coli), Staphylococcus aureus, Enterococcus spp, viridans group streptococci, Pseudomonas aeruginosa, and Candida spp. The comparison of TTD values for the two blood culture systems strongly indicated that growth of the first five groups listed above was detected earlier with VIRTUO than with BTA-3D (p < 0.05). The new VIRTUO blood culture system can reduce the TTD for more than 75% of isolated microorganisms. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Effects of an air pollution personal alert system on health service usage in a high-risk general population: a quasi-experimental study using linked data.

    PubMed

    Lyons, R A; Rodgers, S E; Thomas, S; Bailey, R; Brunt, H; Thayer, D; Bidmead, J; Evans, B A; Harold, P; Hooper, M; Snooks, H

    2016-05-23

    There is no evidence to date on whether an intervention alerting people to high levels of pollution is effective in reducing health service utilisation. We evaluated alert accuracy and the effect of a targeted personal air pollution alert system, airAware, on emergency hospital admissions, emergency department attendances, general practitioner contacts and prescribed medications. Quasi-experimental study describing accuracy of alerts compared with pollution triggers; and comparing relative changes in healthcare utilisation in the intervention group to those who did not sign-up. Participants were people diagnosed with asthma, chronic obstructive pulmonary disease (COPD) or coronary heart disease, resident in an industrial area of south Wales and registered patients at 1 of 4 general practices. Longitudinal anonymised record linked data were modelled for participants and non-participants, adjusting for differences between groups. During the 2-year intervention period alerts were correctly issued on 208 of 248 occasions; sensitivity was 83.9% (95% CI 78.8% to 87.9%) and specificity 99.5% (95% CI 99.3% to 99.6%). The intervention was associated with a 4-fold increase in admissions for respiratory conditions (incidence rate ratio (IRR) 3.97; 95% CI 1.59 to 9.93) and a near doubling of emergency department attendance (IRR=1.89; 95% CI 1.34 to 2.68). The intervention was associated with increased emergency admissions for respiratory conditions. While findings may be context specific, evidence from this evaluation questions the benefits of implementing near real-time personal pollution alert systems for high-risk individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

    PubMed

    Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

    2017-11-01

    Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

  6. Characterization of computer network events through simultaneous feature selection and clustering of intrusion alerts

    NASA Astrophysics Data System (ADS)

    Chen, Siyue; Leung, Henry; Dondo, Maxwell

    2014-05-01

    As computer network security threats increase, many organizations implement multiple Network Intrusion Detection Systems (NIDS) to maximize the likelihood of intrusion detection and provide a comprehensive understanding of intrusion activities. However, NIDS trigger a massive number of alerts on a daily basis. This can be overwhelming for computer network security analysts since it is a slow and tedious process to manually analyse each alert produced. Thus, automated and intelligent clustering of alerts is important to reveal the structural correlation of events by grouping alerts with common features. As the nature of computer network attacks, and therefore alerts, is not known in advance, unsupervised alert clustering is a promising approach to achieve this goal. We propose a joint optimization technique for feature selection and clustering to aggregate similar alerts and to reduce the number of alerts that analysts have to handle individually. More precisely, each identified feature is assigned a binary value, which reflects the feature's saliency. This value is treated as a hidden variable and incorporated into a likelihood function for clustering. Since computing the optimal solution of the likelihood function directly is analytically intractable, we use the Expectation-Maximisation (EM) algorithm to iteratively update the hidden variable and use it to maximize the expected likelihood. Our empirical results, using a labelled Defense Advanced Research Projects Agency (DARPA) 2000 reference dataset, show that the proposed method gives better results than the EM clustering without feature selection in terms of the clustering accuracy.

  7. Heavy Metals in Notifications of Rapid Alert System for Food and Feed.

    PubMed

    Pigłowski, Marcin

    2018-02-20

    Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF) from 1980-2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health.

  8. Heavy Metals in Notifications of Rapid Alert System for Food and Feed

    PubMed Central

    Pigłowski, Marcin

    2018-01-01

    Heavy metals represent the fourth most often notified hazard category in the Rapid Alert System for Food and Feed (RASFF) from 1980–2016. The goal of the study was to examine the similarities in notifications of particular heavy metals within the RASFF year, product category, notifying country, country of origin, notification basis, notification type, distribution status, risk decision, and action taken, taking into account the particular product type, such as food, food contact material, and feed. The data originated from the RASFF database. Cluster analysis on pivot tables was applied using joining and two-way joining methods. Most notifications concerned food, in which the highest number were related to mercury, cadmium, chromium, lead, arsenic, and nickel. Notifications were mainly related to fish and food contact materials, in addition to fruits and vegetables, seafood, and dietetic food. The number of notifications decreased in 2015 and 2016. The majority of products were notified by Italy, Spain, Germany, and France. The notified products originated mainly from China and Spain. The notification was usually based on official controls on the market, as well as border controls. The notification types were mainly information, alert, and border rejections. Products were not frequently distributed due to distribution restriction to the notifying country or the possibility of distribution to the market. A risk decision was not usually made. The taken actions included re-dispatch of products, withdrawal from the market, or destruction. The data on heavy metals from the RASFF database can help European and national authorities in shaping public health. PMID:29461471

  9. Impact of a computer-generated alert system prompting review of antibiotic use in hospitals.

    PubMed

    Lesprit, Philippe; Duong, Trung; Girou, Emmanuelle; Hemery, François; Brun-Buisson, Christian

    2009-05-01

    The aim of this study was to measure the impact on antibiotic use of a computer-generated alert prompting post-prescription review and direct counselling in hospital wards. A computer-generated alert on new prescriptions of 15 antibiotics was reviewed weekly by an infectious disease physician for 41 weeks. During the first 6 months of the study, criteria selected for potential intervention were: (i) a planned duration of treatment of > or =10 days; (ii) discordance between the spectrum of the prescribed antibiotic and available microbiological results; or (iii) prescriptions of broad-spectrum beta-lactams, fluoroquinolones, glycopeptides or linezolid. During the following 5 months, the alert was restricted to any prescription of the 15 antibiotics in the 9 wards where overall antibiotic use had not decreased in the past year. We analysed 2385 prescriptions, 932 (39%) of which generated an alert for potential intervention. Among the latter, 482 (51.7%) prescriptions prompted direct counselling, mainly for shortening the planned duration of therapy (18.9%), withdrawing antibiotics (16.2%) or streamlining therapy (15.5%). The attending physicians' compliance with the recommendations was 80%. The overall median (interquartile range) days of therapy prescribed by the attending physicians was reduced from an initial duration of 8 (7-14) to 7 (6-11) days (P < 0.0001), resulting in 26.5% less antibiotic days prescribed. The time required for the intervention was 6 h per week. This computer-prompted post-prescription review led physicians to modify one half of the antibiotic courses initially prescribed and was well accepted by the majority, although they had not requested counselling.

  10. 78 FR 22270 - Special Fraud Alert: Physician-Owned Entities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ...] Special Fraud Alert: Physician-Owned Entities AGENCY: Office of Inspector General (OIG), HHS. ACTION... Physician-Owned Entities. Specifically, the Special Fraud Alert addressed physician-owned entities that... publication of the Special Fraud Alert on Physician-Owned Entities, an inadvertent error appeared in the DATES...

  11. Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.

    PubMed

    Hoste, Eric A J; Kashani, Kianoush; Gibney, Noel; Wilson, F Perry; Ronco, Claudio; Goldstein, Stuart L; Kellum, John A; Bagshaw, Sean M

    2016-01-01

    Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert. Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts. Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation. This paper reflects the findings of a non-systematic review and expert opinion. We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

  12. Performance of the BacT Alert 3D System Versus Solid Media for Recovery and Drug Susceptibility Testing of Mycobacterium tuberculosis in a Tertiary Hospital in Korea.

    PubMed

    Kim, Seoung-Cheol; Jeon, Bo-Young; Kim, Jin-Sook; Choi, In Hwan; Kim, Jiro; Woo, Jeongim; Kim, Soojin; Lee, Hyeong Woo; Sezim, Monoldorova; Cho, Sang-Nae

    2016-10-01

    Tuberculosis (TB) is a major health problem, and accurate and rapid diagnosis of multidrug-resistant (MDR) and extended drug-resistant (XDR) TB is important for appropriate treatment. In this study, performances of solid and liquid culture methods were compared with respect to MDR- and XDR-TB isolate recovery and drug susceptibility testing. Sputum specimens from 304 patients were stained with Ziehl-Neelsen method. Mycobacterium tuberculosis (Mtb) isolates were tested for recovery on Löwenstein-Jensen (LJ) medium and the BacT Alert 3D system. For drug susceptibility testing of Mtb, isolates were evaluated on M-KIT plates and the BacT Alert 3D system. The recovery rates were 94.9% (206/217) and 98.2% (213/217) for LJ medium and the BacT Alert 3D system, respectively (kappa coefficient, 0.884). The rate of drug resistance was 13.4% for at least one or more drugs, 6.0% for MDR-TB and 2.3% for XDR-TB. M-KIT plate and BacT 3D Alert 3D system were comparable in drug susceptibility testing for isoniazid (97.7%; kappa coefficient, 0.905) and rifampin (98.6%; kappa coefficient, 0.907). Antibiotic resistance was observed using M-KIT plates for 24 of the total 29 Mtb isolates (82.8%). The liquid culture system showed greater reduction in the culture period, as compared with LJ medium; however, drug susceptibility testing using M-KIT plates was advantageous for simultaneous testing against multiple drug targets.

  13. A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

    PubMed

    Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

    2015-09-01

    Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

  14. Automated Health Alerts Using In-Home Sensor Data for Embedded Health Assessment

    PubMed Central

    Guevara, Rainer Dane; Rantz, Marilyn

    2015-01-01

    We present an example of unobtrusive, continuous monitoring in the home for the purpose of assessing early health changes. Sensors embedded in the environment capture behavior and activity patterns. Changes in patterns are detected as potential signs of changing health. We first present results of a preliminary study investigating 22 features extracted from in-home sensor data. A 1-D alert algorithm was then implemented to generate health alerts to clinicians in a senior housing facility. Clinicians analyze each alert and provide a rating on the clinical relevance. These ratings are then used as ground truth for training and testing classifiers. Here, we present the methodology for four classification approaches that fuse multisensor data. Results are shown using embedded sensor data and health alert ratings collected on 21 seniors over nine months. The best results show similar performance for two techniques, where one approach uses only domain knowledge and the second uses supervised learning for training. Finally, we propose a health change detection model based on these results and clinical expertise. The system of in-home sensors and algorithms for automated health alerts provides a method for detecting health problems very early so that early treatment is possible. This method of passive in-home sensing alleviates compliance issues. PMID:27170900

  15. Structure alerts for carcinogenicity, and the Salmonella assay system: a novel insight through the chemical relational databases technology.

    PubMed

    Benigni, Romualdo; Bossa, Cecilia

    2008-01-01

    In the past decades, chemical carcinogenicity has been the object of mechanistic studies that have been translated into valuable experimental (e.g., the Salmonella assays system) and theoretical (e.g., compilations of structure alerts for chemical carcinogenicity) models. These findings remain the basis of the science and regulation of mutagens and carcinogens. Recent advances in the organization and treatment of large databases consisting of both biological and chemical information nowadays allows for a much easier and more refined view of data. This paper reviews recent analyses on the predictive performance of various lists of structure alerts, including a new compilation of alerts that combines previous work in an optimized form for computer implementation. The revised compilation is part of the Toxtree 1.50 software (freely available from the European Chemicals Bureau website). The use of structural alerts for the chemical biological profiling of a large database of Salmonella mutagenicity results is also reported. Together with being a repository of the science on the chemical biological interactions at the basis of chemical carcinogenicity, the SAs have a crucial role in practical applications for risk assessment, for: (a) description of sets of chemicals; (b) preliminary hazard characterization; (c) formation of categories for e.g., regulatory purposes; (d) generation of subsets of congeneric chemicals to be analyzed subsequently with QSAR methods; (e) priority setting. An important aspect of SAs as predictive toxicity tools is that they derive directly from mechanistic knowledge. The crucial role of mechanistic knowledge in the process of applying (Q)SAR considerations to risk assessment should be strongly emphasized. Mechanistic knowledge provides a ground for interaction and dialogue between model developers, toxicologists and regulators, and permits the integration of the (Q)SAR results into a wider regulatory framework, where different types of

  16. Integration of Airborne Aerosol Prediction Systems and Vegetation Phenology to Track Pollen for Asthma Alerts in Public Health Decision Support Systems

    NASA Technical Reports Server (NTRS)

    Luvall, Jeffrey C.; Sprigg, William A.; Huete, Alfredo; Pejanovic, Goran; Nickovic,Slobodan; Ponce-Campos, Guillermo; Krapfl, Heide; Budge, Amy; Zelicoff, Alan; VandeWater, Peter K.; hide

    2011-01-01

    This slide presentation reviews the study that used a model to forecast pollen to assist in warning for asthma populations. Using MODIS daily reflectances to input to a model, PREAM, adapted from the Dust REgional Atmospheric Modeling (DREAM) system, a product of predicted pollen is produced. Using the pollen from Juniper the PREAM model was shown to be an assist in alerting the public of pollen bursts, and reduce the health impact on asthma populations.

  17. Benefit Value to the Air Force of the GIDEP (Government Industry Data Exchange Program) Alert

    DTIC Science & Technology

    1984-06-15

    cost avoidance within that organization is not the result of the ALERT system . 3-1 b) Designed Life - This is the expected life of the item as...Analytics1 Phase II efforts under contract F33615-S3- C-5098. The main findings of the report are: (1) The system set up to handle Government...slow to issue ALERTs. (4) There is no formally documented system for determining that the Air Force’s warranty rights are being enforced on items

  18. Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

    PubMed

    Pfeiffer, Yvonne; Schwappach, David

    2016-01-01

    National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

  19. Description of the AILS Alerting Algorithm

    NASA Technical Reports Server (NTRS)

    Samanant, Paul; Jackson, Mike

    2000-01-01

    This document provides a complete description of the Airborne Information for Lateral Spacing (AILS) alerting algorithms. The purpose of AILS is to provide separation assurance between aircraft during simultaneous approaches to closely spaced parallel runways. AILS will allow independent approaches to be flown in such situations where dependent approaches were previously required (typically under Instrument Meteorological Conditions (IMC)). This is achieved by providing multiple levels of alerting for pairs of aircraft that are in parallel approach situations. This document#s scope is comprehensive and covers everything from general overviews, definitions, and concepts down to algorithmic elements and equations. The entire algorithm is presented in complete and detailed pseudo-code format. This can be used by software programmers to program AILS into a software language. Additional supporting information is provided in the form of coordinate frame definitions, data requirements, calling requirements as well as all necessary pre-processing and post-processing requirements. This is important and required information for the implementation of AILS into an analysis, a simulation, or a real-time system.

  20. Impact of Homeland Security Alert level on calls to a law enforcement peer support hotline.

    PubMed

    Omer, Saad B; Barnett, Daniel J; Castellano, Cherie; Wierzba, Rachel K; Hiremath, Girish S; Balicer, Ran D; Everly, George S

    2007-01-01

    The Homeland Security Advisory System (HSAS) was established by the Department of Homeland Security to communicate the risk of a terrorist event. In order to explore the potential psychological impacts of HSAS we analyzed the effects of terror alerts on the law enforcement community. We used data from the New Jersey Cop 2 Cop crisis intervention hotline. Incidence Rate Ratios--interpreted as average relative increases in the daily number of calls to the Cop 2 Cop hotline during an increased alert period--were computed from Poisson models. The hotline received a total of 4,145 initial calls during the study period. The mean daily number of calls was higher during alert level elevation compared to prior 7 days (7.68 vs. 8.00). In the Poisson regression analysis, the Incidence Rate Ratios of number of calls received during elevated alert levels compared to the reference period of seven days preceding each change in alert were close to 1, with confidence intervals crossing 1 (i.e. not statistically significant) for all lag periods evaluated. This investigation, in the context of New Jersey law enforcement personnel, does not support the concern that elevating the alert status places undue stress upon alert recipients.

  1. Applying the Toyota Production System: using a patient safety alert system to reduce error.

    PubMed

    Furman, Cathie; Caplan, Robert

    2007-07-01

    In 2002, Virginia Mason Medical Center (VMMC) adapted the Toyota Production System, also known as lean manufacturing. To translate the techniques of zero defects and stopping the line into health care, the Patient Safety Alert (PSA) system requires any employee who encounters a situation that is likely to harm a patient to make an immediate report and to cease any activity that could cause further harm (stopping the line). IMPLEMENTING THE PSA SYSTEM--STOPPING THE LINE: If any VMMC employee's practice or conduct is deemed capable of causing harm to a patient, a PSA can cause that person to be stopped from working until the problem is resolved. A policy statement, senior executive commitment, dedicated resources, a 24-hour hotline, and communication were all key features of implementation. As of December 2006, 6,112 PSA reports were received: 20% from managers, 8% from physicians, 44% from nurses, and 23% from nonclinical support personnel, for example. The number of reports received per month increased from an average of 3 in 2002 to 285 in 2006. Most reports were processed within 24 hours and were resolved within 2 to 3 weeks. Implementing the PSA system has drastically increased the number of safety concerns that are resolved at VMMC, while drastically reducing the time it takes to resolve them. Transparent discussion and feedback have helped promote staff acceptance and participation.

  2. Impact of faxed health alerts on the preparedness of general practitioners during communicable disease outbreaks.

    PubMed

    Rosewell, Alexander; Patel, Mahomed; Viney, Kerri; Marich, Andrew; Lawrence, Glenda L

    2010-03-01

    The NSW Department of Health (NSW Health) faxed health alerts to general medical practitioners during measles outbreaks in March and May 2006. We conducted a retrospective cohort study of randomly selected general practitioners (GPs) (1 per medical practice) in New South Wales to investigate the effectiveness of faxing health alerts to GPs during a communicable disease outbreak. Fax transmission data allowed comparison of GPs sent and not sent the measles alert for self-reported awareness and practice actions aimed at the prevention and control of measles. A total of 328 GPs participated in the study. GPs who were sent the alert were more likely to be aware of the measles outbreak (RR 1.18, 95% CI 1.02, 1.38). When analysed by whether a fax had been received from either NSW Health or the Australian General Practice Network, GPs who reported receiving a faxed measles alert were more likely to be aware of the outbreak (RR 2.56, 95% CI 1.84, 3.56), to offer vaccination to susceptible staff (RR 6.46, 95% CI 2.49, 16.78), and be aware of other infection control recommendations. Respondents reported that the faxed alerts were useful with 65% reporting that the alerts had reminded them to consider measles in the differential diagnosis. This study shows that faxed health alerts were useful for preparing GPs to respond effectively to a communicable disease outbreak. The fax alert system could be improved by ensuring that all general practices in New South Wales are included in the faxstream database and that their contact details are updated regularly.

  3. Development of a Human Motor Model for the Evaluation of an Integrated Alerting and Notification Flight Deck System

    NASA Technical Reports Server (NTRS)

    Daiker, Ron; Schnell, Thomas

    2010-01-01

    A human motor model was developed on the basis of performance data that was collected in a flight simulator. The motor model is under consideration as one component of a virtual pilot model for the evaluation of NextGen crew alerting and notification systems in flight decks. This model may be used in a digital Monte Carlo simulation to compare flight deck layout design alternatives. The virtual pilot model is being developed as part of a NASA project to evaluate multiple crews alerting and notification flight deck configurations. Model parameters were derived from empirical distributions of pilot data collected in a flight simulator experiment. The goal of this model is to simulate pilot motor performance in the approach-to-landing task. The unique challenges associated with modeling the complex dynamics of humans interacting with the cockpit environment are discussed, along with the current state and future direction of the model.

  4. Provider management strategies of abnormal test result alerts: a cognitive task analysis.

    PubMed

    Hysong, Sylvia J; Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

    2010-01-01

    Electronic medical records (EMRs) facilitate abnormal test result communication through "alert" notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results.

  5. Acute Kidney Injury in the Era of the AKI E-Alert

    PubMed Central

    Holmes, Jennifer; Rainer, Timothy; Geen, John; Roberts, Gethin; May, Kate; Wilson, Nick; Williams, John D.

    2016-01-01

    Background and objectives Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community– and hospital–acquired adult AKI. Design, setting, participants, & measurements A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults. Mortality and renal outcomes were assessed at 90 days. Results There was a total of 31,601 alerts representing 17,689 incident episodes, giving an incidence of AKI of 577 per 100,000 population. Community-acquired AKI accounted for 49.3% of all incident episodes, and 42% occurred in the context of preexisting CKD (Chronic Kidney Disease Epidemiology Collaboration eGFR); 90-day mortality rate was 25.6%, and 23.7% of episodes progressed to a higher AKI stage than the stage associated with the alert. AKI electronic alert stage and peak AKI stage were associated with mortality, and mortality was significantly higher for hospital-acquired AKI compared with alerts generated in a community setting. Among patients who survived to 90 days after the AKI electronic alert, those who were not hospitalized had a lower rate of renal recovery and a greater likelihood of developing an eGFR<60 ml/min per 1.73 m2 for the first time, which may be indicative of development of de novo CKD. Conclusions The reported incidence of AKI is far greater than the previously reported incidence in studies reliant on clinical identification of adult AKI or hospital coding data. Although an electronic alert system is Information Technology driven and therefore, lacks intelligence and clinical context, these data can be used to identify deficiencies in care, guide the development of appropriate intervention strategies, and provide a baseline against which the

  6. Alerting, orienting or executive attention networks: differential patters of pupil dilations

    PubMed Central

    Geva, Ronny; Zivan, Michal; Warsha, Aviv; Olchik, Dov

    2013-01-01

    Attention capacities, alerting responses, orienting to sensory stimulation, and executive monitoring of performance are considered independent yet interrelated systems. These operations play integral roles in regulating the behavior of diverse species along the evolutionary ladder. Each of the primary attention constructs—alerting, orienting, and executive monitoring—involves salient autonomic correlates as evidenced by changes in reactive pupil dilation (PD), heart rate, and skin conductance. Recent technological advances that use remote high-resolution recording may allow the discernment of temporo-spatial attributes of autonomic responses that characterize the alerting, orienting, and executive monitoring networks during free viewing, irrespective of voluntary performance. This may deepen the understanding of the roles of autonomic regulation in these mental operations and may deepen our understanding of behavioral changes in verbal as well as in non-verbal species. The aim of this study was to explore differences between psychosensory PD responses in alerting, orienting, and executive conflict monitoring tasks to generate estimates of concurrent locus coeruleus (LC) noradrenergic input trajectories in healthy human adults using the attention networks test (ANT). The analysis revealed a construct-specific pattern of pupil responses: alerting is characterized by an early component (Pa), its acceleration enables covert orienting, and executive control is evidenced by a prominent late component (Pe). PD characteristics seem to be task-sensitive, allowing exploration of mental operations irrespective of conscious voluntary responses. These data may facilitate development of studies designed to assess mental operations in diverse species using autonomic responses. PMID:24133422

  7. Chinese Academic Assessment and Incentive System.

    PubMed

    Suo, Qinghui

    2016-02-01

    The Chinese academic assessment and incentive system drew mixed responses from academia. In the essay the author tried to explain why the current assessment system is appropriate in China and an opportunistic behavior in Chinese academia is exposed.

  8. New ways of looking at sector demand and sector alerts

    DOT National Transportation Integrated Search

    2011-03-31

    This report presents the latest results of research conducted at the Volpe Center on improving air traffic demand predictions and enhancing the Traffic Flow Management System (TFMS) Monitor/Alert function for identifying potential congestion at Natio...

  9. AMDIS Case Conference: Intrusive Medication Safety Alerts.

    PubMed

    Graham, J; Levick, D; Schreiber, R

    2010-01-01

    Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center's dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

  10. Wet snow hazard for power lines: a forecast and alert system applied in Italy

    NASA Astrophysics Data System (ADS)

    Bonelli, P.; Lacavalla, M.; Marcacci, P.; Mariani, G.; Stella, G.

    2011-09-01

    Wet snow icing accretion on power lines is a real problem in Italy, causing failures on high and medium voltage power supplies during the cold season. The phenomenon is a process in which many large and local scale variables contribute in a complex way and not completely understood. A numerical weather forecast can be used to select areas where wet snow accretion has an high probability of occurring, but a specific accretion model must also be used to estimate the load of an ice sleeve and its hazard. All the information must be carefully selected and shown to the electric grid operator in order to warn him promptly. The authors describe a prototype of forecast and alert system, WOLF (Wet snow Overload aLert and Forecast), developed and applied in Italy. The prototype elaborates the output of a numerical weather prediction model, as temperature, precipitation, wind intensity and direction, to determine the areas of potential risk for the power lines. Then an accretion model computes the ice sleeves' load for different conductor diameters. The highest values are selected and displayed on a WEB-GIS application principally devoted to the electric operator, but also to more expert users. Some experimental field campaigns have been conducted to better parameterize the accretion model. Comparisons between real accidents and forecasted icing conditions are presented and discussed.

  11. The Effect of Automated Alerts on Provider Ordering Behavior in an Outpatient Setting

    PubMed Central

    Steele, Andrew W; Eisert, Sheri; Witter, Joel; Lyons, Pat; Jones, Michael A; Gabow, Patricia; Ortiz, Eduardo

    2005-01-01

    Background Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug–laboratory interactions in an outpatient primary-care setting. Methods and Findings A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug–laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug–laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274) of the times the rule processed, with 5.6% for only “missing laboratory values,” 6.0% for only “abnormal laboratory values,” and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed (5.6% vs

  12. Commercial Motor Vehicle Driver Fatigue And Alertness Study Executive Summary

    DOT National Transportation Integrated Search

    1996-11-01

    THE DRIVER FATIGUE AND ALERTNESS STUDY (DFAS) WAS THE LARGEST AND MOST COMPREHENSIVE OVER-THE-ROAD STUDY EVER CONDUCTED ON DRIVER FATIGUE AND ALERTNESS IN NORTH AMERICA. IT PROVIDES EXTENSIVE INFORMATION ON THE ALERTNESS, DRIVING PERFORMANCE, AND PHY...

  13. Provider management strategies of abnormal test result alerts: a cognitive task analysis

    PubMed Central

    Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

    2010-01-01

    Objective Electronic medical records (EMRs) facilitate abnormal test result communication through “alert” notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. Design 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Results Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Conclusion Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results. PMID:20064805

  14. AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS.

    PubMed

    Bevan, Amanda; Patel, Niesh

    2016-09-01

    Whilst the prescribing of both in-patient and discharge medicines is electronic, there was no automatic notification to clinical pharmacists when a discharge prescription was ready to be screened. The notification required a member of medical or nursing staff to bleep their pharmacist informing them of a prescription's availability. This manual process led to a delay in pharmacist screening which impacted on discharge. Prescriptions designated for pre-packed or patient's own medicine use were not seen at all by a clinical pharmacist. The initial intention was to develop a text messaging service; however this was not possible due to significant cost implications and its inflexibility. To decrease the time to clinical pharmacist screening for children's discharge prescriptions. A clinical pharmacist prescription alerting system was designed and implemented. The hospital's eDischarge Summaries are created and stored in the Trust's EPR database. A database query is executed that examines documents that have been signed by a prescriber which contain drug orders. The query runs every 15 minutes, Monday to Friday from 0800-2000. The database query exports a HTML data extract which is then packaged and sent using Exchange.Email was preferred as users access hospital WiFi, only receiving notifications on those laptops or smartphones connected to the Trust's email application. The HTML is embedded within the email body. The email is sent to named individuals within a given distribution list. The function is scalable to support all areas using Trust eDischarge Summaries.The system was introduced in April 2015. Data from before (June 2014-January 2015) and after (June 2015) implementation was compared. Prior to the introduction of an electronic alerting system the average time from a prescriber signing a prescription to clinical pharmacist screening was 93 minutes. Three months after starting the new system this time has reduced to 62 minutes, a reduction of 31 minutes or

  15. Project "Hypertension Alert."

    ERIC Educational Resources Information Center

    Sailors, Emma Lou

    1983-01-01

    "Hypertension Alert," a 1979-80 blood pressure screening-awareness project of the Yonkers, New York Public Schools, is described. Data is analyzed in tables for ethnic composition, and range of blood pressure readings for the high school, junior high school, and elementary school students tested. (Author/JMK)

  16. Final Report Program Plan for Search and Rescue Electronics Alerting and Locating System

    DOT National Transportation Integrated Search

    1974-02-01

    This study investigates the requirements that exist for electronic devices for alerting and locating distress incidents and presents a plan for acquiring an adequate capability. Data are provided that bound the problem. Possible alternatives are exam...

  17. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  18. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  19. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  20. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  1. 47 CFR 80.334 - False distress alerts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....S. Coast Guard; (d) Was repeated; or (e) Was transmitted using a false identity. [68 FR 46968, Aug... § 80.334 False distress alerts. A distress alert is false if it was transmitted without any indication that a mobile unit or person was in distress and required immediate assistance. Transmitting a false...

  2. Differential effects of phasic and tonic alerting on the efficiency of executive attention.

    PubMed

    Asanowicz, Dariusz; Marzecová, Anna

    2017-05-01

    The study examined how alerting and executive attention interact in a task involving conflict resolution. We proposed a tentative scenario in which an initial exogenous phasic alerting phase is followed by an endogenous tonic alerting phase, and hypothesized that these two processes may have distinct effects on conflict resolution. Phasic alerting was expected to increase the conflict, whereas tonic alerting was expected to decrease the conflict. Three experiments were conducted using different variants of the flanker task with visual alerting cues and varied cue-target intervals (SOA), to differentiate between effects of phasic alerting (short SOA) and tonic alerting (long SOA). The results showed that phasic alerting consistently decreased the efficiency of conflict resolution indexed by response time and accuracy, whereas tonic alerting increased the accuracy of conflict resolution, but at a cost in the speed of processing the conflict. The third experiment additionally showed that the effects of phasic alerting may be modulated by the psychophysical strength of alerting cues. Discussed are possible mechanisms that could account for the observed interactions between alerting and conflict resolution, as well as some discrepancies between the current and previous studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Early Alert of Academically At-Risk Students: An Open Source Analytics Initiative

    ERIC Educational Resources Information Center

    Jayaprakash, Sandeep M.; Moody, Erik W.; Lauría, Eitel J. M.; Regan, James R.; Baron, Joshua D.

    2014-01-01

    The Open Academic Analytics Initiative (OAAI) is a collaborative, multi-year grant program aimed at researching issues related to the scaling up of learning analytics technologies and solutions across all of higher education. The paper describes the goals and objectives of the OAAI, depicts the process and challenges of collecting, organizing and…

  4. Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

    PubMed

    Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

    2012-04-01

    To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions

  5. Runway Safety Monitor Algorithm for Runway Incursion Detection and Alerting

    NASA Technical Reports Server (NTRS)

    Green, David F., Jr.; Jones, Denise R. (Technical Monitor)

    2002-01-01

    The Runway Safety Monitor (RSM) is an algorithm for runway incursion detection and alerting that was developed in support of NASA's Runway Incursion Prevention System (RIPS) research conducted under the NASA Aviation Safety Program's Synthetic Vision System element. The RSM algorithm provides pilots with enhanced situational awareness and warnings of runway incursions in sufficient time to take evasive action and avoid accidents during landings, takeoffs, or taxiing on the runway. The RSM currently runs as a component of the NASA Integrated Display System, an experimental avionics software system for terminal area and surface operations. However, the RSM algorithm can be implemented as a separate program to run on any aircraft with traffic data link capability. The report documents the RSM software and describes in detail how RSM performs runway incursion detection and alerting functions for NASA RIPS. The report also describes the RIPS flight tests conducted at the Dallas-Ft Worth International Airport (DFW) during September and October of 2000, and the RSM performance results and lessons learned from those flight tests.

  6. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

  7. 47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

  8. Personalized Alert Notifications and Evacuation Routes in Indoor Environments

    PubMed Central

    Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

    2012-01-01

    The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

  9. The Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network.

    PubMed

    Benthin, Cody; Pannu, Sonal; Khan, Akram; Gong, Michelle

    2016-10-01

    The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsis-related syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. A majority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of one common electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

  10. Incident Management in Academic Information System using ITIL Framework

    NASA Astrophysics Data System (ADS)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  11. Revealing the functional neuroanatomy of intrinsic alertness using fMRI: methodological peculiarities.

    PubMed

    Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander T; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

    2011-01-01

    Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that--as a methodological artifact--left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the

  12. Revealing the Functional Neuroanatomy of Intrinsic Alertness Using fMRI: Methodological Peculiarities

    PubMed Central

    Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

    2011-01-01

    Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that – as a methodological artifact – left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing

  13. Acute alerting effects of light: A systematic literature review.

    PubMed

    Souman, Jan L; Tinga, Angelica M; Te Pas, Susan F; van Ee, Raymond; Vlaskamp, Björn N S

    2018-01-30

    Periodic, well timed exposure to light is important for our health and wellbeing. Light, in particular in the blue part of the spectrum, is thought to affect alertness both indirectly, by modifying circadian rhythms, and directly, giving rise to acute effects. We performed a systematic review of empirical studies on direct, acute effects of light on alertness to evaluate the reliability of these effects. In total, we identified 68 studies in which either light intensity, spectral distribution, or both were manipulated, and evaluated the effects on behavioral measures of alertness, either subjectively or measured in reaction time performance tasks. The results show that increasing the intensity of polychromatic white light has been found to increase subjective ratings of alertness in a majority of studies, though a substantial proportion of studies failed to find significant effects, possibly due to small sample sizes or high baseline light intensities. The effect of the color temperature of white light on subjective alertness is less clear. Some studies found increased alertness with higher color temperatures, but other studies reported no detrimental effects of filtering out the short wavelengths from the spectrum. Similarly, studies that used monochromatic light exposure showed no systematic pattern for the effects of blue light compared to longer wavelengths. Far fewer studies investigated the effects of light intensity or spectrum on alertness as measured with reaction time tasks and of those, very few reported significant effects. In general, the small sample sizes used in studies on acute alerting effects of light make it difficult to draw definitive conclusions and better powered studies are needed, especially studies that allow for the construction of dose-response curves. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Machine-learning-based Brokers for Real-time Classification of the LSST Alert Stream

    NASA Astrophysics Data System (ADS)

    Narayan, Gautham; Zaidi, Tayeb; Soraisam, Monika D.; Wang, Zhe; Lochner, Michelle; Matheson, Thomas; Saha, Abhijit; Yang, Shuo; Zhao, Zhenge; Kececioglu, John; Scheidegger, Carlos; Snodgrass, Richard T.; Axelrod, Tim; Jenness, Tim; Maier, Robert S.; Ridgway, Stephen T.; Seaman, Robert L.; Evans, Eric Michael; Singh, Navdeep; Taylor, Clark; Toeniskoetter, Jackson; Welch, Eric; Zhu, Songzhe; The ANTARES Collaboration

    2018-05-01

    The unprecedented volume and rate of transient events that will be discovered by the Large Synoptic Survey Telescope (LSST) demand that the astronomical community update its follow-up paradigm. Alert-brokers—automated software system to sift through, characterize, annotate, and prioritize events for follow-up—will be critical tools for managing alert streams in the LSST era. The Arizona-NOAO Temporal Analysis and Response to Events System (ANTARES) is one such broker. In this work, we develop a machine learning pipeline to characterize and classify variable and transient sources only using the available multiband optical photometry. We describe three illustrative stages of the pipeline, serving the three goals of early, intermediate, and retrospective classification of alerts. The first takes the form of variable versus transient categorization, the second a multiclass typing of the combined variable and transient data set, and the third a purity-driven subtyping of a transient class. Although several similar algorithms have proven themselves in simulations, we validate their performance on real observations for the first time. We quantitatively evaluate our pipeline on sparse, unevenly sampled, heteroskedastic data from various existing observational campaigns, and demonstrate very competitive classification performance. We describe our progress toward adapting the pipeline developed in this work into a real-time broker working on live alert streams from time-domain surveys.

  15. Alertness Modulates Conflict Adaptation and Feature Integration in an Opposite Way

    PubMed Central

    Chen, Jia; Huang, Xiting; Chen, Antao

    2013-01-01

    Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE) and feature integration effect which can be observed as the repetition priming effect (RPE) and feature overlap effect (FOE) depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT) and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy. PMID:24250824

  16. Space Debris Alert System for Aviation

    NASA Astrophysics Data System (ADS)

    Sgobba, Tommaso

    2013-09-01

    Despite increasing efforts to accurately predict space debris re-entry, the exact time and location of re-entry is still very uncertain. Partially, this is due to a skipping effect uncontrolled spacecraft may experience as they enter the atmosphere at a shallow angle. Such effect difficult to model depends on atmospheric variations of density. When the bouncing off ends and atmospheric re-entry starts, the trajectory and the overall location of surviving fragments can be precisely predicted but the time to impact with ground, or to reach the airspace, becomes very short.Different is the case of a functional space system performing controlled re-entry. Suitable forecasts methods are available to clear air and maritime traffic from hazard areas (so-called traffic segregation).In US, following the Space Shuttle Columbia accident in 2003, a re-entry hazard areas location forecast system was putted in place for the specific case of major malfunction of a Reusable Launch Vehicles (RLV) at re-entry. The Shuttle Hazard Area to Aircraft Calculator (SHAAC) is a system based on ground equipment and software analyses and prediction tools, which require trained personnel and close coordination between the organization responsible for RLV operation (NASA for Shuttle) and the Federal Aviation Administration. The system very much relies on the operator's capability to determine that a major malfunction has occurred.This paper presents a US pending patent by the European Space Agency, which consists of a "smart fragment" using a GPS localizer together with pre- computed debris footprint area and direct broadcasting of such hazard areas.The risk for aviation from falling debris is very remote but catastrophic. Suspending flight over vast swath of airspace for every re-entering spacecraft or rocket upper stage, which is a weekly occurrence, would be extremely costly and disruptive.The Re-entry Direct Broadcasting Alert System (R- DBAS) is an original merging and evolution of the Re

  17. Flight controller alertness and performance during spaceflight shiftwork operations.

    PubMed

    Kelly, S M; Rosekind, M R; Dinges, D F; Miller, D L; Gillen, K A; Gregory, K B; Aguilar, R D; Smith, R M

    1998-09-01

    Decreased alertness and performance associated with fatigue, sleep loss, and circadian disruption are issues faced by a diverse range of shiftwork operations personnel. During Space Transportation System (STS) operations, Mission Operations Directorate (MOD) personnel provide 24-hr. coverage of critical tasks. A joint NASA Johnson Space Center and NASA Ames Research Center project was undertaken to examine these issues in flight controllers during MOD shiftwork operations. An initial operational test of procedures and measures was conducted during the STS-53 mission in December 1992. The study measures included a Background Questionnaire, a subjective daily logbook completed on a 24-hour basis (to report sleep patterns, work periods, etc.), and an 8 minute performance and mood test battery administered at the beginning, middle, and end of each shift period. Seventeen flight controllers representing the 3 Orbit shifts participated. The initial results clearly support the need for further data collection during other STS missions to document baseline levels of alertness and performance during MOD shiftwork operations. Countermeasure strategies specific to the MOD environment are being developed to minimize the adverse effects of fatigue, sleep loss, and circadian disruption engendered by shiftwork operations. These issues are especially pertinent for the night shift operations and the acute phase advance required for the transition of day shift personnel into the night for shuttle launch. Implementation and evaluation of the countermeasure strategies to maximize alertness and performance is planned. As STS missions extend to further EDO (extended duration orbiters), and timelines and planning for 24-hour Space Station operations continue, alertness and performance issues related to sleep and circadian disruption will remain highly relevant in the MOD environment.

  18. Experimental evaluation of candidate graphical microburst alert displays

    NASA Technical Reports Server (NTRS)

    Wanke, Craig R.; Hansman, R. John

    1992-01-01

    A piloted flight simulator experiment was conducted to evaluate issues related to the display of microburst alerts on electronic cockpit instrumentation. Issues addressed include display clarity, usefulness of multilevel microburst intensity information, and whether information from multiple sensors should be presented separately or 'fused' into combined alerts. Nine active airline pilots of 'glass cockpit' aircraft participated in the study. Microburst alerts presented on a moving map display were found to be visually clear and useful to pilots. Also, multilevel intensity information coded by colors or patterns was found to be important for decision making purposes. Pilot opinion was mixed on whether to 'fuse' data from multiple sensors, and some resulting design tradeoffs were identified. The positional information included in the graphical alert presentation was found useful by the pilots for planning lateral missed approach maneuvers, but may result in deviations which could interfere with normal airport operations. A number of flight crew training issues were also identified.

  19. Alertness management in two-person long-haul flight operations

    NASA Technical Reports Server (NTRS)

    Rosekind, M. R.; Gander, P. H.

    1992-01-01

    Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.

  20. Education and Training Module in Alertness Management

    NASA Technical Reports Server (NTRS)

    Mallis, M. M.; Brandt, S. L.; Oyung, R. L.; Reduta, D. D.; Rosekind, M. R.

    2006-01-01

    The education and training module (ETM) in alertness management has now been integrated as part of the training regimen of the Pilot Proficiency Awards Program ("WINGS") of the Federal Aviation Administration. Originated and now maintained current by the Fatigue Countermeasures Group at NASA Ames Research Center, the ETM in Alertness Management is designed to give pilots the benefit of the best and most recent research on the basics of sleep physiology, the causes of fatigue, and strategies for managing alertness during flight operations. The WINGS program is an incentive program that encourages pilots at all licensing levels to participate in recurrent training, upon completion of which distinctive lapel or tie pins (wings) and certificates of completion are awarded. In addition to flight training, all WINGS applicants must attend at least one FAA-sponsored safety seminar, FAA-sanctioned safety seminar, or industry recurrent training program. The Fatigue Countermeasures Group provides an FAA-approved industry recurrent training program through an on-line General Aviation (GA) WINGS ETM in alertness management to satisfy this requirement. Since 1993, the Fatigue Countermeasures Group has translated fatigue and alertness information to operational environments by conducting two-day ETM workshops oriented primarily toward air-carrier operations subject to Part 121 of the Federal Aviation Regulations pertaining to such operations. On the basis of the information presented in the two-day ETM workshops, an ETM was created for GA pilots and was transferred to a Web-based version. To comply with the requirements of the WINGS Program, the original Web-based version has been modified to include hypertext markup language (HTML) content that makes information easily accessible, in-depth testing of alertness-management knowledge, new interactive features, and increased informational resources for GA pilots. Upon successful completion of this training module, a participant

  1. Implementing an overdose education and naloxone distribution program in a health system.

    PubMed

    Devries, Jennifer; Rafie, Sally; Polston, Gregory

    To design and implement a health system-wide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies. Academic health system, San Diego, California. University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital. In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdose-related deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions. Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates. Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including

  2. An Evaluation of Alert Services: Quantity versus Quality

    ERIC Educational Resources Information Center

    Zandian, Fatemeh; Riahinia, Nosrat; Azimi, Ali; Poursalehi, Nastaran

    2010-01-01

    Purpose: Online information vendors currently offer a variety of additional services; among these are alert services which present requested information on recent publications to registered users. This paper aims to investigate a variety of alert services provided by four online information vendors. Design/methodology/approach: A comparison of the…

  3. The need for academic electronic health record systems in nurse education.

    PubMed

    Chung, Joohyun; Cho, Insook

    2017-07-01

    The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

  4. Thermodynamic Alerter for Microbursts (TAMP)

    NASA Technical Reports Server (NTRS)

    Eccles, Peter J.

    1991-01-01

    The following subject areas are covered: microburst detection, location and measurement; thermal alerter for microbursts prototypes (TAMP); sensor-transmitters (Senstrans) design; TAMP installation; and DAPAD software.

  5. EEG quantification of alertness: methods for early identification of individuals most susceptible to sleep deprivation

    NASA Astrophysics Data System (ADS)

    Berka, Chris; Levendowski, Daniel J.; Westbrook, Philip; Davis, Gene; Lumicao, Michelle N.; Olmstead, Richard E.; Popovic, Miodrag; Zivkovic, Vladimir T.; Ramsey, Caitlin K.

    2005-05-01

    Electroencephalographic (EEG) and neurocognitive measures were simultaneously acquired to quantify alertness from 24 participants during 44-hours of sleep deprivation. Performance on a three-choice vigilance task (3C-VT), paired-associate learning/memory task (PAL) and modified Maintenance of Wakefulness Test (MWT), and sleep technician-observed drowsiness (eye-closures, head-nods, EEG slowing) were quantified. The B-Alert system automatically classifies each second of EEG on an alertness/drowsiness continuum. B-Alert classifications were significantly correlated with technician-observations, visually scored EEG and performance measures. B-Alert classifications during 3C-VT, and technician observations and performance during the 3C-VT and PAL evidenced progressively increasing drowsiness as a result of sleep deprivation with a stabilizing effect observed at the batteries occurring between 0600 and 1100 suggesting a possible circadian effect similar to those reported in previous sleep deprivation studies. Participants were given an opportunity to take a 40-minute nap approximately 24-hours into the sleep deprivation portion of the study (i.e., 7 PM on Saturday). The nap was followed by a transient period of increased alertness. Approximately 8 hours after the nap, behavioral and physiological measures of drowsiness returned to levels prior to the nap. Cluster analysis was used to stratify individuals into three groups based on their level of impairment as a result of sleep deprivation. The combination of B-Alert and neuro-behavioral measures may identify individuals whose performance is most susceptible to sleep deprivation. These objective measures could be applied in an operational setting to provide a "biobehavioral assay" to determine vulnerability to sleep deprivation.

  6. Bright light during nighttime: effects on the circadian regulation of alertness and performance.

    PubMed

    Daurat, A; Foret, J; Benoit, O; Mauco, G

    2000-01-01

    The present studies evaluated to what extent duration (all-night or 4-hour exposures) and timing of nocturnal bright light (BL) (beginning or end of the night) modulate effects on vigilance. The results showed that all-night BL exposure is able to alleviate the nocturnal decrements in alertness and performance. However, under certain circumstances, this continuous BL exposure may induce adverse effects on mood and finally reveal to be counterproductive. Shorter BL exposure (4 h) during nighttime helps improve mood and performance, although the effects of short BL pulses were less efficacious than all-night BL exposure. The latter part of the night appears the best time for using the alerting effect of BL. The immediate alerting effect of BL seems to be mediated by a global activation of the central nervous system. Copyright 2000 S. Karger AG, Basel

  7. Static Analysis Alert Audits: Lexicon and Rules

    DTIC Science & Technology

    2016-11-04

    collaborators • Includes a standard set of well-defined determinations for static analysis alerts • Includes a set of auditing rules to help auditors make...consistent decisions in commonly-encountered situations Different auditors should make the same determination for a given alert! Improve the quality and...scenarios • Establish assumptions auditors can make • Overall: help make audit determinations more consistent We developed 12 rules • Drew on our own

  8. Preliminary Results with the Design and Implementation of an Academic Management Information System

    PubMed Central

    Evans, Steven

    1984-01-01

    This paper provides an overview of aspects of an academic management information system (AMIS) at Creighton University's Academic Health Center. This report summarizes briefly some of the features of the system, our experiences in implementing it, some of the reactions from our academic community to a “foreign” body (and our attempts to reduce the rejection mechanism), as well as successes to date. Lastly we describe steps underway to expand the system into a full-fledged example of the system as envisioned in the Matheson and Cooper report on “Academic Information in the Academic Health Sciences Center.”

  9. R&D Alert. Volume 7, Number 2, 2005

    ERIC Educational Resources Information Center

    White, Noel, Ed.

    2005-01-01

    "R&D Alert" covers issues affecting schools in the Western Regional Educational Laboratory's four-state region--Arizona, California, Nevada, and Utah--and throughout the United States. This issue of "R&D Alert" shares what WestEd is learning from a sample of their latest work, focusing on three points in the process:…

  10. Airborne derivation of microburst alerts from ground-based Terminal Doppler Weather Radar information: A flight evaluation

    NASA Technical Reports Server (NTRS)

    Hinton, David A.

    1993-01-01

    An element of the NASA/FAA windshear program is the integration of ground-based microburst information on the flight deck, to support airborne windshear alerting and microburst avoidance. NASA conducted a windshear flight test program in the summer of 1991 during which airborne processing of Terminal Doppler Weather Radar (TDWR) data was used to derive microburst alerts. Microburst information was extracted from TDWR, transmitted to a NASA Boeing 737 in flight via data link, and processed to estimate the windshear hazard level (F-factor) that would be experienced by the aircraft in each microburst. The microburst location and F-factor were used to derive a situation display and alerts. The situation display was successfully used to maneuver the aircraft for microburst penetrations, during which atmospheric 'truth' measurements were made. A total of 19 penetrations were made of TDWR-reported microburst locations, resulting in 18 airborne microburst alerts from the TDWR data and two microburst alerts from the airborne reactive windshear detection system. The primary factors affecting alerting performance were spatial offset of the flight path from the region of strongest shear, differences in TDWR measurement altitude and airplane penetration altitude, and variations in microburst outflow profiles. Predicted and measured F-factors agreed well in penetrations near microburst cores. Although improvements in airborne and ground processing of the TDWR measurements would be required to support an airborne executive-level alerting protocol, the practicality of airborne utilization of TDWR data link data has been demonstrated.

  11. Pilot evaluation of a method to assess prescribers' information processing of medication alerts.

    PubMed

    Russ, Alissa L; Melton, Brittany L; Daggy, Joanne K; Saleem, Jason J

    2017-02-01

    Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking. To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display. A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus. This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the

  12. Tracking wakefulness as it fades: Micro-measures of alertness.

    PubMed

    Jagannathan, Sridhar R; Ezquerro-Nassar, Alejandro; Jachs, Barbara; Pustovaya, Olga V; Bareham, Corinne A; Bekinschtein, Tristan A

    2018-08-01

    A major problem in psychology and physiology experiments is drowsiness: around a third of participants show decreased wakefulness despite being instructed to stay alert. In some non-visual experiments participants keep their eyes closed throughout the task, thus promoting the occurrence of such periods of varying alertness. These wakefulness changes contribute to systematic noise in data and measures of interest. To account for this omnipresent problem in data acquisition we defined criteria and code to allow researchers to detect and control for varying alertness in electroencephalography (EEG) experiments under eyes-closed settings. We first revise a visual-scoring method developed for detection and characterization of the sleep-onset process, and adapt the same for detection of alertness levels. Furthermore, we show the major issues preventing the practical use of this method, and overcome these issues by developing an automated method (micro-measures algorithm) based on frequency and sleep graphoelements, which are capable of detecting micro variations in alertness. The validity of the micro-measures algorithm was verified by training and testing using a dataset where participants are known to fall asleep. In addition, we tested generalisability by independent validation on another dataset. The methods developed constitute a unique tool to assess micro variations in levels of alertness and control trial-by-trial retrospectively or prospectively in every experiment performed with EEG in cognitive neuroscience under eyes-closed settings. Copyright © 2018. Published by Elsevier Inc.

  13. Incidence of potential drug interactions in a transplant centre setting and relevance of electronic alerts for clinical practice support.

    PubMed

    Polidori, Piera; Di Giorgio, Concetta; Provenzani, Alessio

    2012-01-01

    Adverse drug events may occur as a result of drug-drug interactions (DDIs). Information technology (IT) systems can be an important decision-making tool for healthcare workers to identify DDIs. The aim of the study is to analyse drug prescriptions in our main hospital units, in order to measure the incidence and severity of potential DDIs. The utility of clinical decision-support systems (CDSSs) and computerised physician order entry (CPOE) in term of alerts adherence was also assessed. DDIs were assessed using a Micromedex® healthcare series database. The system, adopted by the hospital, generates alerts for prescriptions with negative interactions and thanks to an 'acknowledgement function' it is possible to verify physician adherence to alerts. This function, although used previously, became mandatory from September 2010. Physician adherence to alerts and mean monthly incidence of potential DDIs in analysed units, before and after the mandatory 'acknowledgement function', were calculated. The intensive care unit (ICU) registered the greatest incidence of potential DDIs (49.0%), followed by the abdominal surgery unit and dialysis (43.4 and 42.0%, respectively). The cardiothoracic surgery unit (41.6%), step-down unit (38.3%) and post-anaesthesia care unit (30.0%) were comparable. The operating theatre and endoscopy registered the fewest potential DDIs (28.2 and 22.7%, respectively). Adherence to alerts after the 'acknowledgement function' increased by 25.0% in the ICU, 54.0% in the cardiothoracic surgery unit, 52.5% in the abdominal surgery unit, 58.0% in the stepdown unit, 67.0% in dialysis, 51.0% in endoscopy and 48.0% in the post-anaesthesia care unit. In the operating theatre, adherence to alerts decreased from 34.0 to 30.0%. The incidence of potential DDIs after mandatory use of the 'acknowledgement function' decreased slightly in endoscopy (-2.9%), the abdominal surgery unit (-2.7%), dialysis (-1.9%) and the step-down unit (-1.4%). Improving DDI alerts will

  14. Improving Conflict Alert Performance Using Moving Target Detector Data.

    DTIC Science & Technology

    1982-06-01

    2 L136 IIIII I lIlS 1 1 10 11120 125 11111I ~1.6 MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU Of SIANDARDg 19bi A DOT/FAA/RD-82/47 DOT/FAA/CT-81...Differences for Stochastic Case 23 7 Illustration of Scenarios for Warning Time Tests 30 8 Illustration of Scenarios Used for Nuisance Alert 35 Area...Nuisance Alert Area Analysis of Scenario 3 with a Target 64 Velocity of 480 Knots and SPMB= SPPB =2.8 nmi 12 Nuisance Alert Area Analysis of Scenario 3

  15. An Investigation of Drug-Drug Interaction Alert Overrides at a Pediatric Hospital.

    PubMed

    Humphrey, Kate; Jorina, Maria; Harper, Marvin; Dodson, Brenda; Kim, Seung-Yeon; Ozonoff, Al

    2018-05-01

    Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital. There were >41 000 DDI alerts presented to clinicians; ∼90% were overridden. The 5 DDI pairs that were most frequently presented and overridden included the following: potassium chloride-spironolactone, methadone-ondansetron, ketorolac-ibuprofen, cyclosporine-fluconazole, and potassium chloride-enalapril, each with an alert override rate of ≥0.89. Override rates across provider groups ranged between 0.84 and 0.97. In general, patients with high complexity had a higher frequency of alert overrides, but the rates of alert overrides for each DDI pairing did not differ significantly. High rates of DDI alert overrides occur across medications, provider groups, and patient encounters. Methods to decrease DDI alerts which are likely to be overridden exist, but it is also clear that more robust and intelligent tools are needed. Characteristics exist at the medication, hospital, provider, and patient levels that can be used to help specialize and enhance information transmission. Copyright © 2018 by the American Academy of Pediatrics.

  16. Optical flow and driver's kinematics analysis for state of alert sensing.

    PubMed

    Jiménez-Pinto, Javier; Torres-Torriti, Miguel

    2013-03-28

    Road accident statistics from different countries show that a significant number of accidents occur due to driver's fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver's state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS), despite the driver's head and body movements. In this paper, we propose a technique that involves optical flow and driver's kinematics analysis to improve the robustness of the driver's alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver's pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators.

  17. Optical Flow and Driver's Kinematics Analysis for State of Alert Sensing

    PubMed Central

    Jiménez-Pinto, Javier; Torres-Torriti, Miguel

    2013-01-01

    Road accident statistics from different countries show that a significant number of accidents occur due to driver's fatigue and lack of awareness to traffic conditions. In particular, about 60% of the accidents in which long haul truck and bus drivers are involved are attributed to drowsiness and fatigue. It is thus fundamental to improve non-invasive systems for sensing a driver's state of alert. One of the main challenges to correctly resolve the state of alert is measuring the percentage of eyelid closure over time (PERCLOS), despite the driver's head and body movements. In this paper, we propose a technique that involves optical flow and driver's kinematics analysis to improve the robustness of the driver's alert state measurement under pose changes using a single camera with near-infrared illumination. The proposed approach infers and keeps track of the driver's pose in 3D space in order to ensure that eyes can be located correctly, even after periods of partial occlusion, for example, when the driver stares away from the camera. Our experiments show the effectiveness of the approach with a correct eyes detection rate of 99.41%, on average. The results obtained with the proposed approach in an experiment involving fifteen persons under different levels of sleep deprivation also confirm the discriminability of the fatigue levels. In addition to the measurement of fatigue and drowsiness, the pose tracking capability of the proposed approach has potential applications in distraction assessment and alerting of machine operators. PMID:23539029

  18. Human-computer interaction for alert warning and attention allocation systems of the multimodal watchstation

    NASA Astrophysics Data System (ADS)

    Obermayer, Richard W.; Nugent, William A.

    2000-11-01

    The SPAWAR Systems Center San Diego is currently developing an advanced Multi-Modal Watchstation (MMWS); design concepts and software from this effort are intended for transition to future United States Navy surface combatants. The MMWS features multiple flat panel displays and several modes of user interaction, including voice input and output, natural language recognition, 3D audio, stylus and gestural inputs. In 1999, an extensive literature review was conducted on basic and applied research concerned with alerting and warning systems. After summarizing that literature, a human computer interaction (HCI) designer's guide was prepared to support the design of an attention allocation subsystem (AAS) for the MMWS. The resultant HCI guidelines are being applied in the design of a fully interactive AAS prototype. An overview of key findings from the literature review, a proposed design methodology with illustrative examples, and an assessment of progress made in implementing the HCI designers guide are presented.

  19. Careers in Academe: The Academic Labour Market as an Eco-System

    ERIC Educational Resources Information Center

    Baruch, Yehuda

    2013-01-01

    Purpose: This paper aims to explore the contrast between stable and dynamic labour markets in academe in light of career theories that were originally developed for business environments. Design/methodology/approach: A conceptual design, offering the eco-system as a framework. Findings: It evaluates their relevance and applicability to dynamic and…

  20. Development of Effective Academic Affairs Administration System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Thongnoi, Niratchakorn; Srisa-ard, Boonchom; Sri-ampai, Anan

    2013-01-01

    This research aimed to: 1) study current situations and problems of academic affairs administration system in Primary Schools. 2) develop an effective academic affairs administration system, and 3) evaluate the implementation of the developed system in the primary school, Thailand. Research and Development (R&D) was employed which consisted of…

  1. Information Systems Education: The Case for the Academic Cloud

    ERIC Educational Resources Information Center

    Mew, Lionel

    2016-01-01

    This paper discusses how cloud computing can be leveraged to add value to academic programs in information systems and other fields by improving financial sustainment models for institutional technology and academic departments, relieving the strain on overworked technology support resources, while adding richness and improving pedagogical…

  2. Design and evaluation of a personal digital assistant- based alerting service for clinicians.

    PubMed

    Johnson, E Diane; Pancoast, Paul E; Mitchell, Joyce A; Shyu, Chi-Ren

    2004-10-01

    This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.

  3. PERCLOS : a valid psychophysiological measure of alertness as assessed by psychomotor vigilance

    DOT National Transportation Integrated Search

    1998-10-01

    This Tech Brief summarizes an Intelligent Transportation System (ITS) study titled "Evaluation of Techniques for Ocular Measurement as an Index of Fatigue and as the Basis for Alertness Management." The study was funded in part by the Federal Highway...

  4. How Regrouping Alerts in Computerized Physician Order Entry Layout Influences Physicians' Prescription Behavior: Results of a Crossover Randomized Trial.

    PubMed

    Wipfli, Rolf; Ehrler, Frederic; Bediang, Georges; Bétrancourt, Mireille; Lovis, Christian

    2016-06-02

    As demonstrated in several publications, low positive predictive value alerts in computerized physician order entry (CPOE) induce fatigue and may interrupt physicians unnecessarily during prescription of medication. Although it is difficult to increase the consideration of medical alerts by physician through an improvement of their predictive value, another approach consists to act on the way they are presented. The interruption management model inspired us to propose an alternative alert display strategy of regrouping the alerts in the screen layout, as a possible solution for reducing the interruption in physicians' workflow. In this study, we compared 2 CPOE designs based on a particular alert presentation strategy: one design involved regrouping the alerts in a single place on the screen, and in the other, the alerts were located next to the triggering information. Our objective was to evaluate experimentally whether the new design led to fewer interruptions in workflow and if it affected alert handling. The 2 CPOE designs were compared in a controlled crossover randomized trial. All interactions with the system and eye movements were stored for quantitative analysis. The study involved a group of 22 users consisting of physicians and medical students who solved medical scenarios containing prescription tasks. Scenario completion time was shorter when the alerts were regrouped (mean 117.29 seconds, SD 36.68) than when disseminated on the screen (mean 145.58 seconds, SD 75.07; P=.045). Eye tracking revealed that physicians fixated longer on alerts in the classic design (mean 119.71 seconds, SD 76.77) than in the centralized alert design (mean 70.58 seconds, SD 33.53; P=.001). Visual switches between prescription and alert areas, indicating interruption, were reduced with centralized alerts (mean 41.29, SD 21.26) compared with the classic design (mean 57.81, SD 35.97; P=.04). Prescription behavior (ie, prescription changes after alerting), however, did not change

  5. Verbal collision avoidance messages during simulated driving: perceived urgency, alerting effectiveness and annoyance.

    PubMed

    Baldwin, Carryl L

    2011-04-01

    Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Two experiments describe the impact of acoustic and semantic parameters on ratings of perceived urgency, annoyance and alerting effectiveness and on alarm response speed. Within a simulated driving context, participants rated and responded to collision avoidance system (CAS) messages spoken by a female or male voice (experiments 1 and 2, respectively). Results indicated greater perceived urgency and faster alarm response times as intensity increased from -2 dB signal to noise (S/N) ratio to +10 dB S/N, although annoyance ratings increased as well. CAS semantic content interacted with alarm intensity, indicating that at lower intensity levels participants paid more attention to the semantic content. Results indicate that both acoustic and semantic parameters independently and interactively impact CAS alert perceptions in divided attention conditions and this work can inform auditory alarm design for effective hazard matching. Matching the perceived urgency of an alert with the relative hazard level of the situation is critical for effective alarm response. Here, both acoustic and semantic parameters independently and interactively impacted CAS alert perceptions in divided attention conditions. This work can inform auditory alarm design for effective hazard matching. STATEMENT OF RELEVANCE: Results indicate that both acoustic parameters and semantic content can be used to design collision warnings with a range of urgency levels. Further, these results indicate that verbal warnings tailored to a specific hazard situation may improve hazard-matching capabilities without substantial trade-offs in perceived annoyance.

  6. Alert!: In Emergencies, Schools Use Technology to Get the Message out Quickly

    ERIC Educational Resources Information Center

    Violino, Bob

    2008-01-01

    This article describes how a growing number of community colleges have begun deploying emergency alert systems that can be used to send information via e-mail and text messaging directly to students' cell phones and other portable devices. Such systems enable authorized campus administrators to send messages to thousands of people within minutes.…

  7. Monitoring alert and drowsy states by modeling EEG source nonstationarity

    NASA Astrophysics Data System (ADS)

    Hsu, Sheng-Hsiou; Jung, Tzyy-Ping

    2017-10-01

    Objective. As a human brain performs various cognitive functions within ever-changing environments, states of the brain characterized by recorded brain activities such as electroencephalogram (EEG) are inevitably nonstationary. The challenges of analyzing the nonstationary EEG signals include finding neurocognitive sources that underlie different brain states and using EEG data to quantitatively assess the state changes. Approach. This study hypothesizes that brain activities under different states, e.g. levels of alertness, can be modeled as distinct compositions of statistically independent sources using independent component analysis (ICA). This study presents a framework to quantitatively assess the EEG source nonstationarity and estimate levels of alertness. The framework was tested against EEG data collected from 10 subjects performing a sustained-attention task in a driving simulator. Main results. Empirical results illustrate that EEG signals under alert versus drowsy states, indexed by reaction speeds to driving challenges, can be characterized by distinct ICA models. By quantifying the goodness-of-fit of each ICA model to the EEG data using the model deviation index (MDI), we found that MDIs were significantly correlated with the reaction speeds (r  =  -0.390 with alertness models and r  =  0.449 with drowsiness models) and the opposite correlations indicated that the two models accounted for sources in the alert and drowsy states, respectively. Based on the observed source nonstationarity, this study also proposes an online framework using a subject-specific ICA model trained with an initial (alert) state to track the level of alertness. For classification of alert against drowsy states, the proposed online framework achieved an averaged area-under-curve of 0.745 and compared favorably with a classic power-based approach. Significance. This ICA-based framework provides a new way to study changes of brain states and can be applied to

  8. Six years' experience of using the BacT/ALERT system to screen all platelet concentrates, and additional testing of outdated platelet concentrates to estimate the frequency of false-negative results.

    PubMed

    Larsen, C P; Ezligini, F; Hermansen, N O; Kjeldsen-Kragh, J

    2005-02-01

    Approximately 1 in every 2000 units of platelets is contaminated with bacteria. The BacT/ALERT automated blood culture system can be used to screen platelet concentrates (PCs) for bacterial contamination. Data were collected from May 1998 until May 2004. The number of PCs tested during this period was 36 896, most of which were produced from pools of four buffy-coats. On the day following blood collection or platelet apheresis, a 5-10 ml sample of the PC was aseptically transferred to a BacT/ALERT culture bottle for detection of aerobic bacteria. The sample was monitored for bacterial growth during the entire storage period of the PC (6.5 days). When a positive signal was generated, the culture bottle, the PC and the erythrocyte concentrates were tested for bacterial growth. In order to determine the frequency of false-negative BacT/ALERT signals, 1061 outdated PCs were tested during the period from May 2002 to May 2004. Eighty-eight positive signals were detected by the BacT/ALERT system, of which 12 were interpreted as truly positive. Fourteen signals were interpreted as truly false positive. Thirty-three signals were interpreted to be probably false positive. Two of 1061 outdated units tested positive, and Bacillus spp. and Staphylococcus epidermidis, respectively, were isolated from these PCs. Between 0.03% and 0.12% of the PCs were contaminated with bacteria. BacT/ALERT is an efficient tool for monitoring PCs for bacterial contamination; however, it is important to realize that false-negative results may occur.

  9. Time to Detection with BacT/Alert FA Plus Compared to BacT/Alert FA Blood Culture Media.

    PubMed

    Nutman, A; Fisher Even-Tsur, S; Shapiro, G; Braun, T; Schwartz, D; Carmeli, Y

    2016-09-01

    Rapid identification of the causative pathogen in patients with bacteremia allows adjustment of antibiotic therapy and improves patient outcomes. We compared in vitro and real-life time to detection (TTD) of two blood culture media, BacT/Alert FA (FA) and BacT/Alert FA Plus (FA Plus), for the nine most common species of bacterial pathogens recovered from blood samples. Experimental data from simulated cultures was compared with microbiology records of TTD for both culture media with growth of the species of interest in clinical blood cultures. In the experimental conditions, median TTD was 3.8 hours (23.9 %) shorter using FA Plus media. The magnitude of reduction differed between species. Similarly, in real life data, FA Plus had shorter TTD than FA media; however, the difference between culture media was smaller, and median TTD was only 1 hour (8.5 %) less. We found shorter TTD with BacT/Alert FA Plus culture media, both experimentally and in real-life conditions and unrelated to antibiotic neutralization, highlighting the importance of appropriate blood culture media selection.

  10. Runway Safety Monitor Algorithm for Single and Crossing Runway Incursion Detection and Alerting

    NASA Technical Reports Server (NTRS)

    Green, David F., Jr.

    2006-01-01

    The Runway Safety Monitor (RSM) is an aircraft based algorithm for runway incursion detection and alerting that was developed in support of NASA's Runway Incursion Prevention System (RIPS) research conducted under the NASA Aviation Safety and Security Program's Synthetic Vision System project. The RSM algorithm provides warnings of runway incursions in sufficient time for pilots to take evasive action and avoid accidents during landings, takeoffs or when taxiing on the runway. The report documents the RSM software and describes in detail how RSM performs runway incursion detection and alerting functions for NASA RIPS. The report also describes the RIPS flight tests conducted at the Reno/Tahoe International Airport (RNO) and the Wallops Flight Facility (WAL) during July and August of 2004, and the RSM performance results and lessons learned from those flight tests.

  11. 76 FR 81904 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... Special Fraud Alerts. DATES: To assure consideration, public comments must be delivered to the address... and Special Fraud Alerts. Please assist us by referencing the file code OIG-120-N. Inspection of...

  12. Alerting or Somnogenic Light: Pick Your Color.

    PubMed

    Bourgin, Patrice; Hubbard, Jeffrey

    2016-08-01

    In mammals, light exerts pervasive effects on physiology and behavior in two ways: indirectly through clock synchronization and the phase adjustment of circadian rhythms, and directly through the promotion of alertness and sleep, respectively, in diurnal and nocturnal species. A recent report by Pilorz and colleagues describes an even more complex role for the acute effects of light. In mice, blue light acutely causes behavioral arousal, whereas green wavelengths promote sleep. These opposing effects are mediated by melanopsin-based phototransduction through different neural pathways. These findings reconcile nocturnal and diurnal species through a common alerting response to blue light. One can hypothesize that the opposite responses to natural polychromatic light in night- or day-active animals may reflect higher sensitivity of nocturnal species to green, and diurnals to blue wavelengths, resulting in hypnogenic and alerting effects, respectively. Additional questions remain to be clarified. How do different light wavelengths affect other behaviors such as mood and cognition? How do those results apply to humans? How does light pose either a risk or benefit, depending on whether one needs to be asleep or alert? Indeed, in addition to timing, luminance levels, and light exposure duration, these findings stress the need to understand how best to adapt the color spectrum of light to our needs and to take this into account for the design of daily lighting concepts-a key challenge for today's society, especially with the emergence of LED light technology.

  13. Advantages and Disadvantages of Educational Email Alerts for Family Physicians: Viewpoint

    PubMed Central

    Badran, Hani; Grad, Roland

    2015-01-01

    Background Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. Objective The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians’ knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants’ suggestions to improve email alert services for CME. Methods We conducted a qualitative descriptive study using the “Knowledge, Attitude, Behavior” model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. Results All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. Conclusions The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts. PMID:25803184

  14. Advantages and disadvantages of educational email alerts for family physicians: viewpoint.

    PubMed

    Badran, Hani; Pluye, Pierre; Grad, Roland

    2015-02-27

    Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians' knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants' suggestions to improve email alert services for CME. We conducted a qualitative descriptive study using the "Knowledge, Attitude, Behavior" model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts.

  15. Thinking strategically: academic-practice relationships: one health system's experience.

    PubMed

    Wurmser, Teri; Bliss-Holtz, Jane

    2011-01-01

    Strategic planning and joint leverage of the strengths inherent in the academic and practice arenas of nursing are imperative to confront the challenges facing the profession of nursing and its place within the healthcare team of the future. This article presents a description and discussion of the implementation of several academic-practice partnership initiatives by Meridian Health, a health system located in central New Jersey. Included in the strategies discussed are creation of a support program for nonprofessional employees to become registered nurses; active partnership in the development of an accelerated BSN program; construction of support systems and academic partnerships for staff participation in RN-to-BSN programs; construction of on-site clinical simulation laboratories to foster interprofessional learning; and the implementation of a new BSN program, the first and only generic BSN program in two counties of the state. Outcomes of these academic-practice partnerships also are presented, including number of participants; graduation and NCLEX-RN pass rates; MH nurse vacancy rates; and nurse retention rates after first employment. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Flood alert system based on bayesian techniques

    NASA Astrophysics Data System (ADS)

    Gulliver, Z.; Herrero, J.; Viesca, C.; Polo, M. J.

    2012-04-01

    The problem of floods in the Mediterranean regions is closely linked to the occurrence of torrential storms in dry regions, where even the water supply relies on adequate water management. Like other Mediterranean basins in Southern Spain, the Guadalhorce River Basin is a medium sized watershed (3856 km2) where recurrent yearly floods occur , mainly in autumn and spring periods, driven by cold front phenomena. The torrential character of the precipitation in such small basins, with a concentration time of less than 12 hours, produces flash flood events with catastrophic effects over the city of Malaga (600000 inhabitants). From this fact arises the need for specific alert tools which can forecast these kinds of phenomena. Bayesian networks (BN) have been emerging in the last decade as a very useful and reliable computational tool for water resources and for the decision making process. The joint use of Artificial Neural Networks (ANN) and BN have served us to recognize and simulate the two different types of hydrological behaviour in the basin: natural and regulated. This led to the establishment of causal relationships between precipitation, discharge from upstream reservoirs, and water levels at a gauging station. It was seen that a recurrent ANN model working at an hourly scale, considering daily precipitation and the two previous hourly values of reservoir discharge and water level, could provide R2 values of 0.86. BN's results slightly improve this fit, but contribute with uncertainty to the prediction. In our current work to Design a Weather Warning Service based on Bayesian techniques the first steps were carried out through an analysis of the correlations between the water level and rainfall at certain representative points in the basin, along with the upstream reservoir discharge. The lower correlation found between precipitation and water level emphasizes the highly regulated condition of the stream. The autocorrelations of the variables were also

  17. Reliability of Trained Dogs to Alert to Hypoglycemia in Patients With Type 1 Diabetes

    PubMed Central

    Los, Evan A.; Ramsey, Katrina L.; Guttmann-Bauman, Ines; Ahmann, Andrew J.

    2016-01-01

    Background: We examined the reliability of trained dogs to alert to hypoglycemia in individuals with type 1 diabetes. Methods: Patients with type 1 diabetes who currently used diabetes alert dogs participated in this exploratory study. Subjects reported satisfaction, perceived dog glucose sensing ability and reasons for obtaining a trained dog. Reliability of dog alerts was assessed using capillary blood glucose (CBG) and blinded continuous glucose monitoring (CGM) as comparators in 8 subjects (age 4-48). Hypoglycemia was defined as CBG or CGM <70 mg/dL. Results: Dog users were very satisfied (8.9/10 on a Likert-type scale) and largely confident (7.9/10) in their dog’s ability to detect hypoglycemia. Detection of hypoglycemia was the primary reason for obtaining a trained dog. During hypoglycemia, spontaneous dog alerts occurred at a rate 3.2 (2.0-5.2, 95% CI) times higher than during euglycemia (70-179 mg/dL). Dogs provided timely alerts in 36% (sensitivity) of all hypoglycemia events (n = 45). Due to inappropriate alerts, the PPV of a dog alert for hypoglycemia was 12%. When there was concurrence of a hypoglycemic event between the dog alert and CGM (n = 30), CGM would have alerted prior to the dog in 73% of events (median 22-minute difference). Conclusions: This is the first study evaluating reliability of trained dogs to alert to hypoglycemia under real-life conditions. Trained dogs often alert a human companion to otherwise unknown hypoglycemia; however due to high false-positive rate, a dog alert alone is unlikely to be helpful in differentiating hypo-/hyper-/euglycemia. CGM often detects hypoglycemia before a trained dog by a clinically significant margin. PMID:27573791

  18. Reliability of Trained Dogs to Alert to Hypoglycemia in Patients With Type 1 Diabetes.

    PubMed

    Los, Evan A; Ramsey, Katrina L; Guttmann-Bauman, Ines; Ahmann, Andrew J

    2017-05-01

    We examined the reliability of trained dogs to alert to hypoglycemia in individuals with type 1 diabetes. Patients with type 1 diabetes who currently used diabetes alert dogs participated in this exploratory study. Subjects reported satisfaction, perceived dog glucose sensing ability and reasons for obtaining a trained dog. Reliability of dog alerts was assessed using capillary blood glucose (CBG) and blinded continuous glucose monitoring (CGM) as comparators in 8 subjects (age 4-48). Hypoglycemia was defined as CBG or CGM <70 mg/dL. Dog users were very satisfied (8.9/10 on a Likert-type scale) and largely confident (7.9/10) in their dog's ability to detect hypoglycemia. Detection of hypoglycemia was the primary reason for obtaining a trained dog. During hypoglycemia, spontaneous dog alerts occurred at a rate 3.2 (2.0-5.2, 95% CI) times higher than during euglycemia (70-179 mg/dL). Dogs provided timely alerts in 36% (sensitivity) of all hypoglycemia events (n = 45). Due to inappropriate alerts, the PPV of a dog alert for hypoglycemia was 12%. When there was concurrence of a hypoglycemic event between the dog alert and CGM (n = 30), CGM would have alerted prior to the dog in 73% of events (median 22-minute difference). This is the first study evaluating reliability of trained dogs to alert to hypoglycemia under real-life conditions. Trained dogs often alert a human companion to otherwise unknown hypoglycemia; however due to high false-positive rate, a dog alert alone is unlikely to be helpful in differentiating hypo-/hyper-/euglycemia. CGM often detects hypoglycemia before a trained dog by a clinically significant margin.

  19. The Montsec Observatory and the Gaia science alerts

    NASA Astrophysics Data System (ADS)

    Carrasco, J. M.; Burgaz, U.; Vilardell, F.; Jordi, C.

    2017-03-01

    The continuous and reiterative scan of the whole sky performed by Gaia ESA's mission during its (at least) 5 years of mission allows to detect transient events (e.g., supernovae, microlensing events, cataclysmic variables, etc) almost in real time among the daily millions of observations. The pipeline in charge to discover these alerts does a quick look analysis of the daily data stream, identify those sources increasing their brightness with respect to previous Gaia observations and also analyse their spectrophotometry to decide if those sources are good candidates to be published as a Gaia Photometric Science Alerts. These events are publicly announced for follow-up observations (both photometric and spectroscopic are needed). Observatories around the world confirm, classify and study them in detail. Observations are put in common and analysed together in a common interface in order to get a single analysis as detailed and precise as possible. Our team in Barcelona contributes to this Gaia science alerts follow-up programme with the 0.8 m robotic telescope Joan Oró (TJO), at the Montsec Observatory (OAdM), located at Sant Esteve de la Sarga (Lleida, Spain) performing photometric observations to derive the lightcurves of the most interesting alerts accessible from the observatory. Until now we have contributed with about 4500 images in multicolour Johnson-Cousins passbands obtained with TJO for a total of 38 Gaia science alerts, becoming the third most contributing observatory in the programme. Here we summarise the procedure to select new targets to be observed by TJO, submit follow-up observations and we explain the analysis we did for some interesting obtained lightcurves.

  20. The Traffic-Alert and Collision Avoidance System (TCAS) in the glass cockpit

    NASA Technical Reports Server (NTRS)

    Chappell, Sheryl L.

    1988-01-01

    This volume contains the contributions of the participants in the NASA Ames Research Center workshop on the traffic-alert and collision avoidance system (TCAS) implementation for aircraft with cathode ray tube (CRT) or flat panel displays. To take advantage of the display capability of the advanced-technology aircraft, NASA sponsored this workshop with the intent of bringing together industry personnel, pilots, and researchers so that pertinent issues in the area could be identified. During the 2-day workshop participants addressed a number of issues including: What is the optimum format for TCAS advisories. Where and how should maneuver advisories be presented to the crew. Should the maneuver advisories be presented on the primary flight display. Is it appropriate to have the autopilot perform the avoidance maneuver. Where and how should traffic information be presented to the crew. Should traffic information be combined with weather and navigation information. How much traffic should be shown and what ranges should be used. Contained in the document are the concepts and suggestions produced by the workshop participants.

  1. Promoting Safety in Hypnosis: A Clinical Instrument for the Assessment of Alertness.

    PubMed

    Howard, Hedy A

    2017-04-01

    Hypnosis has long demonstrated its power to facilitate various approaches to psychotherapy. Like other potent modalities, hypnosis may produce unwanted effects. Although its negative sequelae are usually mild and transient, more serious complications may occur. Recently, attention has been drawn to the powerful role of failures of dehypnosis or alerting/realerting in producing unwanted effects. Traditionally, alerting has been viewed as a relatively uncomplicated process that requires little more than the simple suggestion that the subject will return or awaken from trance, and exiting from trance has generally been considered the cessation of the phenomena suggested during induction and thereafter. Newer findings challenge these assumptions and suggest that restoring the subject to a prehypnotic baseline level of alertness is of equal or greater importance. Here, I describe the Howard Alertness Scale (HAS), with which subjects can be made aware of their baseline levels of alertness to help them understand the unique ways that their trance states differ from their normal alert states, and assess and measure their subjective perception of alertness before and after hypnosis. Furthermore, regular use of the HAS holds potential to enhance both the therapeutic alliance and the patient's sense of safety and mastery. The development and use of the HAS is discussed along with three vignettes illustrating its clinical application.

  2. 47 CFR 80.1117 - Procedure for receipt and acknowledgement of distress alerts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... radiotelephony of receipt of a distress alert from a ship station or a ship earth station must be given in the... telegraphy of receipt of a distress alert from a ship earth station must be given by the coast earth station... distress alerts. 80.1117 Section 80.1117 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED...

  3. 47 CFR 80.1117 - Procedure for receipt and acknowledgement of distress alerts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... radiotelephony of receipt of a distress alert from a ship station or a ship earth station must be given in the... telegraphy of receipt of a distress alert from a ship earth station must be given by the coast earth station... distress alerts. 80.1117 Section 80.1117 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED...

  4. 47 CFR 80.1117 - Procedure for receipt and acknowledgement of distress alerts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... radiotelephony of receipt of a distress alert from a ship station or a ship earth station must be given in the... telegraphy of receipt of a distress alert from a ship earth station must be given by the coast earth station... distress alerts. 80.1117 Section 80.1117 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED...

  5. 78 FR 78807 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-122-N...

  6. 77 FR 76434 - Solicitation of New Safe Harbors and Special Fraud Alerts

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ... of New Safe Harbors and Special Fraud Alerts AGENCY: Office of Inspector General (OIG), HHS. ACTION... statute (section 1128B(b) of the Social Security Act), as well as developing new OIG Special Fraud Alerts... revised safe harbors and Special Fraud Alerts. Please assist us by referencing the file code OIG-121-N...

  7. Strategies for Managing Smart Pump Alarm and Alert Fatigue: A Narrative Review.

    PubMed

    Shah, Parth K; Irizarry, Jamie; O'Neill, Sean

    2018-06-08

    Although smart infusion pumps are intended to prevent medication errors by alerting users about doses that exceed set thresholds, a large number of clinically insignificant alarms and alerts create the potential for alert and alarm fatigue. We searched the PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for peer-reviewed literature (January 1, 2004-August 31, 2017) on managing smart pump alerts, alarms, and related fatigue. Twenty-nine articles that met the inclusion criteria were reviewed and organized into themes. Smart pumps give users two types of signals: alarms that indicate mechanical issues such as occlusion, air in the line, or low battery; and clinical alerts that indicate that a programmed dose exceeds a predefined safety limit. Mechanical alarms occur with greater frequency than clinical alerts, but alarms and alerts vary widely by pump model, patient population, time of day, month, and type of drug. Several causes of clinically insignificant alerts and alarms may be actionable, and strategies proposed in the literature include development of a multidisciplinary team to oversee the quality improvement effort with involvement of end users, standardization of medication administration practices, widening of drug limit library thresholds when clinically appropriate, maintaining up-to-date drug limit libraries, and interoperability. Whereas many strategies have been proposed, and case studies have been reported, none have been rigorously evaluated. In addition, more research is needed related to managing occlusion and air-in-line alarms, especially for complicated infusions. Future work should focus on the evaluation of specific and replicable alert and alarm reduction strategies with a greater emphasis on quantitative metrics. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Design and evaluation of a personal digital assistant–based alerting service for clinicians*†

    PubMed Central

    Johnson, E. Diane; Pancoast, Paul E.; Mitchell, Joyce A.; Shyu, Chi-Ren

    2004-01-01

    Purpose: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). Description: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via email during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. Results/Outcome: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and email-oriented users. PMID:15494759

  9. IR panoramic alerting sensor concepts and applications

    NASA Astrophysics Data System (ADS)

    de Jong, Arie N.; Schwering, Piet B. W.

    2003-09-01

    During the last decade, protection of military and civilian operational platforms against weapons like guns, grenades, missiles, Unmanned Combat Aerial (and surface) Vehicles (UCAV's) and mines, has been an issue of increased importance due to the improved kill-probability of these threats. The standard countermeasure package of armour, guns, decoys, jammers, camouflage nets and smokes is inadequate when not accompanied by a suitable sensor package, primarily consisting of an alerting device, triggering consecutive steps in the countermeasure-chain. In this process of alert four different detection techniques are considered: pre-alert, giving the directions of possible attack, detection of an action of attack, identification of the threat and finally the precise localization (3-D). The design of the alerting device is greatly depending on the platform, on which it will be used, the associated and affordable cost and the nature of the threat. A number of sensor packages, considered, developed and evaluated at TNO-FEL is presented for simple, medium size and large and expensive platforms. In recent years the requirements for these sensors have become more and more strigent due to the growing number of scenarios. The attack can practically be from any direction, implying the need for a large Field of Regard (FOR), the attack range can vary considerably and the type of threat can be very diverse, implying great flexibility and dynamic range and rapid response of the sensor. Especially the localization at short ranges is a challenging issue. Various configurations including advantages and drawbacks are discussed.

  10. The effect of happiness and sadness on alerting, orienting, and executive attention.

    PubMed

    Finucane, Anne M; Whiteman, Martha C; Power, Mick J

    2010-05-01

    According to the attention network approach, attention is best understood in terms of three functionally and neuroanatomically distinct networks-alerting, orienting, and executive attention. An important question is whether the experience of emotion differentially influences the efficiency of these networks. This study examines 180 participants were randomly assigned to a happy, sad, or control condition and undertook a modified version of the Attention Network Test. The results showed no effect of happiness or sadness on alerting, orienting, or executive attention. However, sad participants showed reduced intrinsic alertness. This suggests that sadness reduces general alertness rather than impairing the efficiency of specific attention networks.

  11. Augmented real-time navigation with critical structure proximity alerts for endoscopic skull base surgery.

    PubMed

    Dixon, Benjamin J; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian J; Irish, Jonathan C

    2014-04-01

    Image-guided surgery (IGS) systems are frequently utilized during cranial base surgery to aid in orientation and facilitate targeted surgery. We wished to assess the performance of our recently developed localized intraoperative virtual endoscopy (LIVE)-IGS prototype in a preclinical setting prior to deployment in the operating room. This system combines real-time ablative instrument tracking, critical structure proximity alerts, three-dimensional virtual endoscopic views, and intraoperative cone-beam computed tomographic image updates. Randomized-controlled trial plus qualitative analysis. Skull base procedures were performed on 14 cadaver specimens by seven fellowship-trained skull base surgeons. Each subject performed two endoscopic transclival approaches; one with LIVE-IGS and one using a conventional IGS system in random order. National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores were documented for each dissection, and a semistructured interview was recorded for qualitative assessment. The NASA-TLX scores for mental demand, effort, and frustration were significantly reduced with the LIVE-IGS system in comparison to conventional navigation (P < .05). The system interface was judged to be intuitive and most useful when there was a combination of high spatial demand, reduced or absent surface landmarks, and proximity to critical structures. The development of auditory icons for proximity alerts during the trial better informed the surgeon while limiting distraction. The LIVE-IGS system provided accurate, intuitive, and dynamic feedback to the operating surgeon. Further refinements to proximity alerts and visualization settings will enhance orientation while limiting distraction. The system is currently being deployed in a prospective clinical trial in skull base surgery. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Best practices: an electronic drug alert program to improve safety in an accountable care environment.

    PubMed

    Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

    2015-04-01

    The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

  13. Expertise and responsibility effects on pilots' reactions to flight deck alerts in a simulator.

    PubMed

    Zheng, Yiyuan; Lu, Yanyu; Yang, Zheng; Fu, Shan

    2014-11-01

    Flight deck alerts provide system malfunction information designed to lead corresponding pilot reactions aimed at guaranteeing flight safety. This study examined the roles of expertise and flight responsibility and their relationship to pilots' reactions to flight deck alerts. There were 17 pilots composing 12 flight crews that were assigned into pairs according to flight hours and responsibilities. The experiment included 9 flight scenarios and was carried out in a CRJ-200 flight simulator. Pilot performance was recorded by a wide angle video camera, and four kinds of reactions to alerts were defined for analysis. Pilots tended to have immediate reactions to uninterrupted cautions, with a turning off rate as high as 75%. However, this rate decreased sharply when pilots encountered interrupted cautions and warnings; they also exhibited many wrong reactions to warnings. Pilots with more expertise had more reactions to uninterrupted cautions than those with less expertise, both as pilot flying and pilot monitoring. Meanwhile, the pilot monitoring, regardless of level of expertise, exhibited more reactions than the pilot flying. In addition, more experienced pilots were more likely to have wrong reactions to warnings while acting as the monitoring pilot. These results suggest that both expertise and flight responsibility influence pilots' reactions to alerts. Considering crew pairing strategy, when a pilot flying is a less experienced pilot, a more experience pilot is suggested to be the monitoring pilot. The results of this study have implications for understanding pilots' behaviors to flight deck alerts, calling for specialized training and design of approach alarms on the flight deck.

  14. Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases.

    PubMed

    Nair, Bala G; Newman, Shu-Fang; Peterson, Gene N; Wu, Wei-Ying; Schwid, Howard A

    2010-11-01

    Administration of prophylactic antibiotics during surgery is generally performed by the anesthesia providers. Timely antibiotic administration within the optimal time window before incision is critical for prevention of surgical site infections. However, this often becomes a difficult task for the anesthesia team during the busy part of a case when the patient is being anesthetized. Starting with the implementation of an anesthesia information management system (AIMS), we designed and implemented several feedback mechanisms to improve compliance of proper antibiotic delivery and documentation. This included generating e-mail feedback of missed documentation, distributing monthly summary reports, and generating real-time electronic alerts with a decision support system. In 20,974 surgical cases for the period, June 2008 to January 2010, the interventions of AIMS install, e-mail feedback, summary reports, and real-time alerts changed antibiotic compliance by -1.5%, 2.3%, 4.9%, and 9.3%, respectively, when compared with the baseline value of 90.0% ± 2.9% when paper anesthesia records were used. Highest antibiotic compliance was achieved when using real-time alerts. With real-time alerts, monthly compliance was >99% for every month between June 2009 and January 2010. Installation of AIMS itself did not improve antibiotic compliance over that achieved with paper anesthesia records. However, real-time guidance and reminders through electronic messages generated by a computerized decision support system (Smart Anesthesia Messenger, or SAM) significantly improved compliance. With such a system a consistent compliance of >99% was achieved.

  15. An Unobtrusive Fall Detection and Alerting System Based on Kalman Filter and Bayes Network Classifier.

    PubMed

    He, Jian; Bai, Shuang; Wang, Xiaoyi

    2017-06-16

    Falls are one of the main health risks among the elderly. A fall detection system based on inertial sensors can automatically detect fall event and alert a caregiver for immediate assistance, so as to reduce injuries causing by falls. Nevertheless, most inertial sensor-based fall detection technologies have focused on the accuracy of detection while neglecting quantization noise caused by inertial sensor. In this paper, an activity model based on tri-axial acceleration and gyroscope is proposed, and the difference between activities of daily living (ADLs) and falls is analyzed. Meanwhile, a Kalman filter is proposed to preprocess the raw data so as to reduce noise. A sliding window and Bayes network classifier are introduced to develop a wearable fall detection system, which is composed of a wearable motion sensor and a smart phone. The experiment shows that the proposed system distinguishes simulated falls from ADLs with a high accuracy of 95.67%, while sensitivity and specificity are 99.0% and 95.0%, respectively. Furthermore, the smart phone can issue an alarm to caregivers so as to provide timely and accurate help for the elderly, as soon as the system detects a fall.

  16. Reducing Unnecessary and Duplicate Ordering for Ovum and Parasite Examinations and Clostridium difficile PCR in Immunocompromised Patients by Using an Alert at the Time of Request in the Order Management System

    PubMed Central

    Shuptar, Susan L.; Milord, Philippe; Essick, Connor J.; Nevrekar, Reshma; Granovsky, Svetlana L.; Seo, Susan K.; Martin, Steven C.; Pessin, Melissa S.

    2015-01-01

    We implemented hospital information system (HIS) alerts to deter unnecessary test orders for ovum and parasite (O&P) exams and Clostridium difficile PCR. The HIS alerts decreased noncompliant O&P orders (orders after >72 h of hospitalization) from 49.8% to 30.9%, an overall decrease of 19%, and reduced noncompliant C. difficile PCR orders (orders <7 days after a previous positive result) from 30.6% to 19.2%, an overall decrease of 31.9%. PMID:26063860

  17. [Non-linear research of alertness levels under sleep deprivation].

    PubMed

    Xue, Ranting; Zhou, Peng; Gao, Xiang; Dong, Xinming; Wang, Xiaolu; Ming, Dong; Qi, Hongzhi; Wang, Xuemin

    2014-06-01

    We applied Lempel-Ziv complexity (LZC) combined with brain electrical activity mapping (BEAM) to study the change of alertness under sleep deprivation in our research. Ten subjects were involved in 36 hours sleep deprivation (SD), during which spontaneous electroencephalogram (EEG) experiments and auditory evoked EEG experiments-Oddball were recorded once every 6 hours. Spontaneous and evoked EEG data were calculated and BEAMs were structured. Results showed that during the 36 hours of SD, alertness could be divided into three stages, i. e. the first 12 hours as the high stage, the middle 12 hours as the rapid decline stage and the last 12 hours as the low stage. During the period SD, LZC of Spontaneous EEG decreased over the whole brain to some extent, but remained consistent with the subjective scales. By BEAMs of event related potential, LZC on frontal cortex decreased, but kept consistent with the behavioral responses. Therefore, LZC can be effective to reflect the change of brain alertness. At the same time LZC could be used as a practical index to monitor real-time alertness because of its simple computation and fast calculation.

  18. Data-driven system to predict academic grades and dropout

    PubMed Central

    Rovira, Sergi; Puertas, Eloi

    2017-01-01

    Nowadays, the role of a tutor is more important than ever to prevent students dropout and improve their academic performance. This work proposes a data-driven system to extract relevant information hidden in the student academic data and, thus, help tutors to offer their pupils a more proactive personal guidance. In particular, our system, based on machine learning techniques, makes predictions of dropout intention and courses grades of students, as well as personalized course recommendations. Moreover, we present different visualizations which help in the interpretation of the results. In the experimental validation, we show that the system obtains promising results with data from the degree studies in Law, Computer Science and Mathematics of the Universitat de Barcelona. PMID:28196078

  19. Data-driven system to predict academic grades and dropout.

    PubMed

    Rovira, Sergi; Puertas, Eloi; Igual, Laura

    2017-01-01

    Nowadays, the role of a tutor is more important than ever to prevent students dropout and improve their academic performance. This work proposes a data-driven system to extract relevant information hidden in the student academic data and, thus, help tutors to offer their pupils a more proactive personal guidance. In particular, our system, based on machine learning techniques, makes predictions of dropout intention and courses grades of students, as well as personalized course recommendations. Moreover, we present different visualizations which help in the interpretation of the results. In the experimental validation, we show that the system obtains promising results with data from the degree studies in Law, Computer Science and Mathematics of the Universitat de Barcelona.

  20. Last name analysis of mobility, gender imbalance, and nepotism across academic systems

    PubMed Central

    2017-01-01

    In biology, last names have been used as proxy for genetic relatedness in pioneering studies of neutral theory and human migrations. More recently, analyzing the last name distribution of Italian academics has raised the suspicion of nepotism, with faculty hiring their relatives for academic posts. Here, we analyze three large datasets containing the last names of all academics in Italy, researchers from France, and those working at top public institutions in the United States. Through simple randomizations, we show that the US academic system is geographically well-mixed, whereas Italian academics tend to work in their native region. By contrasting maiden and married names, we can detect academic couples in France. Finally, we detect the signature of nepotism in the Italian system, with a declining trend. The claim that our tests detect nepotism as opposed to other effects is supported by the fact that we obtain different results for the researchers hired after 2010, when an antinepotism law was in effect. PMID:28673985