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1

AN EMERGENT FRAMEWORK FOR REALISTIC PSYCHOSOCIAL BEHAVIOUR IN NON PLAYER  

E-print Network

for emergent psychosocial behaviour in non player characters in video games. This framework uses concepts of reputation systems where NPCs share opinions of the game player based on their behaviour in the game world [1AN EMERGENT FRAMEWORK FOR REALISTIC PSYCHOSOCIAL BEHAVIOUR IN NON PLAYER CHARACTERS Christine

Katchabaw, Michael James

2

A realistic evaluation: the case of protocol-based care  

PubMed Central

Background 'Protocol based care' was envisioned by policy makers as a mechanism for delivering on the service improvement agenda in England. Realistic evaluation is an increasingly popular approach, but few published examples exist, particularly in implementation research. To fill this gap, within this paper we describe the application of a realistic evaluation approach to the study of protocol-based care, whilst sharing findings of relevance about standardising care through the use of protocols, guidelines, and pathways. Methods Situated between positivism and relativism, realistic evaluation is concerned with the identification of underlying causal mechanisms, how they work, and under what conditions. Fundamentally it focuses attention on finding out what works, for whom, how, and in what circumstances. Results In this research, we were interested in understanding the relationships between the type and nature of particular approaches to protocol-based care (mechanisms), within different clinical settings (context), and what impacts this resulted in (outcomes). An evidence review using the principles of realist synthesis resulted in a number of propositions, i.e., context, mechanism, and outcome threads (CMOs). These propositions were then 'tested' through multiple case studies, using multiple methods including non-participant observation, interviews, and document analysis through an iterative analysis process. The initial propositions (conjectured CMOs) only partially corresponded to the findings that emerged during analysis. From the iterative analysis process of scrutinising mechanisms, context, and outcomes we were able to draw out some theoretically generalisable features about what works, for whom, how, and what circumstances in relation to the use of standardised care approaches (refined CMOs). Conclusions As one of the first studies to apply realistic evaluation in implementation research, it was a good fit, particularly given the growing emphasis on understanding how context influences evidence-based practice. The strengths and limitations of the approach are considered, including how to operationalise it and some of the challenges. This approach provided a useful interpretive framework with which to make sense of the multiple factors that were simultaneously at play and being observed through various data sources, and for developing explanatory theory about using standardised care approaches in practice. PMID:20504293

2010-01-01

3

Remembering and Celebrating a Realistic Evaluation Visionary  

ERIC Educational Resources Information Center

In this article, Michael Quinn Patton pays tribute to Carol Hirschon Weiss, a woman who brought passion to evaluation use. She also brought attention to it, publishing the first article on evaluation in 1967. Weiss' many contributions have come into evaluation currency and overtaken formerly taken-for-granted assumptions. Indeed, her insights…

Patton, Michael Quinn

2013-01-01

4

An Emergent Framework For Realistic Psychosocial Behaviour In Non Player Characters  

E-print Network

for emergent psychosocial behaviour in non player characters in video games. This framework uses concepts on their #12;behaviour in the game world (Alt and King, 2002; Brockington, 2003; Electronic Arts, 2005; GrondAn Emergent Framework For Realistic Psychosocial Behaviour In Non Player Characters Christine

Katchabaw, Michael James

5

The use and limitation of realistic evaluation as a tool for evidence-based practice: a critical realist perspective.  

PubMed

The use and limitation of realistic evaluation as a tool for evidence-based practice: a critical realist perspective In this paper, we assess realistic evaluation's articulation with evidence-based practice (EBP) from the perspective of critical realism. We argue that the adoption by realistic evaluation of a realist causal ontology means that it is better placed to explain complex healthcare interventions than the traditional method used by EBP, the randomized controlled trial (RCT). However, we do not conclude from this that the use of RCTs is without merit, arguing that it is possible to use both methods in combination under the rubric of realist theory. More negatively, we contend that the rejection of critical theory and utopianism by realistic evaluation in favour of the pragmatism of piecemeal social engineering means that it is vulnerable to accusations that it promotes technocratic interpretations of human problems. We conclude that, insofar as realistic evaluation adheres to the ontology of critical realism, it provides a sound contribution to EBP, but insofar as it rejects the critical turn of Bhaskar's realism, it replicates the technocratic tendencies inherent in EBP. PMID:22212367

Porter, Sam; O'Halloran, Peter

2012-03-01

6

Emergency evaluation of adolescents.  

PubMed

Psychiatric emergencies faced by adolescents are often linked to developmental issues such as separating from parents, establishing attachments to peers, and developing autonomy. In a vulnerable adolescent, a stressful developmental event may trigger a pathological response--acute anxiety, depression with or without suicidal ideation or behavior, severe conduct disturbance, a first psychotic episode, or explosive or violent behavior--that requires emergency psychiatric treatment. The basic components of an emergency psychiatric evaluation of an adolescent include initial observation of the patient, taking a history, interviewing the patient and others accompanying the patient, conducting a mental status examination, making a diagnosis, and planning for disposition and further treatment. Such an evaluation may be the first contact with the mental health system for many adolescents, and the intervention of a sensitive clinician may help the adolescent be more comfortable seeking mental health care in the future. PMID:1601405

Kalogerakis, M G

1992-06-01

7

A realist evaluation of the management of a well- performing regional hospital in Ghana  

PubMed Central

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

2010-01-01

8

Time-scale invariance as an emergent property in a perceptron with realistic, noisy neurons  

PubMed Central

In most species, interval timing is time-scale invariant: errors in time estimation scale up linearly with the estimated duration. In mammals, time-scale invariance is ubiquitous over behavioral, lesion, and pharmacological manipulations. For example, dopaminergic drugs induce an immediate, whereas cholinergic drugs induce a gradual, scalar change in timing. Behavioral theories posit that time-scale invariance derives from particular computations, rules, or coding schemes. In contrast, we discuss a simple neural circuit, the perceptron, whose output neurons fire in a clockwise fashion (interval timing) based on the pattern of coincidental activation of its input neurons. We show numerically that time-scale invariance emerges spontaneously in a perceptron with realistic neurons, in the presence of noise. Under the assumption that dopaminergic drugs modulate the firing of input neurons, and that cholinergic drugs modulate the memory representation of the criterion time, we show that a perceptron with realistic neurons reproduces the pharmacological clock and memory patterns, and their time-scale invariance, in the presence of noise. These results suggest that rather than being a signature of higher-order cognitive processes or specific computations related to timing, time-scale invariance may spontaneously emerge in a massively-connected brain from the intrinsic noise of neurons and circuits, thus providing the simplest explanation for the ubiquity of scale invariance of interval timing. PMID:23518297

Buhusi, Catalin V.; Oprisan, Sorinel A.

2013-01-01

9

Emergency nurse residency program evaluation.  

PubMed

The purpose of this mixed method descriptive study was to perform a program evaluation on an emergency nurse residency program. The study identified leaders' goals, objectives, and outcomes and the nurse residents' perceptions of the program, including whether they felt prepared to make the transition into their new role. The program evaluation revealed that the nurse residents felt confident, secure, and prepared to function as well-rounded emergency nurses after completing the emergency nurse residency program, in congruence with leaders' objectives. PMID:24060658

Johnson, Anitra; Salisbury, Helen; Johannsson, Mark; Barajas, Kenny

2013-01-01

10

Method to Filter ECGs and Evaluate Clinical Parameter Distortion using Realistic ECG Model Parameter Fitting  

E-print Network

Method to Filter ECGs and Evaluate Clinical Parameter Distortion using Realistic ECG Model Abstract By fitting a previously published nonlinear model for generating realistic ECG to waveforms, the authors demonstrate that significant points (P, Q, R, S, and T) on the ECG can be determined

McSharry, Patrick E.

11

Realistic assessment of the physican-staffed emergency services in Germany  

Microsoft Academic Search

In Germany the emergency medical services, which include dispatching emergency physicians to the scene, are considered to be among the best in the world. However, the hospitals admitting these patients still report shortcomings in prehospital care. The quality of an emergency medical service depends on both formal qualification and experience in managing such emergencies. Therefore, we determined how frequently emergency

A. Gries; W. Zink; M. Bernhard; M. Messelken; T. Schlechtriemen

2006-01-01

12

Sonar authentication performance evaluation under realistically simulated undersea channels  

NASA Astrophysics Data System (ADS)

Undersea communication channels are filled with acoustic emissions of various kinds. From sonar to the signals used in acoustic communications, man-made noise, and biological signals generated by marine life, the ocean is a complex conduit for diverse emissions. In this work we propose an algorithm in which an acoustic emission such as a sonar signal is transparently and securely embedded with signatures known as a digital watermark. Extracting the watermark helps to distinguish, for example, a friendly sonar from other acoustic emissions that may exist as part of the natural undersea environment, or from pings that may have originated from hostile forces or echoes fabricated by an adversary. We have adopted spread spectrum as an embedding technique. Spread spectrum allows for matching the watermark to propagation, multipath, and noise profiles of the channel. The sonar is first characterized by its spectrogram and divided up into non-overlapping blocks in time. Each block is individually embedded with a single bit drawn from the watermark payload. The seeds used to generate the spreading codes are the keys used by authorized receivers to recover the watermark. The detector is a maximum likelihood detector using test statistics obtained by integrating a correlation detector output over the entire sonar pulse width. Performance of the detector is controlled by signal-to-watermark ratio, specific frequency bands selected for watermarking, watermark payload, and processing gain. For validation, we use Sonar Simulation Toolset (SST). SST is a software tool that is custom-made for the simulation of undersea channels using realistic propagation properties in oceans. Probabilities of detection and false alarm rates, as well as other performance boundaries, are produced for a shallow water channel subject to multipath and additive noise.

Mobasseri, Bijan G.; Lynch, Robert S.

2010-04-01

13

An Evaluation Model for Emergency Logistics System  

Microsoft Academic Search

The emergency logistics system plays an important role in fighting against diseases and natural disasters. Evaluation of the emergency logistics system provide a basis for system optimization. An evaluation model for emergency logistics system based on hierarchy gray method is presented, which can solve uncertainty and complexity problems of emergency logistics system evaluation. The model establishes an evaluation index system

Zhang Guanxiang; Zhang Meng; Zhang Zhiyong; Li Guihai

2010-01-01

14

Evaluating Action Learning: A Critical Realist Complex Network Theory Approach  

ERIC Educational Resources Information Center

This largely theoretical paper will argue the case for the usefulness of applying network and complex adaptive systems theory to an understanding of action learning and the challenge it is evaluating. This approach, it will be argued, is particularly helpful in the context of improving capability in dealing with wicked problems spread around…

Burgoyne, John G.

2010-01-01

15

Basic requirements for realistic and unprejudiced evaluation of musical instruments  

NASA Astrophysics Data System (ADS)

In the past, the laboratory of musical acoustics of the PTB had to develop methods of subjective and objective evaluations of all kinds of musical instruments for a competition which was launched by the German ministry of economics. For this work the following questions had to be answered: (1) What makes a musical instrument play well from physical and subjective viewpoints? (2) How does the musician play the instrument, and what does he think when playing? (3) What is the influence of room acoustical parameters on sound quality? (4) How strong is the influence of prejudices concerning the brand, color, and type? (5) How can we measure the main acoustical parameters objectively? (6) What is the correlation between objective and subjective results? This presentation will give answers to these questions based on 10 years of experience with such evaluations by the author.

Wogram, Klaus

2003-10-01

16

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.  

PubMed

AIM: To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. BACKGROUND: Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. DESIGN: Research methodology - Evaluation using theory-based realist methods for policy implementation. METHODS: An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. RESULTS: Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. CONCLUSIONS: Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. PMID:23713840

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2013-05-28

17

Realist Evaluation in Wraparound: A New Approach in Social Work Evidence-Based Practice  

ERIC Educational Resources Information Center

Objectives: The purpose of this study was to develop a realist evaluation paradigm in social work evidence-based practice. Method: Wraparound (at Gateway-Longview Inc., New York) used a reliable outcome measure and an electronic database to systematically collect and analyze data on the interventions, the client demographics and circumstances, and…

Kazi, Mansoor A. F.; Pagkos, Brian; Milch, Heidi A.

2011-01-01

18

Online Assessment, Measurement and Evaluation: Emerging Practices  

ERIC Educational Resources Information Center

"Online Assessment, Measurement and Evaluation: Emerging Practices" provides a view of the possibilities and challenges facing online educators and evaluators in the 21st Century. As technology evolves and online measurement and assessment follow, "Online Assessment, Measurement and Evaluation: Emerging Practices" uses established evaluation

Williams, David, Ed.; Hricko, Mary, Ed.; Howell, Scott, Ed.

2006-01-01

19

Realistic numerical simulations of solar convection: emerging flux, pores, and Stokes spectra  

NASA Astrophysics Data System (ADS)

We report on magneto-convection simulations of magnetic flux emerging through the upper layers of the solar convection zone into the photosphere. Simulations by Georgobiani, Stein and Nordlund start from minimally structured, uniform, untwisted horizontal field advected into the computational domain by supergranule scale inflows at 20 Mm depth. At the opposite extreme, simulations by Cheung (2007, 2008, 2011) start with a coherent flux tube inserted into or forced into the bottom of the computational domain. Several robust results have emerged from the comparison of results from these two very different initial states. First, rising magnetic flux gets deformed into undulating, serpentine shapes by the influence of the convective up- and down-flows. The flux develops fine structure and appears at the surface first as a "pepper and salt" pattern of mixed polarity. Where magnetic flux approaches the surface, granules become darker and elongated in the direction of the field. Subsequently, the underlying large scale magnetic structures make the field collect into unipolar regions. Magneto-convection produces a complex, small-scale magnetic field topology, whatever the initial state. A heirarchy of magnetic loops corresponding to the different scales of convective motions are produced. Vertical vortex tubes form at intergranule lane vertices which can lead to tornado-like magnetic fields in the photosphere. Gradients in field strength and velocity produce asymmetric Stokes spectra. Where emerging Omega loops leave behind nearly vertical legs, long lived pores can spontaneously form. The field in the pores first becomes concentrated and evacuated near the surface and the evacuated flux concentration then extends downward.

Georgobiani, D.; Stein, R.; Nordlund, A.

2012-12-01

20

The management challenge for household waste in emerging economies like Brazil: realistic source separation and activation of reverse logistics.  

PubMed

Business opportunities in the household waste sector in emerging economies still evolve around the activities of bulk collection and tipping with an open material balance. This research, conducted in Brazil, pursued the objective of shifting opportunities from tipping to reverse logistics in order to close the balance. To do this, it illustrated how specific knowledge of sorted waste composition and reverse logistics operations can be used to determine realistic temporal and quantitative landfill diversion targets in an emerging economy context. Experimentation constructed and confirmed the recycling trilogy that consists of source separation, collection infrastructure and reverse logistics. The study on source separation demonstrated the vital difference between raw and sorted waste compositions. Raw waste contained 70% biodegradable and 30% inert matter. Source separation produced 47% biodegradable, 20% inert and 33% mixed material. The study on collection infrastructure developed the necessary receiving facilities. The study on reverse logistics identified private operators capable of collecting and processing all separated inert items. Recycling activities for biodegradable material were scarce and erratic. Only farmers would take the material as animal feed. No composting initiatives existed. The management challenge was identified as stimulating these activities in order to complete the trilogy and divert the 47% source-separated biodegradable discards from the landfills. PMID:24990590

Fehr, M

2014-09-01

21

Evaluation of an Intervention To Increase Realistic Self-Efficacy and Interests in College Women.  

ERIC Educational Resources Information Center

College women (n=24) with moderate Realistic career interests and low Realistic confidence took part in an intervention focused on building, repair, and construction activities. Compared with 30 controls, the treatment group had a statistically significant increase in confidence regarding Realistic occupations. (SK)

Betz, Nancy E.; Schifano, Ross S.

2000-01-01

22

Evaluation of automated emergency response systems  

SciTech Connect

Automated Emergency Response (ER) systems are playing a greater role in providing prompt and reliable predictions of the impact of inadvertent releases of hazardous materials to the environment. Observed and forecast environmental and accident source term data are input into environmental transport and dispersion models to provide dosimetry estimates used as decision making aids for responding to emergencies. Several automated ER systems have been developed for US Federal Government facilities and many are available commercially. For such systems to be useful, they must reliably and consistently deliver a timely product to the decision makers. Evaluation of the entire ER system is essential to determine the performance that can be expected from the system during an emergency. Unfortunately, seldom are ER systems evaluated as a whole. Usually Quality Assurance programs evaluate the performance of individual components of the system. Most atmospheric pollution model evaluation methods usually involve an evaluation of the predictive performance of the transport and dispersion model when compared either with experimental tracer results or results from other models. Rarely, however, is the ability of the ER system to provide timely, reliable and consistent information evaluated. Such an evaluation is vital to determine the system performance during an emergency and to provide valuable information to aid in improving the system.

Addis, R.P.

1988-12-31

23

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol  

PubMed Central

Background Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. Methods This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Discussion Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system. PMID:23522404

2013-01-01

24

The toxicological evaluation of realistic emissions of source aerosols study: statistical methods.  

PubMed

The Toxicological Evaluation of Realistic Emissions of Source Aerosols (TERESA) study involved withdrawal, aging, and atmospheric transformation of emissions of three coal-fired power plants. Toxicological evaluations were carried out in rats exposed to different emission scenarios with extensive exposure characterization. Data generated had multiple levels of resolution: exposure, scenario, and constituent chemical composition. Here, we outline a multilayered approach to analyze the associations between exposure and health effects beginning with standard ANOVA models that treat exposure as a categorical variable. The model assessed differences in exposure effects across scenarios (by plant). To assess unadjusted associations between pollutant concentrations and health, univariate analyses were conducted using the difference between the response means under exposed and control conditions and a single constituent concentration as the predictor. Then, a novel multivariate analysis of exposure composition and health was used based on Random Forests(™), a recent extension of classification and regression trees that were applied to the outcome differences. For each exposure constituent, this approach yielded a nonparametric measure of the importance of that constituent in predicting differences in response on a given day, controlling for the other measured constituent concentrations in the model. Finally, an R(2) analysis compared the relative importance of exposure scenario, plant, and constituent concentrations on each outcome. Peak expiratory flow (PEF) is used to demonstrate how the multiple levels of the analysis complement each other to assess constituents most strongly associated with health effects. PMID:21913820

Coull, Brent A; Wellenius, Gregory A; Gonzalez-Flecha, Beatriz; Diaz, Edgar; Koutrakis, Petros; Godleski, John J

2011-08-01

25

Toxicological Evaluation of Realistic Emission Source Aerosols (TERESA): Introduction and overview  

PubMed Central

Determining the health impacts of sources and components of fine particulate matter (PM2.5) is an important scientific goal. PM2.5 is a complex mixture of inorganic and organic constituents that are likely to differ in their potential to cause adverse health outcomes. The Toxicological Evaluation of Realistic Emissions of Source Aerosols (TERESA) study focused on two PM sources—coal-fired power plants and mobile sources—and sought to investigate the toxicological effects of exposure to emissions from these sources. The set of papers published here document the power plant experiments. TERESA attempted to delineate health effects of primary particles, secondary (aged) particles, and mixtures of these with common atmospheric constituents. TERESA involved withdrawal of emissions from the stacks of three coal-fired power plants in the United States. The emissions were aged and atmospherically transformed in a mobile laboratory simulating downwind power plant plume processing. Toxicological evaluations were carried out in laboratory rats exposed to different emission scenarios with extensive exposure characterization. The approach employed in TERESA was ambitious and innovative. Technical challenges included the development of stack sampling technology that prevented condensation of water vapor from the power plant exhaust during sampling and transfer, while minimizing losses of primary particles; development and optimization of a photochemical chamber to provide an aged aerosol for animal exposures; development and evaluation of a denuder system to remove excess gaseous components; and development of a mobile toxicology laboratory. This paper provides an overview of the conceptual framework, design, and methods employed in the study. PMID:21639692

Godleski, John J.; Rohr, Annette C.; Kang, Choong M.; Diaz, Edgar A.; Ruiz, Pablo A.; Koutrakis, Petros

2013-01-01

26

Action learning sets in a nursing and midwifery practice learning context: a realistic evaluation.  

PubMed

Action learning sets (ALS) are used widely for organisational and workforce development, including in nursing (Anderson and Thorpe, 2004; Pounder, 2009; Young et al., 2010). In the United Kingdom, a multi-faceted educational Pilot programme for new nurses and midwives was implemented to accelerate their clinical practice and leadership development (NHS Education Scotland, 2010). Action Learning Sets were provided for peer support and personal development. The Realistic Evaluation study reported in this paper explored issues of context, mechanism and outcome (Pawson and Tilley, 1997) influencing the action learning experiences of: programme participants (recently qualified nurses and midwives, from different practice settings); and programme supporters. A range of data were collected via: online questionnaires from 66 participants and 29 supporters; three focus groups, each comprising between eight and 10 programme participants; and one focus group with three action learning facilitators. The qualitative data pertaining to the ALS are presented in this paper. Thematic data analysis of context, mechanism and outcome configurations, generated five themes: creating and sustaining a collective learning environment; challenging constructively; collective support; the role of feedback; and effectiveness of ALS. Study outcomes suggest nursing and midwifery action learning should (a) be facilitated positively to improve participants' experience; (b) be renamed to avoid learning methodology confusion; and (c) be outcome focused to evidence impact on practice. PMID:24480095

Machin, Alison I; Pearson, Pauline

2014-08-01

27

Toxicological Evaluation of Realistic Emission Source Aerosols (TERESA)-power plant studies: assessment of cellular responses  

PubMed Central

The Toxicological Evaluation of Realistic Emission Source Aerosols (TERESA) project assessed primary and secondary particulate by simulating the chemical reactions that a plume from a source might undergo during atmospheric transport and added other atmospheric constituents that might interact with it. Three coal-fired power plants with different coal and different emission controls were used. Male Sprague-Dawley rats were exposed for 6 h to either filtered air or aged aerosol from the power plant. Four exposure scenarios were studied: primary particles (P); primary + secondary (oxidized) particles (PO); primary + secondary (oxidized) particles + SOA (POS); and primary + secondary (oxidized) particles neutralized + SOA (PONS). Exposure concentrations varied by scenario to a maximum concentration of 257.1 ± 10.0 µg/m3. Twenty-four hours after exposure, pulmonary cellular responses were assessed by bronchoalveolar lavage (BAL), complete blood count (CBC), and histopathology. Exposure to the PONS and POS scenarios produced significant increases in BAL total cells and macrophage numbers at two plants. The PONS and P scenarios were associated with significant increases in BAL neutrophils and the presence of occasional neutrophils and increased macrophages in the airways and alveoli of exposed animals. Univariate analyses and random forest analyses showed that increases in total cell count and macrophage cell count were significantly associated with neutralized sulfate and several correlated measurements. Increases in neutrophils in BAL were associated with zinc. There were no significant differences in CBC parameters or blood vessel wall thickness by histopathology. The association between neutrophils increases and zinc raises the possibility that metals play a role in this response. PMID:21466245

Godleski, John J.; Diaz, Edgar A.; Lemos, Miriam; Long, Mark; Ruiz, Pablo; Gupta, Tarun; Kang, Choong-Min; Coull, Brent

2013-01-01

28

Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation  

PubMed Central

Background Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes. Methods This study draws on the principles of realist evaluation -- a largely qualitative approach, chiefly concerned with testing and refining programme theories by exploring the complex interactions of contexts, mechanisms, and outcomes. Mixed methods were used in data collection, including individual interviews, non-participant observation, and document reviews. A thematic framework approach was adopted for the data analysis. Results The study found that while the A4R approach to priority setting was helpful in strengthening transparency, accountability, stakeholder engagement, and fairness, the efforts at integrating it into the current district health system were challenging. Participatory structures under the decentralisation framework, central government's call for partnership in district-level planning and priority setting, perceived needs of stakeholders, as well as active engagement between researchers and decision makers all facilitated the adoption and implementation of the innovation. In contrast, however, limited local autonomy, low level of public awareness, unreliable and untimely funding, inadequate accountability mechanisms, and limited local resources were the major contextual factors that hampered the full implementation. Conclusion This study documents an important first step in the effort to introduce the ethical framework A4R into district planning processes. This study supports the idea that a greater involvement and accountability among local actors through the A4R process may increase the legitimacy and fairness of priority-setting decisions. Support from researchers in providing a broader and more detailed analysis of health system elements, and the socio-cultural context, could lead to better prediction of the effects of the innovation and pinpoint stakeholders' concerns, thereby illuminating areas that require special attention to promote sustainability. PMID:21310021

2011-01-01

29

Multi-user system for training and evaluation of environmental emergency management response -- MUSTER  

SciTech Connect

The efficiency with which complex, large-scale organizations respond to emergencies and critical situations depends crucially on the coordination of actions and communication among decision makers. However, decision makers have typically few opportunities to train distributed crisis management under artificial, yet realistic conditions; and at the same time, real emergencies occur fortunately so relatively infrequently that few decision makers have a chance of establishing a useful real-life experience of crisis management. There is therefore a need for having available realistic and flexible multi-user training environments in which coordinated response to crises or emergencies may be trained. At the same time, a flexible training environment supporting tactical training of coordinated emergency response can be used as a platform on the basis of which not only emergency response capability can be evaluated but also different procedures and practices and even control systems may be assessed before they are put into real use. In order to identify requirements to, develop specifications of and finally produce a prototype of a flexible training and evaluation environment, a two-year project, MUSTER: Multi-User System for Training and Evaluation of Environmental Emergency Response, was started in 1993 and is now approaching its completion by mid-95.

Andersen, V.; Andersen, H.B. [Risoe National Lab., Roskilde (Denmark). Systems Analysis Dept.

1995-12-31

30

A subjective and objective evaluation of a realistic 3D IPTV transmission chain  

E-print Network

of content types and a realistic transmission chain that includes a hardware encoder and commercial Set compared to objective measurements with VQM and VQUAD. I. INTRODUCTION 3DTV is the next step for television the bitrate is high enough to encode the sequence without visible distortion. This threshold value

Paris-Sud XI, Université de

31

Evaluation of an Emerging Research Center: Lessons Learned  

PubMed Central

Problem statement Rigorous evaluation assures that research endeavors meet their purpose and achieve stated goals. This is especially true for federally funded exploratory research centers, which tend to be more complex due to the involvement of multiple, interdisciplinary investigators. This study provides an overview of the approach used to develop an evaluation strategy and reports the lessons learned during the initial development of the Center for Ohana Self-Management of Chronic Illness (COSMCI) at the University of Hawai’i at M?noa School of Nursing and Dental Hygiene. The COSMCI is composed of an interdisciplinary team of researchers and practitioners and aims to advance knowledge in the field of self management of chronic disease in the community setting. Approach A systematic approach was utilized that included formative and summative strategies for ongoing evaluation. The problem was solved by addressing five key concerns: (1) development of research structure, (2) observing the process of the research pilot projects, (3) scholarly activity of COSMCI faculty, (4) dissemination and translation and (5) sustainability prospects. The method of research included formulating process strategies and determine if the plans for developing the Center were followed and whether these plans were effective. Interviews were also conducted at year one and at mid-point though the project. Results Themes that emerged from our evaluation included inclusion, timelines, realistic expectations, ongoing evaluation and preparing for changes in the team. This provided timely recognition of successes and challenges and facilitated a rapid response for interventions especially during the early development stage of the center. Conclusion/Recommendations Effective development of a successful Center is highly dependent upon having a strong evaluation process in place that can inform ongoing development. An exploratory research center requires ongoing evaluation that allows for celebration of successes, as well as early identification of problems and rapid response. PMID:22485191

Nigg, C.R.; Qureshi, K.; Inouye, J.; Sy, A.; Sullivan, K.; Boland, M.G.

2012-01-01

32

EVALUATING FLEXIBILITY AND RELIABILITY IN EMERGENCY RESPONSE INFORMATION SYSTEMS  

E-print Network

EVALUATING FLEXIBILITY AND RELIABILITY IN EMERGENCY RESPONSE INFORMATION SYSTEMS Edward Mahinda3@njit.edu, bwithworth@acm.org. Keywords: Emergency response information systems, flexibility, reliability, evaluation, questionnaire instrument Abstract: Flexibility, variously known as adaptability

Whitworth, Brian

33

Cardiac autonomic functions and the emergence of violence in a highly realistic model of social conflict in humans  

PubMed Central

Among the multitude of factors that can transform human social interactions into violent conflicts, biological features received much attention in recent years as correlates of decision making and aggressiveness especially in critical situations. We present here a highly realistic new model of human aggression and violence, where genuine acts of aggression are readily performed and which at the same time allows the parallel recording of biological concomitants. Particularly, we studied police officers trained at the International Training Centre (Budapest, Hungary), who are prepared to perform operations under extreme conditions of stress. We found that aggressive arousal can transform a basically peaceful social encounter into a violent conflict. Autonomic recordings show that this change is accompanied by increased heart rates, which was associated earlier with reduced cognitive complexity of perceptions (“attentional myopia”) and promotes a bias toward hostile attributions and aggression. We also observed reduced heart rate variability in violent subjects, which is believed to signal a poor functioning of prefrontal-subcortical inhibitory circuits and reduces self-control. Importantly, these autonomic particularities were observed already at the beginning of social encounters i.e., before aggressive acts were initiated, suggesting that individual characteristics of the stress-response define the way in which social pressure affects social behavior, particularly the way in which this develops into violence. Taken together, these findings suggest that cardiac autonomic functions are valuable external symptoms of internal motivational states and decision making processes, and raise the possibility that behavior under social pressure can be predicted by the individual characteristics of stress responsiveness. PMID:25374519

Haller, Jozsef; Raczkevy-Deak, Gabriella; Gyimesine, Katalin P.; Szakmary, Andras; Farkas, Istvan; Vegh, Jozsef

2014-01-01

34

Simulation Evaluation of Controller-Managed Spacing Tools under Realistic Operational Conditions  

NASA Technical Reports Server (NTRS)

Controller-Managed Spacing (CMS) tools have been developed to aid air traffic controllers in managing high volumes of arriving aircraft according to a schedule while enabling them to fly efficient descent profiles. The CMS tools are undergoing refinement in preparation for field demonstration as part of NASA's Air Traffic Management (ATM) Technology Demonstration-1 (ATD-1). System-level ATD-1 simulations have been conducted to quantify expected efficiency and capacity gains under realistic operational conditions. This paper presents simulation results with a focus on CMS-tool human factors. The results suggest experienced controllers new to the tools find them acceptable and can use them effectively in ATD-1 operations.

Callantine, Todd J.; Hunt, Sarah M.; Prevot, Thomas

2014-01-01

35

Use of a realistic breathing lung phantom to evaluate dose delivery errors  

SciTech Connect

Purpose: To compare the effect of respiration-induced motion on delivered dose (the interplay effect) for different treatment techniques under realistic clinical conditions. Methods: A flexible resin tumor model was created using rapid prototyping techniques based on a computed tomography (CT) image of an actual tumor. Twenty micro-MOSFETs were inserted into the tumor model and the tumor model was inserted into an anthropomorphic breathing phantom. Phantom motion was programed using the motion trajectory of an actual patient. A four-dimensional CT image was obtained and several treatment plans were created using different treatment techniques and planning systems: Conformal (Eclipse), step-and-shoot intensity-modulated radiation therapy (IMRT) (Pinnacle), step-and-shoot IMRT (XiO), dynamic IMRT (Eclipse), complex dynamic IMRT (Eclipse), hybrid IMRT [60% conformal, 40% dynamic IMRT (Eclipse)], volume-modulated arc therapy (VMAT) [single-arc (Eclipse)], VMAT [double-arc (Eclipse)], and complex VMAT (Eclipse). The complex plans were created by artificially pushing the optimizer to give complex multileaf collimator sequences. Each IMRT field was irradiated five times and each VMAT field was irradiated ten times, with each irradiation starting at a random point in the respiratory cycle. The effect of fractionation was calculated by randomly summing the measured doses. The maximum deviation for each measurement point per fraction and the probability that 95% of the model tumor had dose deviations less than 2% and 5% were calculated as a function of the number of fractions. Tumor control probabilities for each treatment plan were calculated and compared. Results: After five fractions, measured dose deviations were less than 2% for more than 95% of measurement points within the tumor model for all plans, except the complex dynamic IMRT, step-and-shoot IMRT (XiO), complex VMAT, and single-arc VMAT plans. Reducing the dose rate of the complex IMRT plans from 600 to 200 MU/min reduced the dose deviations to less than 2%. Dose deviations were less than 5% after five fractions for all plans, except the complex single-arc VMAT plan. Conclusions: Rapid prototyping techniques can be used to create realistic tumor models. For most treatment techniques, the dose deviations averaged out after several fractions. Treatments with unusually complicated multileaf collimator sequences had larger dose deviations. For IMRT treat-ments, dose deviations can be reduced by reducing the dose rate. For VMAT treatments, using two arcs instead of one is effective for reducing dose deviations.

Court, Laurence E.; Seco, Joao; Lu Xingqi; Ebe, Kazuyu; Mayo, Charles; Ionascu, Dan; Winey, Brian; Giakoumakis, Nikos; Aristophanous, Michalis; Berbeco, Ross; Rottman, Joerg; Bogdanov, Madeleine; Schofield, Deborah; Lingos, Tania [Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115 (United States); Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114 (United States); Beth-Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02130 (United States); JA Jouetsu Hospital, Jouetsu 355-0063 (Japan); University of Massachusetts Memorial Medical Center, Worcester, Massachusetts 01655 (United States); William Beaumont Hospital, Royal Oak, Michigan 48073 (United States); Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115 (United States) and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114 (United States); Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115 (United States)

2010-11-15

36

Emergency department evaluation of child abuse.  

PubMed

Child abuse presents commonly to emergency departments. Emergency providers are confronted with medical, social, and legal dilemmas with each case. A solid understanding of the definitions and risk factors of victims and perpetrators aids in identifying abuse cases. Forensic examination should be performed only after the child is medically stable. Emergency providers are mandatory reporters of a reasonable suspicion of abuse. The role of the emergency provider is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and to provide an ethical testimony if called to court. PMID:23915607

Leetch, Aaron N; Woolridge, Dale

2013-08-01

37

AntispamLab - A Tool for Realistic Evaluation of Email Spam Filters  

Microsoft Academic Search

The existing tools for testing spam fllters evaluate a fllter instance by simply feeding it with a stream of emails, pos- sibly also providing a feedback to the fllter about the cor- rectness of the detection. In such a scenario the evaluated fllter is disconnected from the network of email servers, fll- ters, and users, which makes the approach inappropriate

Slavisa Sarafijanovic; Luis Hernandez; Raphael Naefen; Jean-yves Le Boudec

2007-01-01

38

A Realistic Neural Mass Model of the Cortex with Laminar-Specific Connections and Synaptic Plasticity - Evaluation with Auditory Habituation  

PubMed Central

In this work we propose a biologically realistic local cortical circuit model (LCCM), based on neural masses, that incorporates important aspects of the functional organization of the brain that have not been covered by previous models: (1) activity dependent plasticity of excitatory synaptic couplings via depleting and recycling of neurotransmitters and (2) realistic inter-laminar dynamics via laminar-specific distribution of and connections between neural populations. The potential of the LCCM was demonstrated by accounting for the process of auditory habituation. The model parameters were specified using Bayesian inference. It was found that: (1) besides the major serial excitatory information pathway (layer 4 to layer 2/3 to layer 5/6), there exists a parallel “short-cut” pathway (layer 4 to layer 5/6), (2) the excitatory signal flow from the pyramidal cells to the inhibitory interneurons seems to be more intra-laminar while, in contrast, the inhibitory signal flow from inhibitory interneurons to the pyramidal cells seems to be both intra- and inter-laminar, and (3) the habituation rates of the connections are unsymmetrical: forward connections (from layer 4 to layer 2/3) are more strongly habituated than backward connections (from Layer 5/6 to layer 4). Our evaluation demonstrates that the novel features of the LCCM are of crucial importance for mechanistic explanations of brain function. The incorporation of these features into a mass model makes them applicable to modeling based on macroscopic data (like EEG or MEG), which are usually available in human experiments. Our LCCM is therefore a valuable building block for future realistic models of human cognitive function. PMID:24205009

Wang, Peng; Knosche, Thomas R.

2013-01-01

39

Evaluation of Emerging Diagnostic Tools for Commercial HVAC Systems  

E-print Network

This paper compares and evaluates the capabilities of six emerging diagnostic tools for commercial HVAC systems. We present a brief description of the diagnostic tools, and then focus on evaluating the features of the tools. We include the following...

Friedman, H.; Piette, M. A.

2001-01-01

40

A Realist Evaluation Approach to Unpacking the Impacts of the Sentencing Guidelines  

ERIC Educational Resources Information Center

Evaluations of complex interventions such as sentencing guidelines provide an opportunity to understand the mechanisms by which policies and programs can impact intermediate and long-term outcomes. There is limited previous discussion of the underlying frameworks by which sentencing guidelines can impact outcomes such as crime rates. Guided by a…

Hunt, Kim Steven; Sridharan, Sanjeev

2010-01-01

41

A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care  

PubMed Central

The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success, or PRECESS) alone or combined with education was an effective strategy to change and sustain the standard of care for skin-to-skin practice (p < 0.00001). The intended outcome of sustained practice change toward implementation of skin-to-skin care through immersion or a combined approach shows promise and should be repeated in other localities. PMID:23730126

Brimdyr, Kajsa; Widstrom, Ann-Marie; Cadwell, Karin; Svensson, Kristin; Turner-Maffei, Cynthia

2012-01-01

42

SimNewB is an interactive simulator, designed by Laerdal with the American Academy of Pediatrics to meet the training requirements of neonatal emergency medicine and resuscitation courses. With realistic newborn traits  

E-print Network

SIMNEWB SimNewB is an interactive simulator, designed by Laerdal with the American Academy of Pediatrics to meet the training requirements of neonatal emergency medicine and resuscitation courses. With realistic newborn traits and lifelike clinical feedback, SimNewB is ideal for training for the specific

Zhou, Pei

43

Toxicological Evaluation of Realistic Emission Source Aerosols (TERESA)--Power plant studies: assessment of breathing pattern  

PubMed Central

Our approach to study multi-pollutant aerosols isolates a single emissions source, evaluates the toxicity of primary and secondary particles derived from this source, and simulates chemical reactions that occur in the atmosphere after emission. Three U.S. coal-fired power plants utilizing different coals and with different emission controls were evaluated. Secondary organic aerosol (SOA) derived from ?-pinene and/or ammonia was added in some experiments. Male Sprague-Dawley rats were exposed for 6 h to filtered air or different atmospheric mixtures. Scenarios studied at each plant included the following: primary particles (P); secondary (oxidized) particles (PO); oxidized particles + SOA (POS); and oxidized and neutralized particles + SOA (PONS); additional control scenarios were also studied. Continuous respiratory data were obtained during exposures using whole body plethysmography chambers. Of the 12 respiratory outcomes assessed, each had statistically significant changes at some plant and with some of the 4 scenarios. The most robust outcomes were found with exposure to the PO scenario (increased respiratory frequency with decreases in inspiratory and expiratory time); and the PONS scenario (decreased peak expiratory flow and expiratory flow at 50%). PONS findings were most strongly associated with ammonium, neutralized sulfate, and elemental carbon (EC) in univariate analyses, but only with EC in multivariate analyses. Control scenario O (oxidized without primary particles) had similar changes to PO. Adjusted R2 analyses showed that scenario was a better predictor of respiratory responses than individual components, suggesting that the complex atmospheric mixture was responsible for respiratory effects. PMID:21639693

Diaz, Edgar A.; Lemos, Miriam; Coull, Brent; Long, Mark S.; Rohr, Annette C.; Ruiz, Pablo; Gupta, Tarun; Kang, Choong-Min; Godleski, John J.

2013-01-01

44

Physical activity guides for Canadians: messaging strategies, realistic expectations for change, and evaluation.  

PubMed

Physical activity guidelines offer evidence-based behavioural benchmarks that relate to reduced risk of morbidity and mortality if people adhere to them. Essentially, the guidelines tell people what to do, but not why and how they should do it. Thus, to motivate adherence, messages that translate guidelines should convey not only how much physical activity one should attempt and why it is recommended, but also how to achieve such a recommendation. Canada's physical activity guides exemplify how guidelines can be translated. This paper (i) provides a brief overview of the challenges encountered in creating the existing guides and (ii) highlights important practical issues and empirical evidence that should be considered in the future when translating guidelines into messages and disseminating these messages. We draw on the successes of past efforts to translate the goals of physical activity guidelines and on recent literature on messages and media campaigns to make recommendations. Information to motivate people to move toward the goals in physical activity guidelines should be translated into a set of messages that are informative, thought provoking, and persuasive. These messages should be disseminated to the public via a multi-phase social-marketing campaign that is carefully planned and thoroughly evaluated. PMID:18213947

Brawley, Lawrence R; Latimer, Amy E

2007-01-01

45

Monte Carlo evaluation of water equivalency of some plastic materials for realistic electron IORT beams  

NASA Astrophysics Data System (ADS)

The water equivalency of some commercially available water substitute materials for high energy electron beams dosimetry (PMMA, polystyrene and solid water WT1) has been investigated in this work for electron beams generated by the IORT linear accelerator NOVAC 7. The beams were simulated by the BEAMnrc/EGSnrc Monte Carlo code, while the dose distributions in water and plastic phantoms were calculated using DOSXYZnrc. The stopping power ratios were evaluated using SPRRZnrc user code. The results obtained for the depth-and fluence-scaling factors have been compared with the values recommended by the TRS-398 IAEA code of practice for absorbed dose determination in external beam radiotherapy. Due to the significant differences observed (sometimes more than 1%) and to the dependence of the scaling factors on the beam quality we can conclude that every time when plastic phantoms are used in electron IORT dosimetry, a theoretical or experimental investigation of the water equivalency of the water substitute materials must be done.

Oprea, M.; Mihailescu, D.; Borcia, C.

2012-12-01

46

TOXICOLOGICAL EVALUATION OF REALISTIC EMISSIONS OF SOURCE AEROSOLS (TERESA): APPLICATION TO POWER PLANT-DERIVED PM2.5  

SciTech Connect

TERESA (Toxicological Evaluation of Realistic Emissions of Source Aerosols) involves exposing laboratory rats to realistic coal-fired power plant and mobile source emissions to help determine the relative toxicity of these PM sources. There are three coal-fired power plants in the TERESA program; this report describes the results of fieldwork conducted at the first plant, located in the Upper Midwest. The project was technically challenging by virtue of its novel design and requirement for the development of new techniques. By examining aged, atmospherically transformed aerosol derived from power plant stack emissions, we were able to evaluate the toxicity of PM derived from coal combustion in a manner that more accurately reflects the exposure of concern than existing methodologies. TERESA also involves assessment of actual plant emissions in a field setting--an important strength since it reduces the question of representativeness of emissions. A sampling system was developed and assembled to draw emissions from the stack; stack sampling conducted according to standard EPA protocol suggested that the sampled emissions are representative of those exiting the stack into the atmosphere. Two mobile laboratories were then outfitted for the study: (1) a chemical laboratory in which the atmospheric aging was conducted and which housed the bulk of the analytical equipment; and (2) a toxicological laboratory, which contained animal caging and the exposure apparatus. Animal exposures were carried out from May-November 2004 to a number of simulated atmospheric scenarios. Toxicological endpoints included (1) pulmonary function and breathing pattern; (2) bronchoalveolar lavage fluid cytological and biochemical analyses; (3) blood cytological analyses; (4) in vivo oxidative stress in heart and lung tissue; and (5) heart and lung histopathology. Results indicated no differences between exposed and control animals in any of the endpoints examined. Exposure concentrations for the scenarios utilizing secondary particles (oxidized emissions) ranged from 70-256 {micro}g/m{sup 3}, and some of the atmospheres contained high acidity levels (up to 49 {micro}g/m{sup 3} equivalent of sulfuric acid). However, caution must be used in generalizing these results to other power plants utilizing different coal types and with different plant configurations, as the emissions may vary based on these factors.

Annette Rohr

2006-03-01

47

Turning around an ailing district hospital: a realist evaluation of strategic changes at Ho Municipal Hospital (Ghana)  

PubMed Central

Background There is a growing consensus that linear approaches to improving the performance of health workers and health care organisations may only obtain short-term results. An alternative approach premised on the principle of human resource management described as a form of 'High commitment management', builds upon a bundles of balanced practices. This has been shown to contribute to better organisational performance. This paper illustrates an intervention and outcome of high commitment management (HiCom) at an urban hospital in Ghana. Few studies have shown how HiCom management might contribute to better performance of health services and in particular of hospitals in low and middle-income settings. Methods A realist case study design was used to analyse how specific management practices might contribute to improving the performance of an urban district hospital in Ho, Volta Region, in Ghana. Mixed methods were used to collect data, including document review, in-depth interviews, group discussions, observations and a review of routine health information. Results At Ho Municipal Hospital, the management team dealt with the crisis engulfing the ailing urban district hospital by building an alliance between hospital staff to generate a sense of ownership with a focus around participative problem analysis. The creation of an alliance led to improving staff morale and attitude, and contributed also to improvements in the infrastructure and equipment. This in turn had a positive impact on the revenue generating capacity of the hospital. The quick turn around in the state of this hospital showed that change was indeed possible, a factor that greatly motivated the staff. In a second step, the management team initiated the development of a strategic plan for the hospital to maintain the dynamics of change. This was undertaken through participative methods and sustained earlier staff involvement, empowerment and feelings of reciprocity. We found that these factors acted as the core mechanisms underlying the changes taking place at Ho Municipal Hospital. Conclusions This study shows how a hospital management team in Ghana succeeded in resuscitating an ailing hospital. Their high commitment management approach led to the active involvement and empowerment of staff. It also showed how a realist evaluation approach such as this, could be used in the research of the management of health care organisations to explain how management interventions may or may not work. PMID:21184678

2010-01-01

48

TOXICOLOGICAL EVALUATION OF REALISTIC EMISSIONS OF SOURCE AEROSOLS (TERESA): APPLICATION TO POWER PLANT-DERIVED PM2.5  

SciTech Connect

Determining the health impacts of different sources and components of fine particulate matter (PM2.5) is an important scientific goal, because PM is a complex mixture of both inorganic and organic constituents that likely differ in their potential to cause adverse health outcomes. The TERESA (Toxicological Evaluation of Realistic Emissions of Source Aerosols) study focused on two PM sources - coal-fired power plants and mobile sources - and sought to investigate the toxicological effects of exposure to realistic emissions from these sources. The DOE-EPRI Cooperative Agreement covered the performance and analysis of field experiments at three power plants. The mobile source component consisted of experiments conducted at a traffic tunnel in Boston; these activities were funded through the Harvard-EPA Particulate Matter Research Center and will be reported separately in the peer-reviewed literature. TERESA attempted to delineate health effects of primary particles, secondary (aged) particles, and mixtures of these with common atmospheric constituents. The study involved withdrawal of emissions directly from power plant stacks, followed by aging and atmospheric transformation of emissions in a mobile laboratory in a manner that simulated downwind power plant plume processing. Secondary organic aerosol (SOA) derived from the biogenic volatile organic compound {alpha}-pinene was added in some experiments, and in others ammonia was added to neutralize strong acidity. Specifically, four scenarios were studied at each plant: primary particles (P); secondary (oxidized) particles (PO); oxidized particles + secondary organic aerosol (SOA) (POS); and oxidized and neutralized particles + SOA (PONS). Extensive exposure characterization was carried out, including gas-phase and particulate species. Male Sprague Dawley rats were exposed for 6 hours to filtered air or different atmospheric mixtures. Toxicological endpoints included (1) breathing pattern; (2) bronchoalveolar lavage (BAL) fluid cytology and biochemistry; (3) blood cytology; (4) in vivo oxidative stress in heart and lung tissue; and (5) heart and lung histopathology. In addition, at one plant, cardiac arrhythmias and heart rate variability (HRV) were evaluated in a rat model of myocardial infarction. Statistical analyses included analyses of variance (ANOVA) to determine differences between exposed and control animals in response to different scenario/plant combinations; univariate analyses to link individual scenario components to responses; and multivariate analyses (Random Forest analyses) to evaluate component effects in a multipollutant setting. Results from the power plant studies indicated some biological responses to some plant/scenario combinations. A number of significant breathing pattern changes were observed; however, significant clinical changes such as specific irritant effects were not readily apparent, and effects tended to be isolated changes in certain respiratory parameters. Some individual exposure scenario components appeared to be more strongly and consistently related to respiratory parameter changes; however, the specific scenario investigated remained a better predictor of response than individual components of that scenario. Bronchoalveolar lavage indicated some changes in cellularity of BAL fluid in response to the POS and PONS scenarios; these responses were considered toxicologically mild in magnitude. No changes in blood cytology were observed at any plant or scenario. Lung oxidative stress was increased with the POS scenario at one plant, and cardiac oxidative stress was increased with the PONS scenario also at one plant, suggesting limited oxidative stress in response to power plant emissions with added atmospheric constituents. There were some mild histological findings in lung tissue in response to the P and PONS scenarios. Finally, the MI model experiments indicated that premature ventricular beat frequency was increased at the plant studied, while no changes in heart rate, HRV, or electrocardiographic intervals were observed. Overall, the

Annette C. Rohr; Petros Koutrakis; John Godleski

2011-03-31

49

PET and MRI based treatment planning systems: a methodology for a realistic evaluation of the dose and fluence distributions in BNCT and in GdNCT  

NASA Astrophysics Data System (ADS)

The article focuses on the methodology for a realistic evaluation of the dose and fluence distributions in Neutron Capture Therapy (NCT), based on the Treatment Planning System (TPS) that takes into account the real macroscopic distribution of the neutron capturer. The neutron capturers considered in the present study are 10B and 157Gd, used in BNCT and GdNCT respectively.

Cerullo, N.; Daquino, G. G.; Bufalino, D.

2006-05-01

50

Towards a holistic framework for the evaluation of emergency plans in indoor environments.  

PubMed

One of the most promising fields for ambient intelligence is the implementation of intelligent emergency plans. Because the use of drills and living labs cannot reproduce social behaviors, such as panic attacks, that strongly affect these plans, the use of agent-based social simulation provides an approach to evaluate these plans more thoroughly. (1) The hypothesis presented in this paper is that there has been little interest in describing the key modules that these simulators must include, such as formally represented knowledge and a realistic simulated sensor model, and especially in providing researchers with tools to reuse, extend and interconnect modules from different works. This lack of interest hinders researchers from achieving a holistic framework for evaluating emergency plans and forces them to reconsider and to implement the same components from scratch over and over. In addition to supporting this hypothesis by considering over 150 simulators, this paper: (2) defines the main modules identified and proposes the use of semantic web technologies as a cornerstone for the aforementioned holistic framework; (3) provides a basic methodology to achieve the framework; (4) identifies the main challenges; and (5) presents an open and free software tool to hint at the potential of such a holistic view of emergency plan evaluation in indoor environments. PMID:24662453

Serrano, Emilio; Poveda, Geovanny; Garijo, Mercedes

2014-01-01

51

More than a checklist: a realist evaluation of supervision of mid-level health workers in rural Guatemala  

PubMed Central

Background Mid-level health workers (MLHWs) form the front-line of service delivery in many low- and middle-income countries. Supervision is a critical institutional intervention linking their work to the health system, and it consists of activities intended to support health workers’ motivation and enable them to perform. However its impact depends not only on the frequency of these activities but also how they are carried out and received. This study aims to deepen understanding of the mechanisms through which supervision activities support the performance of auxiliary nurses, a cadre of MLHWs, in rural Guatemala. Methods A multiple case study was conducted to examine the operation of supervision of five health posts using a realist evaluation approach. A program theory was formulated describing local understanding of how supervision activities are intended to work. Data was collected through interviews and document review to test the theory. Analysis focused on comparison of activities, outcomes, mechanisms and the influence of context across cases, leading to revision of the program theory. Results The supervisor’s orientation was identified as the main mechanism contributing to variation observed in activities and their outcomes. Managerial control was the dominant orientation, reflecting the influence of standardized performance criteria and institutional culture. Humanized support was present in one case where the auxiliary nurse was motivated by the sense that the full scope of her work was valued. This orientation reflected the supervisor’s integration of her professional identity as a nurse. Conclusions The nature of the support health workers received was shaped by supervisors’ orientation, and in this study, nursing principles were central to humanized support. Efforts to strengthen the support that supervision provides to MLHWs should promote professional ethos as a means of developing shared performance goals and orient supervisors to a more holistic view of the health worker and their work. PMID:24602196

2014-01-01

52

Diagnostic errors in the evaluation of nontraumatic aortic emergencies.  

PubMed

Nontraumatic aortic emergencies (NTAE) are a complex and dynamic group of serious, potentially fatal conditions affecting the aorta. These entities most often present in the emergency department setting, and include aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, as well as aortic rupture and impending rupture. The radiologist plays a critical role in prompt diagnosis and evaluation since presenting signs and symptoms are often nonspecific. This article focuses on the potential sources of error in the imaging evaluation of patients presenting with NTAE. PMID:22824122

Souza, Daniel; Ledbetter, Stephen

2012-08-01

53

Project REALISTIC: Evaluation and Modification of REAding, LIStening, and ArithmeTIC Needs in Military Jobs Having Civilian Counterparts.  

ERIC Educational Resources Information Center

The papers in this collection present a description of, and the results of, research in Work Unit REALISTIC. In addition to the first paper which is an overview, the three papers are: "Psychometric Determination of Relationships Among Literacy Skills and Job Proficiency,""Reading Ability, Readability, and Readership: Identifying Job-Related…

Sticht, Thomas G.; And Others

54

Evaluation of the Emergency Response Dose Assessment System(ERDAS)  

NASA Technical Reports Server (NTRS)

The emergency response dose assessment system (ERDAS) is a protype software and hardware system configured to produce routine mesoscale meteorological forecasts and enhanced dispersion estimates on an operational basis for the Kennedy Space Center (KSC)/Cape Canaveral Air Station (CCAS) region. ERDAS provides emergency response guidance to operations at KSC/CCAS in the case of an accidental hazardous material release or an aborted vehicle launch. This report describes the evaluation of ERDAS including: evaluation of sea breeze predictions, comparison of launch plume location and concentration predictions, case study of a toxic release, evaluation of model sensitivity to varying input parameters, evaluation of the user interface, assessment of ERDA's operational capabilities, and a comparison of ERDAS models to the ocean breeze dry gultch diffusion model.

Evans, Randolph J.; Lambert, Winifred C.; Manobianco, John T.; Taylor, Gregory E.; Wheeler, Mark M.; Yersavich, Ann M.

1996-01-01

55

Avertable dose intervention applied in emergency response dose evaluation system for nuclear emergency preparedness in Taiwan  

NASA Astrophysics Data System (ADS)

In Taiwan the new guides for the nuclear emergency public protective action were laid down by the Atomic Energy Council (AEC) of Executive Yuan, Taiwan, ROC on July 15th, 2005. The main modifications of the guides are that the avertable dose is applied as the intervention levels and suggests the public protective actions. The emergency response dose evaluation system named RPDOSE, which was developed in 2005, was employed in this work to enhance the capability of the avertable dose evaluation for the villages in the emergency planning zone (EPZ). The period of the long-term weather forecasting data was extended from 4 to 8 days to satisfy the requirement of avertable dose computing. According to the intervention levels, the RPDOSE system is used to calculate the avertable dose and suggest appropriate public protective actions such as sheltering, evacuation or iodine prophylaxis as well as the proposed acting times for each village in the EPZ. This system was employed and examined in the annual nuclear emergency exercise of 2008 in the Maanshan nuclear power plant.

Lu, Chung-hsin; Teng, Jen-hsin; Yang, Yung-muh; Chang, Bor-jing

2010-06-01

56

TOXICOLOGICAL EVALUATION OF REALISTIC EMISSIONS OF SOURCE AEROSOLS (TERESA): APPLICATION TO POWER PLANT-DERIVED PM2.5  

SciTech Connect

This report documents progress made on the subject project during the period of March 1, 2004 through August 31, 2004. The TERESA Study is designed to investigate the role played by specific emissions sources and components in the induction of adverse health effects by examining the relative toxicity of coal combustion and mobile source (gasoline and/or diesel engine) emissions and their oxidative products. The study involves on-site sampling, dilution, and aging of coal combustion emissions at three coal-fired power plants, as well as mobile source emissions, followed by animal exposures incorporating a number of toxicological endpoints. The DOE-EPRI Cooperative Agreement (henceforth referred to as ''the Agreement'') for which this technical progress report has been prepared covers the analysis and interpretation of the field data collected at the first power plant (henceforth referred to as Plant 0, and located in the Upper Midwest), followed by the performance and analysis of similar field experiments at two additional coal-fired power plants (Plants 1 and 2) utilizing different coal types and with different plant configurations. Significant progress was made on the Project during this reporting period, with field work being initiated at Plant 0. Initial testing of the stack sampling system and reaction apparatus revealed that primary particle concentrations were lower than expected in the emissions entering the mobile chemical laboratory. Initial animal exposures to primary emissions were carried out (Scenario 1) to ensure successful implementation of all study methodologies and toxicological assessments. Results indicated no significant toxicological effects in response to primary emissions exposures. Exposures were then carried out to diluted, oxidized, neutralized emissions with the addition of secondary organic aerosol (Scenario 5), both during the day and also at night when primary particle concentrations in the sampled stack emissions tended to be slightly higher. Exposure concentrations were about 249 {micro}g/m{sup 3} PM, of which 87 {micro}g/m{sup 3} was sulfate and approximately 110 {micro}g/m{sup 3} was secondary organic material ({approx}44%). Results indicated subtle differences in breathing pattern between exposed and control (sham) animals, but no differences in other endpoints (in vivo chemiluminescence, blood cytology, bronchoalveolar lavage fluid analysis). It was suspected that primary particle losses may have been occurring in the venturi aspirator/orifice sampler; therefore, the stack sampling system was redesigned. The modified system resulted in no substantial increase in particle concentration in the emissions, leading us to conclude that the electrostatic precipitator at the power plant has high efficiency, and that the sampled emissions are representative of those exiting the stack into the atmosphere. This is important, since the objective of the Project is to carry out exposures to realistic coal combustion-derived secondary PM arising from power plants. During the next reporting period, we will document and describe the remainder of the fieldwork at Plant 0, which we expect to be complete by mid-November 2004. This report will include detailed Phase I toxicological findings for all scenarios run, and Phase II toxicological findings for one selected scenario. Depending upon the outcome of the ongoing fieldwork at Plant 0 (i.e. the biological effects observed), not all the proposed scenarios may be evaluated. The next report is also expected to include preliminary field data for Plant 1, located in the Southeast.

Annette Rohr

2004-12-02

57

EVALUATION OF FORMALDEHYDE LEVELS IN OCCUPIED FEDERAL EMERGENCY MANAGEMENT AGENCY-OWNED TEMPORARY HOUSING UNITS  

E-print Network

EVALUATION OF FORMALDEHYDE LEVELS IN OCCUPIED FEDERAL EMERGENCY MANAGEMENT AGENCY-OWNED TEMPORARY to severely damaged housing. The Federal Emergency Management Agency (FEMA) provided disaster related housing

58

Differential evaluations of alcohol-related consequences among emerging adults.  

PubMed

Personalized feedback interventions (PFIs) to reduce drinking in college students often provide feedback about negative alcohol-related consequences experienced by students to motivate them to drink less. Yet, there is evidence which suggests that not everyone perceives consequences as negative and raises questions regarding the utility of consequence-specific feedback for some individuals. The purpose of the current study was to extend this research to examine salience of consequences among both college and non-college emerging adults, differences in ratings by sex, age, and frequency of experiencing consequences, and the relationship between salience measured in emerging adulthood and drinking patterns in young adulthood. Data were from an accelerated cohort study of males and females (N?=?1,308), who were either age 18, 21, or 24 years at the time of consequence evaluation and followed-up 7 years later. Most experienced consequences were rated as at least a little bothersome. Regression analyses indicated that females, older participants, and those who experienced a consequence more often evaluated consequences as more bothersome but there were no differences by college status. Mean ratings of bother did not predict quitting drinking or alcohol problems 7 years later, whereas the number of consequences experienced did. Overall, the results suggest that most consequences are rated similarly by emerging adults regardless of college attendance but that feedback on consequences may be more salient for females and older emerging adults. PFIs may need to differ in the types of feedback they provide depending on demographic characteristics and baseline level of alcohol problems. PMID:23412945

White, Helene R; Ray, Anne E

2014-02-01

59

Evaluation of the dentists' knowledge on medical urgency and emergency.  

PubMed

This study aimed at evaluating how well dentists understand medical emergency/urgency procedures and issues during dental treatment at a hospital specialized in cleft lip and palate. It comprised a hundred dentists from the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Brazil, from different dental specialties. A questionnaire was applied to evaluate their knowledge of medical emergencies/urgencies from June through September 2011. The questionnaire was anonymous, confidential and constructed with closed questions and either yes-no or multiple-choice responses. Results showed that most professionals (87%) were trained in basic life support (BLS), but only 43% considered themselves capable of providing first aid and performing the necessary maneuvers. Most participants (94%) claimed that they knew the difference between medical urgencies and emergencies, and 69% had BLS training in their undergraduate courses, as opposed to 37%, during their specialization. Some participants (23%) mentioned that they had received knowledge of the subject during extracurricular courses and/or graduate courses (12%). Only 9% had not been educated on the subject; however, all participants showed interest in attending a course in BLS. In regard to assessing training that dentists who attended BLS courses received, 49% were satisfied and 42% were dissatisfied. Results of the present study emphasize that dentists from HRAC/USP have little knowledge about BLS procedures to perform them. Dentists must gain adequate education and training to minimize possible technical, ethical and legal problems associated with dental practice. It is necessary to improve both knowledge and practice in order to become well-qualified practitioners. PMID:25141014

Stafuzza, Tássia Carina; Carrara, Cleide Felício Carvalho; Oliveira, Fernanda Veronese; Santos, Carlos Ferreira; Oliveira, Thais Marchini

2014-01-01

60

Emergency exercise methodology  

SciTech Connect

Competence for proper response to hazardous materials emergencies is enhanced and effectively measured by exercises which test plans and procedures and validate training. Emergency exercises are most effective when realistic criteria is used and a sequence of events is followed. The scenario is developed from pre-determined exercise objectives based on hazard analyses, actual plans and procedures. The scenario should address findings from previous exercises and actual emergencies. Exercise rules establish the extent of play and address contingencies during the exercise. All exercise personnel are assigned roles as players, controllers or evaluators. These participants should receive specialized training in advance. A methodology for writing an emergency exercise plan will be detailed.

Klimczak, C.A.

1993-03-01

61

Emergency exercise methodology  

SciTech Connect

Competence for proper response to hazardous materials emergencies is enhanced and effectively measured by exercises which test plans and procedures and validate training. Emergency exercises are most effective when realistic criteria is used and a sequence of events is followed. The scenario is developed from pre-determined exercise objectives based on hazard analyses, actual plans and procedures. The scenario should address findings from previous exercises and actual emergencies. Exercise rules establish the extent of play and address contingencies during the exercise. All exercise personnel are assigned roles as players, controllers or evaluators. These participants should receive specialized training in advance. A methodology for writing an emergency exercise plan will be detailed.

Klimczak, C.A.

1993-01-01

62

Performance evaluation of two emerging media processors: VIRAM and imagine  

SciTech Connect

This work presents two emerging media microprocessors, VIRAM and Imagine, and compares the implementation strategies and performance results of these unique architectures. VIRAM is a complete system on a chip which uses PIM technology to combine vector processing with embedded DRAM. Imagine is a programmable streaming architecture with a specialized memory hierarchy designed for computationally intensive data-parallel codes. First, we present a simple and effective approach for understanding and optimizing vector/stream applications. Performance results are then presented from a number of multimedia benchmarks and a computationally intensive scientific kernel. We explore the complex interact ions between programming paradigms, the architectural support at the ISA lever and the underlying microarchitecture of these two systems. Our long term goal is to evaluate leading media microprocessors as possible building blocks for future high performance systems.

Oliker, Leonid; Duell, Jason; Narayanan, Manikandan; Chatterji, Sourav

2003-01-01

63

Emergency evaluation, imaging, and classification of thoracolumbar injuries.  

PubMed

Thoracolumbar injuries usually are the result of high-energy trauma and frequently are associated with multisystem concomitant injuries. Whenever a thoracolumbar injury is suspected, a prompt and thorough evaluation should be performed in the emergency department, using the guidelines of the American College of Surgeons and including full primary and secondary surveys as well as resuscitation. Protection of the spine and spinal cord is of paramount importance during the initial evaluation. A careful and complete neurologic examination is warranted as part of the secondary survey. Plain radiography, CT, and MRI studies are useful in diagnosing and classifying thoracolumbar injuries. At many trauma centers, CT has become the standard imaging technology for the initial evaluation of the spine. MRI is particularly accurate in detecting injury to the posterior ligamentous complex of the thoracolumbar spine. Classification and treatment of thoracolumbar injuries are controversial. The comprehensive, reproducible classification system of the Spine Trauma Study Group has prognostic significance and can guide treatment decisions. The Thoracolumbar Injury Classification and Severity scale classifies thoracolumbar injures based on three pivotal characteristics: the morphology of the injury, the integrity of the posterior ligamentous complex, and the patient's neurologic status. A total severity score is used in conjunction with the classification system to determine the treatment. PMID:19385571

Rihn, Jeffrey A; Anderson, David T; Sasso, Rick C; Zdeblick, Thomas A; Lenke, Lawrence G; Harris, Mitchel B; Chapman, Jens R; Vaccaro, Alexander R

2009-01-01

64

Evaluation of Rugged Wireless Mesh Nodes for Use In Emergency Response  

SciTech Connect

During the summer of 2007, engineers at the Idaho National Laboratory (INL) conducted a two-day evaluation of commercially available battery powered, wireless, self-forming mesh nodes for use in emergency response. In this paper, the author describes the fundamentals of this emerging technology, applciations for emergency response and specific results of the technology evaluation conducted at the Idaho National Laboratory.

Kevin L Young; Alan M Snyder

2007-11-01

65

Beyond the Realist Theories: \\  

Microsoft Academic Search

The American war on terror and the invasion of Iraq remain spectacular developments in the history of international relations. This article probes the explanatory powers of the existing academic realist theories to account for the Bush administration's war against Al-Qaeda, a non- state shadowy organization, and the invasion of Iraq. It argues that the realist theories are largely deficient frameworks

MOHAMMED NURUZZAMAN

2006-01-01

66

Performance Evaluation of Emerging High Performance Computing Technologies using WRF  

NASA Astrophysics Data System (ADS)

The Arctic Region Supercomputing Center (ARSC) has evaluated multicore processors and other emerging processor technologies for a variety of high performance computing applications in the earth and space sciences, especially climate and weather applications. A flagship effort has been to assess dual core processor nodes on ARSC's Midnight supercomputer, in which two-socket systems were compared to eight-socket systems. Midnight is utilized for ARSC's twice-daily weather research and forecasting (WRF) model runs, available at weather.arsc.edu. Among other findings on Midnight, it was found that the Hypertransport system for interconnecting Opteron processors, memory, and other subsystems does not scale as well on eight-socket (sixteen processor) systems as well as two-socket (four processor) systems. A fundamental limitation is the cache snooping operation performed whenever a computational thread accesses main memory. This increases memory latency as the number of processor sockets increases. This is particularly noticeable on applications such as WRF that are primarily CPU-bound, versus applications that are bound by input/output or communication. The new Cray XT5 supercomputer at ARSC features quad core processors, and will host a variety of scaling experiments for WRF, CCSM4, and other models. Early results will be presented, including a series of WRF runs for Alaska with grid resolutions under 2km. ARSC will discuss a set of standardized test cases for the Alaska domain, similar to existing test cases for CONUS. These test cases will provide different configuration sizes and resolutions, suitable for single processors up to thousands. Beyond multi-core Opteron-based supercomputers, ARSC has examined WRF and other applications on additional emerging technologies. One such technology is the graphics processing unit, or GPU. The 9800-series nVidia GPU was evaluated with the cuBLAS software library. While in-socket GPUs might be forthcoming in the future, current generations of GPUs lack a sufficient balance of computational resources to replace the general-purpose microprocessor found in most traditional supercomputer architectures. ARSC has also worked with the Cell Broadband Engine in a small Playstation3 cluster, as well as a 24-processor system based on IBM's QS22 blades. The QS22 system, called Quasar, features the PowerXCell 8i processor found in the RoadRunner system, along with an InfiniBand network and high performance storage. Quasar overcomes the limitations of the small memory and relatively slow network of the PS3 systems. The presentation will include system-level benchmarks on Quasar, as well as evaluation of the WRF test cases. Another technology evaluation focused on Sun's UltraSPARC T2+ processor, which ARSC evaluated in a two-way system. Each T2+ provides eight processor cores, each of which provides eight threads, for a total of 128 threads in a single system. WRF scalability was good up to the number of cores, but multiple threads per core did not scale as well. Throughout the discussion, practical findings from ARSC will be summarized. While multicore general-purpose microprocessors are anticipated to remain important for large computers running earth and space science applications, the role of other potentially disruptive technologies is less certain. Limitations of current and future technologies will be discussed. class="ab'>

Newby, G. B.; Morton, D.

2008-12-01

67

TOXICOLOGICAL EVALUATION OF REALISTIC EMISSIONS OF SOURCE AEROSOLS (TERESA): APPLICATION TO POWER PLANT-DERIVED PM2.5  

SciTech Connect

This report documents progress made on the subject project during the period of September 1, 2004 through February 28, 2005. The TERESA Study is designed to investigate the role played by specific emissions sources and components in the induction of adverse health effects by examining the relative toxicity of coal combustion and mobile source (gasoline and/or diesel engine) emissions and their oxidative products. The study involves on-site sampling, dilution, and aging of coal combustion emissions at three coal-fired power plants, as well as mobile source emissions, followed by animal exposures incorporating a number of toxicological endpoints. The DOE-EPRI Cooperative Agreement (henceforth referred to as ''the Agreement'') for which this technical progress report has been prepared covers the performance and analysis of field experiments at the first TERESA plant, located in the Upper Midwest and henceforth referred to as Plant 0, and at two additional coal-fired power plants (Plants 1 and 2) utilizing different coal types and with different plant configurations. During this reporting period, all fieldwork at Plant 0 was completed. Stack sampling was conducted in October to determine if there were significant differences between the in-stack PM concentrations and the diluted concentrations used for the animal exposures. Results indicated no significant differences and therefore confidence that the revised stack sampling methodology described in the previous semiannual report is appropriate for use in the Project. Animal exposures to three atmospheric scenarios were carried out. From October 4-7, we conducted exposures to oxidized emissions with the addition of secondary organic aerosol (SOA). Later in October, exposures to the most complex scenario (oxidized, neutralized emissions plus SOA) were repeated to ensure comparability with the results of the June/July exposures where a different stack sampling setup was employed. In November, exposures to oxidized emissions were performed. Stage I toxicological assessments were carried out in Sprague-Dawley rats. Biological endpoints included breathing pattern/pulmonary function; in vivo chemiluminescence (an indicator of oxidative stress); blood cytology; bronchoalveolar lavage (BAL) fluid analysis; and histopathology. No significant differences between exposed animals and sham animals (exposed to filtered air) were observed for any of the endpoints; histopathological results are pending and will be reported in the next semiannual report. The scenarios evaluated during this reporting period were slightly modified from those originally proposed. We substituted a new scenario, secondary aerosol + SOA, to investigate the effects of a strongly acidic aerosol with a biogenic component. Since we did not observe any biological response to this scenario, the neutralized secondary aerosol scenario (i.e., oxidized emissions + ammonia) was deemed unnecessary. Moreover, in light of the lack of response observed in the Stage I assessment, it was decided that a Stage II assessment (evaluation of cardiac function in a compromised rat model) was unlikely to provide useful information. However, this model will be employed at Plant 1 and/or 2. During this reporting period, significant progress was made in planning for fieldwork at Plant 1. Stack sampling was carried out at the plant in mid-December to determine the concentration of primary particles. It was found that PM{sub 2.5} mass concentrations were approximately three times higher than those observed at Plant 0. In mid-February, installation and setup for the mobile laboratories began. Animal exposures are scheduled to begin at this plant on March 21, 2005. During the next reporting period, we will initiate fieldwork at Plant 1. At either or both Plants 1 and 2, a detailed Stage II assessment will be performed, even if no significant findings are observed in Stage I. The next semiannual report is expected to include a detailed description of the fieldwork at Plant 1, including toxicological findings and interpretation.

Annette Rohr

2005-03-31

68

Evaluating emergency nurse practitioner services: a randomised controlled trial  

Microsoft Academic Search

Emergency Nurse Practitioners (ENP) are increasingly managing minor injuries in Accident and Emergency departments across the United Kingdom. This study aimed to develop methods and tools that could be used to measure the quality of ENP-led care. These tools were then tested in a randomized controlled trial. A convenience sample of 199 eligible patients, over 16 years old, and with

Mark A. Cooper; Grace M. Lindsay; Sue Kinn; Ian J. Swann

2002-01-01

69

Realistic Human Action Recognition with Audio Context  

Microsoft Academic Search

Recognizing human actions in realistic scenes has emerged as a challenging topic due to various aspects such as dynamic backgrounds. In this paper, we present a novel approach to taking audio context into account for better action recognition performance, since audio can provide strong evidence to certain actions such as phone-ringing to answer-phone. At first, classifiers are established for visual

Qiuxia Wu; Zhiyong Wang; Feiqi Deng; David Dagan Feng

2010-01-01

70

Realistic Animation of Liquids  

Microsoft Academic Search

We present a comprehensive methodology for realistically animating liquid phenomena. Our ap- proach unifies existing computer graphics techniques for simulating fluids and extends them by incorporating more complex behavior. It is based on the Navier-Stokes equations which couple momentum and mass conservation to completely describe fluid motion. Our starting point is an environment containing an arbitrary distribution of fluid, and

Nick Foster; Dimitris N. Metaxas

1996-01-01

71

Design And Evaluation Of Emergent Behaviour For Artificial Haemostasis  

Microsoft Academic Search

Abstract This report describes an investigation into the specification, design and simulation of artificial haemostasis. Natural haemostasis (blood clotting) in the human body is reviewed, and used as a guide in creating the specification. A swarm,of software agents are used to implement,a set of emergent primitives (behavioural rules), designed after a discussion of development issues include distribution, parallelism, communication, common

Edward Jackson

72

Evaluation of the shock index in dogs presenting as emergencies  

PubMed Central

Objectives To 1) determine the normal range for Shock Index (SI) [defined as heart rate (HR)/systolic blood pressure (SBP)], in healthy dogs, and 2) compare SI in healthy dogs with dogs presenting to the emergency room (ER) deemed to be in or not in a state of shock. Design Prospective study. Animals 68 clinically normal dogs,,18 dogs that were presented to the ER deemed to be in shock and 19 dogs presenting to the ER not deemed to be in shock. Setting University teaching hospital. Interventions Peripheral or central venous blood sampling. Measurements and Main Results Heart rate and SBP were recorded on simulated presentation (healthy dogs), and emergency presentations for both dogs deemed to be in shock and dogs not deemed in shock. Dogs in shock had a median SI of 1.37 (0.87–3.13), which was significantly higher than both other groups; dogs not deemed in shock had median SI 0.73 (0.56–1.20), P<0.0001 and healthy dogs had median SI 0.78 (0.37–1.30) P<0.0001), respectively. Receiver operator characteristic curve analysis suggested a SI cut-off of 1.0, yielding an area under the receiver operator characteristic (AUROC) of 0.89 (Specificity (Sp) 89, Sensitivity (Sn) 90) when comparing dogs deemed in shock with healthy dogs, and 0.92 (Sp 95, Sn 89) when comparing dogs in shock with to dogs not deemed in shock. Conclusions The SI is an easy and non-invasive patient parameter that is higher in dogs that are deemed to be in shock than both healthy dogs and dogs presented as emergencies but not deemed to be in a state of shock. The measurement of SI may have some benefit in clinical assessment of emergency patients. PMID:23855723

Porter, Adam E.; Rozanski, Elizabeth A.; Sharp, Claire R.; Dixon, Kursten L.; Lyn Price, Lori; Shaw, Scott P.

2013-01-01

73

[Evaluation of emergency surgery in gestational trophoblastic tumours].  

PubMed

We retrospectively analyzed 27 cases of gestational trophoblastic neoplasia treated by emergency surgery from 1985-1996 at PUMC hospital. Seventeen cases were diagnosed of choriocarcinoma and 10 were invasive mole. Sixteen out of 27 patients were subjected to hysterectomy because of uterine perforation or severe uterine bleeding; 4 cases received unilateral oophorectomy because of torsion of theca lutein cyst. Emergency open surgery and excision of the metastatic brain tumour were undertaken in 3 patients with elevated intracranial pressure caused by brain edema and haemorrhage; 2 patients showed lifethreatening haemorrhage from vaginal metastatic tumour and were managed by operative intervention. Partial jejunectomy was performed in 2 patients due to rupture of jejunal metastatic mass. Of these 27 cases, 17 hadn't been treated with chemical reagents and 6 cases had received one course of chemotherapy before surgical procedures. After multiple courses of combined chemotherapy postoperatively, 23 patients had achieved complete remission. It is concluded that surgical intervention plays an important role in patients with trophoblastic disease when emergency situations (e.g. life-threatening haemorrhages) occur; early diagnosis and prompt initiation of chemotherapy might have rendered surgery unnecessary. PMID:10453523

Xiang, Y; Yang, X; Zhang, L; Song, H

1997-10-01

74

Evaluation of EMERGE, a Medical Decision Making Aid for Analysis of Chest Pain  

PubMed Central

EMERGE, a rule-based medical decision making aid for analysis of chest pain in the emergency room, was evaluated using retrospective patient data. The analysis consisted of two phases. In the initial phase, patient cases were run in order to make minor modifications and adjustments in the criteria used for determination of admission. In the second phase, patient cases were analyzed to determine the effectiveness of the EMERGE system in arriving at the proper conclusion.

Hudson, Donna L.; Cohen, Moses E.; Deedwania, Prakash C.; Watson, Patricia E.

1983-01-01

75

Evaluation of potassium iodide prophylaxis knowledge and nuclear emergency preparedness: New Jersey 2005.  

PubMed

The Nuclear Regulatory Commission requires states to consider including potassium iodide as a protective measure in the unlikely event of a major release of radioactivity from a nuclear power plant. We evaluated emergency preparedness knowledge, including proper potassium iodide use, among the general public and emergency responders located around New Jersey's nuclear power plants. We found that knowledge about responder chain of command, evacuation routes, and some aspects of potassium iodide usage was incomplete among the general public and emergency responders. PMID:17413064

Blando, James; Robertson, Corwin; Pearl, Katina; Dixon, Carline; Valcin, Martin; Bresnitz, Eddy

2007-04-01

76

Evaluation Research of Emergency Logistics System Based on Set Pair Analysis Model  

Microsoft Academic Search

Each year, there are kinds of new diseases or natural disasters that break out around the world. And, the emergency logistics system plays an important role in the process of fighting against these diseases and natural disasters. How to evaluate and optimize the emergency logistics system in contingencies is becoming the hot researching topic. This article establishes the set pair

Zhang Zhi-yong; Liu Cheng; Yang Lei

2009-01-01

77

Emergent Evaluation and Educational Reforms in Latin America  

ERIC Educational Resources Information Center

The aim of this chapter is to characterize educational reforms in Latin America over the last 25 years, and the way they reflect the role, method, and use of evaluation processes. The main theoretical and methodological tensions that are created by the development of evaluations will be reviewed, concluding with the identification of some of the…

Martinic, Sergio

2012-01-01

78

EVALUATING AND TESTING EMERGENCY TESTING MONITORING DEVICES IN EXTREME COLD TEMPERATURES  

EPA Science Inventory

EPA Identifier: F8P11070 Title: Evaluating and Testing Emergency Testing Monitoring Devices in Extreme Cold Temperatures Fellow (Principal Investigator): Tyler S. O?Dell Institution: Lake Superior State University EPA GRANT Represent...

79

National Evaluation of the Emergency School Aid Act (ESAA): a Review of Methodological Issues  

Microsoft Academic Search

Large-scale field evaluations of education programs typically present complex and competing design requirements that can rarely be satisfied by ideal, textbook solutions. This paper uses a recently completed national evaluation of the federally-funded Emergency School Aid Act (ESAA) Program to illustrate in concrete fashion some of the problems often encountered in major program evaluations, and traces the evolution of efforts

John E. Coulson

1978-01-01

80

Updating realistic access  

PubMed Central

Nearly six years ago Ira Mellman, then Editor-in-Chief of the JCB, published an editorial entitled “Providing realistic access” (1). It described the Journal's efforts to reconcile its subscription-basedbusiness model with the goal of providing public access to scholarly journal content. Since then, developments in the public-access movement are bringing us closer to the ideal of universal public access. But will there still be a place for selective journals like the JCB when we achieve that objective? PMID:20375430

2010-01-01

81

Developing a Standardized Faculty Evaluation in an Emergency Medicine Residency  

Microsoft Academic Search

Background: Quality educators are a core component of successful residency training. A structured, consistent, validated evaluation of clinical educators is important to improve teaching aptitude, further faculty development, and improve patient care. Study Objectives: The authors sought to identify specific domains of instructional quality and to develop a composite instrument for assessing instructional quality. Methods: The study setting is a

James E. Colletti; Thomas J. Flottemesch; Tara A. O'Connell; Felix K. Ankel; Brent R. Asplin

2010-01-01

82

Development and evaluation of emerging design patterns for ubiquitous computing  

Microsoft Academic Search

Design patterns are a format for capturing and sharing design knowledge. In this paper, we look at a new domain for design patterns, namely ubiquitous computing. The overall goal of this work is to aid practice by speeding up the diffusion of new interaction techniques and evaluation results from researchers, presenting the information in a form more usable to practicing

Eric S. Chung; Jason I. Hong; James Lin; Madhu K. Prabaker; James A. Landay; Alan L. Liu

2004-01-01

83

Use of field experimental studies to evaluate emergency response models  

SciTech Connect

The three-dimensional diagnostic wind field model (MATHEW) and the particle-in-cell atmospheric transport and diffusion model (ADPIC) are used by the Atmospheric Release Advisory Capability to estimate the environmental consequences of accidental releases of radioactivity into the atmosphere. These models have undergone extensive evaluations against field experiments conducted in a variety of environmental settings ranging from relatively flat to very complex terrain areas. Simulations of tracer experiments conducted in a complex mountain valley setting revealed that 35 to 50% of the comparisons between calculated and measured tracer concentrations were within a factor of 5. This may be compared with a factor of 2 for 50% of the comparisons for relatively flat terrain. This degradation of results in complex terrain is due to a variety of factors such as the limited representativeness of measurements in complex terrain, the limited spatial resolution afforded by the models, and the turbulence parameterization based on sigma/sub theta/ measurements to evaluate the eddy diffusivities. Measurements of sigma/sub theta/ in complex terrain exceed those measured over flat terrain by a factor of 2 to 3 leading to eddy diffusivities that are unrealistically high. The results of model evaluations are very sensitive to the quality and the representativeness of the meteorological data. This is particularly true for measurements near the source. The capability of the models to simulate the dispersion of an instantaneously produced cloud of particulates was illustrated to be generally within a factor of 2 over flat terrain. 19 refs., 16 figs.

Gudiksen, P.H.; Lange, R.; Rodriguez, D.J.; Nasstrom, J.S.

1985-07-16

84

An evaluation of emerging vaccines for childhood pneumococcal pneumonia  

PubMed Central

Background Pneumonia is the leading cause of child mortality worldwide. Streptococcus pneumoniae (SP) or pneumococcus is estimated to cause 821,000 child deaths each year. It has over 90 serotypes, of which 7 to 13 serotypes are included in current formulations of pneumococcal conjugate vaccines that are efficacious in young children. To further reduce the burden from SP pneumonia, a vaccine is required that could protect children from a greater diversity of serotypes. Two different types of vaccines against pneumococcal pneumonia are currently at varying stages of development: a multivalent pneumococcal conjugate vaccine covering additional SP serotypes; and a conserved common pneumococcal protein antigen (PPA) vaccine offering protection for all serotypes. Methods We used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging SP vaccines relevant to several criteria of interest: answerability; efficacy and effectiveness; cost of development, production and implementation; deliverability, affordability and sustainability; maximum potential for disease burden reduction; acceptability to the end users and health workers; and effect on equity. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to sensitive nature of their involvement in such exercises. They answered questions from CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%. Results The experts expressed very high level of optimism (over 80%) that low-cost polysaccharide conjugate SP vaccines would satisfy each of the 9 relevant CHNRI criteria. The median potential effectiveness of conjugate SP vaccines in reduction of overall childhood pneumonia mortality was predicted to be about 25% (interquartile range 20-38%, min. 15%, max 45%). For low cost, cross-protective common protein vaccines for SP the experts expressed concerns over answerability (72%) and the level of development costs (50%), while the scores for all other criteria were over 80%. The median potential effectiveness of common protein vaccines in reduction of overall childhood pneumonia mortality was predicted to be about 30% (interquartile range 26-40%, min. 20%, max 45%). Conclusions Improved SP vaccines are a very promising investment that could substantially contribute to reduction of child mortality world-wide. PMID:21501444

2011-01-01

85

Psychiatric Evaluation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Psychiatric Evaluation Workgroup  

PubMed Central

It is difficult to fully assess an agitated patient, and the complete psychiatric evaluation usually cannot be completed until the patient is calm enough to participate in a psychiatric interview. Nonetheless, emergency clinicians must perform an initial mental status screening to begin this process as soon as the agitated patient presents to an emergency setting. For this reason, the psychiatric evaluation of the agitated patient can be thought of as a 2-step process. First, a brief evaluation must be aimed at determining the most likely cause of agitation, so as to guide preliminary interventions to calm the patient. Once the patient is calmed, more extensive psychiatric assessment can be completed. The goal of the emergency assessment of the psychiatric patient is not necessarily to obtain a definitive diagnosis. Rather, ascertaining a differential diagnosis, determining safety, and developing an appropriate treatment and disposition plan are the goals of the assessment. This article will summarize what components of the psychiatric assessment can and should be done at the time the agitated patient presents to the emergency setting. The complete psychiatric evaluation of the patient whose agitation has been treated successfully is beyond the scope of this article and Project BETA (Best practices in Evaluation and Treatment of Agitation), but will be outlined briefly to give the reader an understanding of what a full psychiatric assessment would entail. Other issues related to the assessment of the agitated patient in the emergency setting will also be discussed. PMID:22461916

Stowell, Keith R; Florence, Peter; Harman, Herbert J; Glick, Rachel L

2012-01-01

86

Outside Educational Evaluation of the Emergency School Assistance Program. Interim Report.  

ERIC Educational Resources Information Center

This progress report describes study objectives, research design, field survey activities, and analysis plans for the evaluation of the Emergency School Assistance Program (ESAP), a federal program to aid local educational agencies in bringing about racial desegregation of their public school systems. A need for evaluation is explained in terms of…

RMC Research Corp., Arlington, VA.

87

Evaluation of a Device to Speed Emergence from Volatile Anesthetic Using a Computer Model  

Microsoft Academic Search

Introduction: We used a computer model of anesthetic uptake and distribution to evaluate the expected emergence time reduction when using a rebreathing\\/absorber device. The computer model describes transport of anesthetic in multiple body tissue compartments as well as in the breathing circuit. We modified the model to simulate use of a rebreathing\\/absorber device. The modification allows the simulated patient to

Joseph Orr; Nishant Gopalakrishnan; Dwayne Westenskow; Noah Syroid

88

Development of a checklist for evaluating emergency procedures used in nuclear power plants  

Microsoft Academic Search

This report describes the process for developing a checklist to be used by US Nuclear Regulatory Commission Office of Inspection and Enforcement (I and E) inspectors during their evaluation of emergency procedures used in nuclear power plants. The objective of the checklist is to aid inspectors in identifying procedural characteristics that can lead to reactor operator performance deviations. Four nuclear

R. L. Brune; M. Weinstein

1981-01-01

89

Integrating realistic job previews and realistic living conditions previews : Realistic recruitment for internationally mobile knowledge workers  

Microsoft Academic Search

Purpose – The purpose of this paper is to explore the use of realistic job previews (RJPs) and realistic living conditions previews (RLCPs) during the recruitment of a group of internationally mobile knowledge workers who elect to go overseas independently rather than as part of an overseas assignment. It also aims to explore individual perceptions of the value of RJPs

Julia Richardson; Ken McBey; Steve McKenna

2008-01-01

90

Development and use of consolidated criteria for evaluation of emergency preparedness plans for DOE facilities  

SciTech Connect

Emergency preparedness at US Department of Energy (DOE) facilities is promoted by development and quality control of response plans. To promote quality control efforts, DOE has developed a review document that consolidates requirements and guidance pertaining to emergency response planning from various DOE and regulatory sources. The Criteria for Evaluation of Operational Emergency Plans (herein referred to as the Criteria document) has been constructed and arranged to maximize ease of use in reviewing DOE response plans. Although developed as a review instrument, the document also serves as a de facto guide for plan development, and could potentially be useful outside the scope of its original intended DOE clientele. As regulatory and DOE requirements are revised and added in the future, the document will be updated to stay current.

Lerner, K.; Kier, P.H.; Baldwin, T.E.

1995-07-01

91

Non-realistic digital rendering  

E-print Network

and expression. The artist knows that "a galloping horse has not four legs; it has twenty, and their movements are triangular" [7] while the computer is instructed to "create objects that look and behave as realistically as possible. "[5] Artists represent... and expression. The artist knows that "a galloping horse has not four legs; it has twenty, and their movements are triangular" [7] while the computer is instructed to "create objects that look and behave as realistically as possible. "[5] Artists represent...

Ronai, Amanda Sharon

2012-06-07

92

Evaluation of the xpert flu rapid PCR assay in high-risk emergency department patients.  

PubMed

We prospectively evaluated the performance of Cepheid's GeneXpert Xpert Flu assay in a target population of 281 adults presenting to the emergency department with an acute respiratory illness who met Centers for Disease Control and Prevention (CDC) criteria for recommended antiviral treatment. Compared with the Prodesse ProFlu+ assay, Xpert Flu had an overall sensitivity of 95.3% and specificity of 99.2%. PMID:25253792

Dugas, Andrea F; Valsamakis, Alexandra; Gaydos, Charlotte A; Forman, Michael; Hardick, Justin; Kidambi, Pranav; Amin, Sharmeen; Gupta, Alisha; Rothman, Richard E

2014-12-01

93

The Evaluation Exchange: Emerging Strategies in Evaluating Child and Family Services, 2001.  

ERIC Educational Resources Information Center

This document is comprised of the two 2001 issues of a newsletter of the Harvard Family Research Project, designed to share new ideas and experiences in evaluating systems reform and comprehensive child and family services. The first issue focuses on strategic communications and efforts of nonprofit agencies to evaluate strategic communication…

Goodyear, Leslie, Ed.; Bohan-Baker, Marielle, Ed.

2001-01-01

94

The Evaluation Exchange: Emerging Strategies in Evaluating Child and Family Services, 1999.  

ERIC Educational Resources Information Center

This document is comprised of the 1999 issues (issues 2 and 3 are combined) of a newsletter of the Harvard Family Research Project, designed to share new ideas and experiences in evaluating systems reform and comprehensive child and family services. The first issue focuses on the evaluation of youth programs and includes the following articles:…

The Evaluation Exchange: Emerging Strategies in Evaluating Child and Family Services, 1999

1999-01-01

95

The Evaluation Exchange: Emerging Strategies in Evaluating Child and Family Services, 2002.  

ERIC Educational Resources Information Center

This document is comprised of the three 2002 issues of a newsletter of the Harvard Family Research Project, designed to share new ideas and experiences in evaluating systems reform and comprehensive child and family services. The Spring issue focuses on family support evaluations and their role in advancing the field of family support and includes…

Lopez, M. Elena, Ed.

2002-01-01

96

Evaluator/controller practicum for US Department of Energy emergency exercises  

SciTech Connect

Argonne National Laboratory has designed a practicum to help ensure that exercises at Department of Energy (DOE) facilities provide results that will be useful in maintaining or improving emergency preparedness while ensuring the safety of the public and the exercise participants. Participants in the first two offerings of the practicum came from DOE facilities nationwide. The practicum augments the usual forms of controller and evaluator training with actual practice in carrying out controller and evaluator roles. Feedback from participants indicated substantial benefit from the training. Many of the participants expressed a desire to present such training to others at their home facilities.

Lacher, L.; Converse, R.; Gasper, W.; Mitrani, J. [and others

1996-12-31

97

Realistic Radio Communications in Pilot Simulator Training  

NASA Technical Reports Server (NTRS)

Simulators used for total training and evaluation of airline pilots must satisfy stringent criteria in order to assure their adequacy for training and checking maneuvers. Air traffic control and company radio communications simulation, however, may still be left to role-play by the already taxed instructor/evaluators in spite of their central importance in every aspect of the flight environment. The underlying premise of this research is that providing a realistic radio communications environment would increase safety by enhancing pilot training and evaluation. This report summarizes the first-year efforts of assessing the requirement and feasibility of simulating radio communications automatically. A review of the training and crew resource/task management literature showed both practical and theoretical support for the need for realistic radio communications simulation. A survey of 29 instructor/evaluators from 14 airlines revealed that radio communications are mainly role-played by the instructor/evaluators. This increases instructor/evaluators' own workload while unrealistically lowering pilot communications load compared to actual operations, with a concomitant loss in training/evaluation effectiveness. A technology review searching for an automated means of providing radio communications to and from aircraft with minimal human effort showed that while promising, the technology is still immature. Further research and the need for establishing a proof-of-concept are also discussed.

Burki-Cohen, Judith; Kendra, Andrew J.; Kanki, Barbara G.; Lee, Alfred T.

2000-01-01

98

Evaluating adverse drug event reporting in administrative data from emergency departments: a validation study  

PubMed Central

Background Adverse drug events are a frequent cause of emergency department presentations. Administrative data could be used to identify patients presenting with adverse drug events for post-market surveillance, and to conduct research in patient safety and in drug safety and effectiveness. However, such data sources have not been evaluated for their completeness with regard to adverse drug event reporting. Our objective was to determine the proportion of adverse drug events to outpatient medications diagnosed at the point-of-care in emergency departments that were documented in administrative data. Methods We linked the records of patients enrolled in a prospective observational cohort study on adverse drug events conducted in two Canadian tertiary care emergency departments to their administrative data. We compared the number of adverse drug events diagnosed and recorded at the point-of-care in the prospective study with the number of adverse drug events recorded in the administrative data. Results Among 1574 emergency department visits, 221 were identified as adverse drug event-related in the prospective database. We found 15 adverse drug events documented in administrative records with ICD-10 codes clearly indicating an adverse drug event, indicating a sensitivity of 6.8% (95% CI 4.0–11.2%) of this code set. When the ICD-10 code categories were broadened to include codes indicating a very likely, likely or possible adverse event to a medication, 62 of 221 events were identifiable in administrative data, corresponding to a sensitivity of 28.1% (95% CI 22.3-34.6%). Conclusions Adverse drug events to outpatient medications were underreported in emergency department administrative data compared to the number of adverse drug events diagnosed and recorded at the point-of-care. PMID:24219303

2013-01-01

99

The Potential and Challenges of Critical Realist Ethnography  

ERIC Educational Resources Information Center

This article revisits the critical realist ethnographic process that was adopted in my doctoral thesis, which was concerned with the experiences of ethnic identity of white British and Pakistani British children as they started kindergarten in the northwest of England. The article focuses on the ethnography that emerged from the visits that I…

Barron, Ian

2013-01-01

100

The potential and challenges of critical realist ethnography  

Microsoft Academic Search

This article revisits the critical realist ethnographic process that was adopted in my doctoral thesis, which was concerned with the experiences of ethnic identity of white British and Pakistani British children as they started kindergarten in the northwest of England. The article focuses on the ethnography that emerged from the visits that I carried out alongside staff to children's homes

Ian Barron

2012-01-01

101

Value of Acute Rest Sestamibi Perfusion Imaging for Evaluation of Patients Admitted to the Emergency Department With Chest Pain  

Microsoft Academic Search

Objectives. This study sought to determine the ability of early perfusion imaging using technetium-99m sestamibi to predict adverse cardiac outcomes in patients who present to the emergency department with possible cardiac ischemia and nondiagnostic electrocardiograms (ECGs).Background. Evaluation of patients presenting to the emergency department with possible acute coronary syndromes and nondiagnostic ECGs is problematic. Accurate risk stratification is necessary to

Michael C Kontos; Robert L Jesse; Kristin L Schmidt; Joseph P Ornato; James L Tatum

1997-01-01

102

Evaluation of emergency-locator-transmitter performance in real and simulated crash tests  

NASA Technical Reports Server (NTRS)

Emergency locator transmitter (ELT) activation problems were investigated by testing a sampling of ELT units in actual airplane crashes and in a special test apparatus which simulated longitudinal crash pulses with superimposed local structural resonances. Probable causes of excessive false alarms and nonactivations of ELT's during crash situations were determined and solutions to the current operational and technical problems were obtained. The results, which considered placement, mounting, and activation of ELT's under simulated crash impacts, and an evaluation of the sensitivity of ELT impact switches to orientation and to local structural vibrations are discussed.

Carden, H. D.

1981-01-01

103

Evaluation and management of acute abdominal pain in the emergency department  

PubMed Central

Evaluation of the emergency department patient with acute abdominal pain is sometimes difficult. Various factors can obscure the presentation, delaying or preventing the correct diagnosis, with subsequent adverse patient outcomes. Clinicians must consider multiple diagnoses, especially those life-threatening conditions that require timely intervention to limit morbidity and mortality. This article will review general information on abdominal pain and discuss the clinical approach by review of the history and the physical examination. Additionally, this article will discuss the approach to unstable patients with abdominal pain. PMID:23055768

Macaluso, Christopher R; McNamara, Robert M

2012-01-01

104

Realistic modeling for facial animation  

Microsoft Academic Search

A major unsolved problem in computer graphics is the construc- tion and animation of realistic human facial models. Traditionally, facial models have been built painstakingly by manual digitization and animated by ad hoc parametrically controlled facial mesh defor- mations or kinematic approximation of muscle actions. Fortunately, animators are now able to digitize facial geometries through the use of scanning range

Yuencheng Lee; Demetri Terzopoulos; Keith Walters

1995-01-01

105

Time management: a realistic approach.  

PubMed

Realistic time management and organization plans can improve productivity and the quality of life. However, these skills can be difficult to develop and maintain. The key elements of time management are goals, organization, delegation, and relaxation. The author addresses each of these components and provides suggestions for successful time management. PMID:19467489

Jackson, Valerie P

2009-06-01

106

Pilot Wisconsin Emerging Scholars Program 1993-94 [and] Script for the Audio Program. Final Evaluation Report.  

ERIC Educational Resources Information Center

This document contains the final evaluation report of the Wisconsin Emerging Scholars Program 1993-94 and the script for the audio program. The evaluation report includes an executive summary; a discussion of the parameters of the evaluation including research questions and methods; implementation processes and outcomes for faculty and…

Millar, Susan B.; And Others

107

Logic Modeling as a Tool to Prepare to Evaluate Disaster and Emergency Preparedness, Response, and Recovery in Schools  

ERIC Educational Resources Information Center

The authors propose a comprehensive evaluation framework to prepare for evaluating school emergency management programs. This framework involves a logic model that incorporates Government Performance and Results Act (GPRA) measures as a foundation for comprehensive evaluation that complements performance monitoring used by the U.S. Department of…

Zantal-Wiener, Kathy; Horwood, Thomas J.

2010-01-01

108

Standardized Approaches to Syncope Evaluation for Reducing Hospital Admissions and Costs in Overcrowded Emergency Departments  

PubMed Central

Purpose The evaluation of syncope is often disorganized and ineffective. The objective of this study was to examine whether implementation of a standardized emergency department (ED) protocol improves the quality of syncope evaluation. Materials and Methods This study was a prospective, non-randomized study conducted at a 1900-bed, tertiary teaching hospital in South Korea. We compared two specific periods, including a 12-month observation period (control group, January-December 2009) and a 10-month intervention period after the implementation of standardized approaches, comprising risk stratification, hospital order sets and establishment of a syncope observational unit (intervention group, March-December 2010). Primary end points were hospital admission rates and medical costs related to syncope evaluation. Results A total of 244 patients were enrolled in this study (116 patients in the control group and 128 patients in the intervention group). The admission rate decreased by 8.3% in the intervention group (adjusted odds ratio 0.31, 95% confidence interval 0.13-0.70, p=0.005). There was a cost reduction of about 30% during the intervention period [369000 Korean won (KRW), interquartile range (IQR) 240000-602000 KRW], compared with the control period (542000 KRW, IQR 316000-1185000 KRW). The length of stay in the ED was also reduced in the intervention group (median: 4.6 hours vs. 3.4 hours). Conclusion Standardized approaches to syncope evaluation reduced hospital admissions, medical costs and length of stay in the overcrowded emergency department of a tertiary teaching hospital in South Korea. PMID:23918559

Shin, Tae Gun; Jo, Ik Joon; Sim, Min Seob; Park, Seung-Jung

2013-01-01

109

Emergency and backup power supplies at Department of Energy facilities: Augmented Evaluation Team -- Final report  

SciTech Connect

This report documents the results of the Defense Programs (DP) Augmented Evaluation Team (AET) review of emergency and backup power supplies (i.e., generator, uninterruptible power supply, and battery systems) at DP facilities. The review was conducted in response to concerns expressed by former Secretary of Energy James D. Watkins over the number of incidents where backup power sources failed to provide electrical power during tests or actual demands. The AET conducted a series of on-site reviews for the purpose of understanding the design, operation, maintenance, and safety significance of emergency and backup power (E&BP) supplies. The AET found that the quality of programs related to maintenance of backup power systems varies greatly among the sites visited, and often among facilities at the same site. No major safety issues were identified. However, there are areas where the AET believes the reliability of emergency and backup power systems can and should be improved. Recommendations for improving the performance of E&BP systems are provided in this report. The report also discusses progress made by Management and Operating (M&O) contractors to improve the reliability of backup sources used in safety significant applications. One area that requires further attention is the analysis and understanding of the safety implications of backup power equipment. This understanding is needed for proper graded-approach implementation of Department of Energy (DOE) Orders, and to help ensure that equipment important to the safety of DOE workers, the public, and the environment is identified, classified, recognized, and treated as such by designers, users, and maintainers. Another area considered important for improving E&BP system performance is the assignment of overall ownership responsibility and authority for ensuring that E&BP equipment performs adequately and that reliability and availability are maintained at acceptable levels.

Not Available

1993-11-01

110

Emergent Expertise?  

ERIC Educational Resources Information Center

The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

McGivern, Patrick

2014-01-01

111

Toxicological evaluation of three contaminants of emerging concern by use of the Allium cepa test.  

PubMed

Di(2-ethylhexyl)phthalate, triclosan and propylparaben are contaminants of emerging concern that have been subjected to extensive toxicological studies, but for which limited information is currently available concerning adverse effects on terrestrial plant systems. The Allium cepa test, which is considered one of the most efficient approaches to assess toxic effects of environmental chemicals, was selected to evaluate the potential risks of these ubiquitous pollutants. Our data demonstrate that all three compounds studied may in some way be considered toxic, but different effects were noted depending on the chemical and the end point analysed. Results derived from the analysis of macroscopic parameters used in testing for general toxicity, revealed that while di(2-ethylhexyl)phthalate had no apparent effects, the other two chemicals inhibited A. cepa root growth in a dose-dependent manner. On the other hand, although all three compounds caused alterations in the mitotic index of root-tip cells, propylparaben was the only one that did not show evidence of genotoxicity in assays for chromosome aberrations and micronuclei. The results of the present study clearly indicate that sensitive plant bioassays are useful and complementary tools to determine environmental impact of contaminants of emerging concern. PMID:22249112

Herrero, O; Pérez Martín, J M; Fernández Freire, P; Carvajal López, L; Peropadre, A; Hazen, M J

2012-03-18

112

Simulator Evaluation of Simplified Propulsion-Only Emergency Flight Control Systems on Transport Aircraft  

NASA Technical Reports Server (NTRS)

With the advent of digital engine control systems, considering the use of engine thrust for emergency flight control has become feasible. Many incidents have occurred in which engine thrust supplemented or replaced normal aircraft flight controls. In most of these cases, a crash has resulted, and more than 1100 lives have been lost. The NASA Dryden Flight Research Center has developed a propulsion-controlled aircraft (PCA) system in which computer-controlled engine thrust provides emergency flight control capability. Using this PCA system, an F-15 and an MD-11 airplane have been landed without using any flight controls. In simulations, C-17, B-757, and B-747 PCA systems have also been evaluated successfully. These tests used full-authority digital electronic control systems on the engines. Developing simpler PCA systems that can operate without full-authority engine control, thus allowing PCA technology to be installed on less capable airplanes or at lower cost, is also a desire. Studies have examined simplified ?PCA Ultralite? concepts in which thrust control is provided using an autothrottle system supplemented by manual differential throttle control. Some of these concepts have worked well. The PCA Ultralite study results are presented for simulation tests of MD-11, B-757, C-17, and B-747 aircraft.

Burcham, Frank W., Jr.; Kaneshige, John; Bull, John; Maine, Trindel A.

1999-01-01

113

Study designs and evaluation models for emergency department public health research.  

PubMed

Abstract Public health research requires sound design and thoughtful consideration of potential biases that may influence the validity of results. It also requires careful implementation of protocols and procedures that are likely to translate from the research environment to actual clinical practice. This article is the product of a breakout session from the 2009 Academic Emergency Medicine consensus conference entitled "Public Health in the ED: Screening, Surveillance, and Intervention" and serves to describe in detail aspects of performing emergency department (ED)-based public health research, while serving as a resource for current and future researchers. In doing so, the authors describe methodologic features of study design, participant selection and retention, and measurements and analyses pertinent to public health research. In addition, a number of recommendations related to research methods and future investigations related to public health work in the ED are provided. Public health investigators are poised to make substantial contributions to this important area of research, but this will only be accomplished by employing sound research methodology in the context of rigorous program evaluation. PMID:20053232

Broderick, Kerry B; Ranney, Megan L; Vaca, Federico E; D'Onofrio, Gail; Rothman, Richard E; Rhodes, Karin V; Becker, Bruce; Haukoos, Jason S

2009-11-01

114

Evaluation of Clinical Reasoning in Basic Emergencies Using a Script Concordance Test  

PubMed Central

Objectives To develop and assess the reliability of a script concordance test (SCT) to evaluate pharmacy students' clinical reasoning when facing basic emergency situations. Design A first aid course was designed that consisted of 8 weekly instructional sessions (4 on internal medicine, including life threatening situations; 2 on pediatrics; and 2 on trauma) in which the instructor presented case studies in a small-group format. In the first and final sessions of the course, a practice SCT was administered to familiarize students with the test format. Assessment A 66-question SCT examination was administered to the 68 third-year pharmacy students enrolled in the first aid course. The students' mean score was 68.5% ± 9.8% and panel members' mean score was 86.5% ± 4.2%. Twenty students were selected randomly to complete a course survey and 85% indicated they were satisfied with using the SCT. Conclusions A first aid SCT was found to be both a practical and reliable testing instrument for assessing the clinical reasoning of pharmacy students in basic emergency situations. PMID:21436943

Charlin, Bernard; Vanpee, Dominique

2010-01-01

115

Use of sentinel laboratories by clinicians to evaluate potential bioterrorism and emerging infections.  

PubMed

With the persistent threat of emerging infectious diseases and bioterrorism, it has become increasingly important that clinicians be able to identify the diseases that might signal the occurrence of these unusual events. Essential to a thoughtful diagnostic approach is understanding when to initiate a public health investigation and how to appropriately use commonly performed microbiology procedures in the sentinel laboratory to evaluate potential pathogens. Although diagnostic test development is evolving rapidly, recognizing many of these pathogens continues to challenge the capabilities of most sentinel laboratories. Therefore, effective, ongoing communication and education among clinicians, infection control personnel, sentinel laboratorians, public health authorities, and Laboratory Response Network reference laboratorians is the key to preparedness. PMID:16586392

Pien, Brian C; Saah, J Royden; Miller, Sara E; Woods, Christopher W

2006-05-01

116

Implementation and performance evaluation of mobile ad hoc network for Emergency Telemedicine System in disaster areas.  

PubMed

So far we have developed Emergency Telemedicine System (ETS) which is a robust system using heterogeneous networks. In disaster areas, however, ETS cannot be used if the primary network channel is disabled due to damages on the network infrastructures. Thus we designed network management software for disaster communication network by combination of Mobile Ad hoc Network (MANET) and Wireless LAN (WLAN). This software maintains routes to a Backbone Gateway Node in dynamic network topologies. In this paper, we introduce the proposed disaster communication network with management software, and evaluate its performance using ETS between Medical Center and simulated disaster areas. We also present the results of network performance analysis which identifies the possibility of actual Telemedicine Service in disaster areas via MANET and mobile network (e.g. HSDPA, WiBro). PMID:19964544

Kim, J C; Kim, D Y; Jung, S M; Lee, M H; Kim, K S; Lee, C K; Nah, J Y; Lee, S H; Kim, J H; Choi, W J; Yoo, S K

2009-01-01

117

New methods for improved evaluation of patients with suspected acute coronary syndrome in the emergency department  

PubMed Central

This paper aims to identify and review new and unproven emergency department (ED) methods for improved evaluation in cases of suspected acute coronary syndrome (ACS). Systematic news coverage through PubMed from 2000 to 2006 identified papers on new methods for ED assessment of patients with suspected ACS. Articles found described decision support models, new ECG methods, new biomarkers and point?of?care testing, cardiac imaging, immediate exercise tests and the chest pain unit concept. None of these new methods is likely to be the perfect solution, and the best strategy today is therefore a combination of modern methods, where the optimal protocol depends on local resources and expertise. With a suitable combination of new methods, it is likely that more patients can be managed as outpatients, that length of stay can be shortened for those admitted, and that some patients with ACS can get earlier treatment. PMID:18029508

Ekelund, U; Forberg, J L

2007-01-01

118

Flight Simulator Evaluation of Enhanced Propulsion Control Modes for Emergency Operation  

NASA Technical Reports Server (NTRS)

This paper describes piloted evaluation of enhanced propulsion control modes for emergency operation of aircraft. Fast Response and Overthrust modes were implemented to assess their ability to help avoid or mitigate potentially catastrophic situations, both on the ground and in flight. Tests were conducted to determine the reduction in takeoff distance achievable using the Overthrust mode. Also, improvements in Dutch roll damping, enabled by using yaw rate feedback to the engines to replace the function of a stuck rudder, were investigated. Finally, pilot workload and ability to handle the impaired aircraft on approach and landing were studied. The results showed that improvement in all aspects is possible with these enhanced propulsion control modes, but the way in which they are initiated and incorporated is important for pilot comfort and perceived benefit.

Litt, Jonathan, S; Sowers, T.; Owen, A., Karl; Fulton, Christopher, E.; Chicatelli, Amy, K.

2012-01-01

119

Kenya's emergency-hire nursing programme: a pilot evaluation of health service delivery in two districts  

PubMed Central

Objective To assess the feasibility of utilizing a small-scale, low-cost, pilot evaluation in assessing the short-term impact of Kenya’s emergency-hire nursing programme (EHP) on the delivery of health services (outpatient visits and maternal-child health indicators) in two underserved health districts with high HIV/AIDS prevalence. Methods Six primary outcomes were assessed through the collection of data from facility-level health management forms—total general outpatient visits, vaginal deliveries, caesarean sections, antenatal care (ANC) attendance, ANC clients tested for HIV, and deliveries to HIV-positive women. Data on outcome measures were assessed both pre-and post-emergency-hire nurse placement. Informal discussions were also conducted to obtain supporting qualitative data. Findings The majority of EHP nurses were placed in Suba (15.5%) and Siaya (13%) districts. At the time of the intervention, we describe an increase in total general outpatient visits, vaginal deliveries and caesarean sections within both districts. Similar significant increases were seen with ANC attendance and deliveries to HIV-positive women. Despite increases in the quantity of health services immediately following nurse placement, these levels were often not sustained. We identify several factors that challenge the long-term sustainability of these staffing enhancements. Conclusions There are multiple factors beyond increasing the supply of nurses that affect the delivery of health services. We believe this pilot evaluation sets the foundation for future, larger and more comprehensive studies further elaborating on the interface between interventions to alleviate nursing shortages and promote enhanced health service delivery. We also stress the importance of strong national and local relationships in conducting future studies. PMID:24636052

2014-01-01

120

Electromagnetic Scattering from Realistic Targets  

NASA Technical Reports Server (NTRS)

The general goal of the project is to develop computational tools for calculating radar signature of realistic targets. A hybrid technique that combines the shooting-and-bouncing-ray (SBR) method and the finite-element method (FEM) for the radiation characterization of microstrip patch antennas in a complex geometry was developed. In addition, a hybridization procedure to combine moment method (MoM) solution and the SBR method to treat the scattering of waveguide slot arrays on an aircraft was developed. A list of journal articles and conference papers is included.

Lee, Shung- Wu; Jin, Jian-Ming

1997-01-01

121

Evaluation of PACS at Hammersmith Hospital: assessment of radiology performance in the accident and emergency department  

NASA Astrophysics Data System (ADS)

In the Accident and Emergency Department (A&E) x-ray images are used to assist in the initial diagnosis and management of the patient. It is therefore expected that the main benefits of PACS in A&E will arise from the ability of clinicians to manipulate the digital image and thus potentially improve their diagnostic performance. In order to evaluate whether this benefit is realized or not a case-study evaluation has been undertaken; this has three components: (a) monitoring the extent of misdiagnosis by A&E clinicians before and after the PACS implementation; (b) an examination of the decision performance of the clinician-image combination for the visualization of the lower cervical spine/upper thoracic spine and of fracture of the head of the radius; and (c) a more general monitoring of the impact of the image archiving and communication aspects of PACS. In this paper the study of the impact of PACS on misdiagnosis by A&E clinicians at the Hammersmith Hospital, London, is described and pre-PACS results for the period 31 March 1992 to 30 September 1992 are presented.

Weatherburn, Gwyneth C.; Bryan, Stirling; Cocks, Robert

1993-09-01

122

Evaluation of field triage decision scheme educational resources: audience research with emergency medical service personnel.  

PubMed

In an effort to encourage appropriate field triage procedures, the Centers for Disease Control and Prevention (CDC), in collaboration with the National Highway Traffic Safety Administration and the American College of Surgeons-Committee on Trauma, convened the National Expert Panel on Field Triage to update the Field Triage Decision Scheme: The National Trauma Triage Protocol (Decision Scheme). In support of the Decision Scheme, CDC developed educational resources for emergency medical service (EMS) professionals, one of CDC's first efforts to develop and broadly disseminate educational information for the EMS community. CDC wanted to systematically collect information from the EMS community on what worked and what did not with respect to these educational materials and which materials were of most use. An evaluation was conducted to obtain feedback from EMS professionals about the Decision Scheme and use of Decision Scheme educational materials. The evaluation included a survey and a series of focus groups. Findings indicate that a segment of the Decision Scheme's intended audience is using the materials and learning from them, and they have had a positive influence on their triage practices. However, many of the individuals who participated in this research are not using the Decision Scheme and indicated that the materials have not affected their triage practices. Findings presented in this article can be used to inform development and distribution of additional Decision Scheme educational resources to ensure they reach a greater proportion of EMS professionals and to inform other education and dissemination efforts with the EMS community. PMID:22773617

Sarmiento, Kelly; Eckstein, Daniel; Zambon, Allison

2013-03-01

123

Realistic modeling of neurons and networks: towards brain simulation  

PubMed Central

Summary Realistic modeling is a new advanced methodology for investigating brain functions. Realistic modeling is based on a detailed biophysical description of neurons and synapses, which can be integrated into microcircuits. The latter can, in turn, be further integrated to form large-scale brain networks and eventually to reconstruct complex brain systems. Here we provide a review of the realistic simulation strategy and use the cerebellar network as an example. This network has been carefully investigated at molecular and cellular level and has been the object of intense theoretical investigation. The cerebellum is thought to lie at the core of the forward controller operations of the brain and to implement timing and sensory prediction functions. The cerebellum is well described and provides a challenging field in which one of the most advanced realistic microcircuit models has been generated. We illustrate how these models can be elaborated and embedded into robotic control systems to gain insight into how the cellular properties of cerebellar neurons emerge in integrated behaviors. Realistic network modeling opens up new perspectives for the investigation of brain pathologies and for the neurorobotic field. PMID:24139652

D'Angelo, Egidio; Solinas, Sergio; Garrido, Jesus; Casellato, Claudia; Pedrocchi, Alessandra; Mapelli, Jonathan; Gandolfi, Daniela; Prestori, Francesca

124

An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station  

NASA Technical Reports Server (NTRS)

Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS Crewmembers to more speedily and accurately respond to medical situations on the ISS.

Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

2003-01-01

125

Protective Action Evaluator for Chemical Emergencies: A user's manual (MS-DOS reg sign Version 1. 0)  

SciTech Connect

The protective action evaluator for chemical emergencies (PAECE) is a package of computer programs developed to simulate an emergency response to airborne release of chemical agents. This user's manual documents the use of PAECE in the evaluation of chemical agent emergencies in areas potentially affected by the Chemical Stockpile Emergency Planning Program (CSEPP). This research documents the development and use of a method for the evaluation of protective action alternatives in conjunction with potential chemical agent emergencies. The user's manual highlights the development of the PAECE model, the selection of appropriate parameters to represent various scenarios, generate results and interpret them in the analysis of protective action alternatives during the planning and preparedness phases of the CSEPP. The PAECE model is designed to evaluate protective actions in the context of potential accidents, the emergency management systems required to implement protective actions, and the anticipated consequences for human receptors. The implications and uncertainties of the model are discussed to provide potential users with insight into the use, limitations, and uncertainties associated with evaluating the effectiveness of protective action alternatives. While PAECE represents a unique and powerful tool to evaluate protective actions, the user must exercise caution when interpreting the results to avoid misrepresentation. The expected value interpretation of the PAECE results biases the results toward extreme values. Hence, the PAECE results have to be interpreted in the context exposures similar to those represented by the unprotected exposure and the protection capacity that tend to be associated with people completing the implementation of the required actions later than and earlier than average, respectively. 16 refs., 24 figs., 1 tab. (JF)

Rogers, G.O.; Sharp, R.D.

1990-10-01

126

Realist Ethics and the ‘War on Terror’  

Microsoft Academic Search

This article makes the case that realist international theory provides firm theoretical and conceptual foundations for thinking ethically about the ‘war on terror’. It begins by outlining the fundamental political and theoretical assumptions underpinning the realist approach to ethics, arguing that realist theory is based on three core principles: prudence, scepticism, and reciprocity. Drawing on the political philosophy of Michael

Adrian Hyde-Price

2009-01-01

127

Breaking bad news: realistic versus unrealistic hopes  

Microsoft Academic Search

Hope is an essential aspect of the therapeutic relationship between cancer patients and their carers. Realistic hopes provide considerable support, whereas unrealistic hopes can be destructive by impairing the ability to make appropriate decisions about future plans, treatment, and issues of personal importance. Realistic hopes exist for cancer patients at all stages of their illness. Provision of realistic hope facilitates

Matthew Links; Jocelyn Kramer

1994-01-01

128

Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency  

NASA Technical Reports Server (NTRS)

International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.

Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

2006-01-01

129

[An evaluation of acute effects of sulfur compounds for the human organism in natural gas fields emergencies (review)].  

PubMed

A trend towards a growing number of emergency situations at industrial enterprises has been recently traced throughout the world. The main reasons of such phenomenon are: a comprehensive use of highly dangerous technologies and materials; large-scale violations of the operational rules and norms; and an inadmissibly high wear-and-tear of the main production funds in economic branches with extra risk. The world experience is indicative of a high degree of danger related with exploiting the natural-gas fields with a high content of sulfur compounds. The occurrence of emergency situations in the mentioned fields is accompanied by development of acute and sub-acute toxic effects in the workers and population. It necessitated, recently, an elaboration of a concept of a relative safety, in view of an unfavorable impact produced by chemical substances in emergencies, and an elaboration of methods applicable to the evaluation of emergency regulations. PMID:12852038

Salikhova, L R; Zebseev, V V; Karpov, A I; Eremin, M N; Gorlov, A V

2003-01-01

130

Evaluation of an Emergency Department Educational Campaign for Recognition of Suicidal Patients  

PubMed Central

Introduction To evaluate the impact of a simple emergency department (ED)–based educational intervention designed to assist ED providers in detecting occult suicidal behavior in patients who present with complaints that are not related to behavioral health. Methods Staff from 5 ED sites participated in the study. Four ED staff members were exposed to a poster and clinical guide for the recognition and management of suicidal patients. Staff members in 1 ED were not exposed to training material and served as a comparator group. Results At baseline, only 36% of providers reported that they had sufficient training in how to assess level of suicide risk in patients. Greater than two thirds of providers agreed that additional training would be helpful in assessing the level of patient suicide risk. More than half of respondents who were exposed to the intervention (51.6%) endorsed increased knowledge of suicide risk during the study period, while 41% indicated that the intervention resulted in improved skills in managing suicidal patients. Conclusion This brief, free intervention appeared to have a beneficial impact on providers' perceptions of how well suicidality was recognized and managed in the ED. PMID:22461920

Currier, Glenn W; Litts, David; Walsh, Patrick; Schneider, Sandra; Richardson, Thomas; Grant, William; Triner, Wayne; Robak, Nancy; Moscati, Ronald

2012-01-01

131

The Emerging Role of HE4 in the Evaluation of Advanced Epithelial Ovarian and Endometrial Carcinomas  

PubMed Central

HE4 (human epididymis protein 4) is overexpressed in both ovarian and endometrial cancers. Levels of the shed HE4 protein are elevated in sera from ovarian and endometrial cancer patients. HE4 is less frequently elevated than cancer antigen 125 (CA 125) in benign gynecological conditions and is found in a fraction of endometrial and ovarian cancers that lack CA 125 expression. Consequently, HE4 has emerged as an important biomarker that complements CA 125 in discriminating between benign and malignant pelvic masses, monitoring response to treatment, and detecting recurrences of both ovarian and endometrial cancer. The risk of ovarian malignancy algorithm (ROMA) incorporates CA 125, HE4 and menopausal status to distinguish benign from malignant adnexal masses and has been approved by the US Food and Drug Administration to aid in referring patients who are likely to have ovarian cancer to specially trained gynecologic oncologists for surgery. HE4 also promises to augment the sensitivity of CA_125 for detecting early-stage ovarian cancer. In this review, we discuss the discovery and biological significance of HE4 and evaluate available evidence regarding the utility of HE4 as a biomarker for ovarian and endometrial cancer. PMID:23909069

Simmons, Archana R.; Baggerly, Keith; Bast, Robert C.

2014-01-01

132

Role of presepsin for the evaluation of sepsis in the emergency department.  

PubMed

Abstract Sepsis, severe sepsis and septic shock are among the most common conditions handled in the emergency department (ED). According to new Sepsis Guidelines, early diagnosis and treatment are the keys to improve survival. Plasma C-reactive protein (CRP) and procalcitonin (PCT) levels, when associated with documented or suspected infection, are now part of the definitions of sepsis. Blood culture is the gold standard method for detecting microorganisms but it requires too much time for results to be known. Sensitive biomarkers are required for early diagnosis and as indexes of prognosis sepsis. CRP is one of the acute phase proteins synthesized by the liver: it has a great sensitivity but a very poor specificity for bacterial infections. Moreover, the evolution of sepsis does not correlate with CRP plasma changes. In recent years PCT has been widely used for sepsis differential diagnosis, because of its close correlation with infections, but it still retains some limitations and false positivity (such as in multiple trauma and burns). Soluble CD14 subtype (sCD14-ST), also known as presepsin, is a novel and promising biomarker that has been shown to increase significantly in patients with sepsis, in comparison to the healthy population. Studies pointed out the capability of this biomarker for diagnosing sepsis, assessing the severity of the disease and providing a prognostic evaluation of patient outcome. In this mini review we mainly focused on presepsin: we evaluate its diagnostic and prognostic roles in patients presenting to the ED with systemic inflammatory response syndrome (SIRS), suspected sepsis or septic shock. PMID:24897403

Pizzolato, Elisa; Ulla, Marco; Galluzzo, Claudia; Lucchiari, Manuela; Manetta, Tilde; Lupia, Enrico; Mengozzi, Giulio; Battista, Stefania

2014-10-01

133

Emergency department imaging protocol for suspected acute renal colic: re-evaluating our service  

PubMed Central

Objectives The objective of our study is to determine the positive rate for urolithiasis in male and female patients, and evaluate whether there has been any change at our institution in the use and outcome of unenhanced multidetector CT (CT KUB) performed in the emergency department (ER) for patients presenting with suspected acute renal colic. Methods A retrospective review of all 1357 consecutive cases between August 2007 and August 2009 admitted to the ER and investigated with CT KUB. Results The positive rate for urolithiasis was 47.5% and the rate of other significant findings was 10%. Female patients had a significantly lower positive rate than male patients (26.8% vs 61.6%, p<0.001). Urological intervention was required in 37% and these patients had a larger average stone size. In young female patients with a significantly sized ureteric calculus (>4 mm), the presence of hydronephrosis vs no hydronephrosis was 83% vs 17%, respectively. Among them, only three patients required ureteroscopy for stone removal. Conclusion Contrary to other studies there has been no “indication creep” in the use of CT KUB at our institution. However, the young female patient presenting with suspected urolithiasis presents a particular diagnostic problem, and the significant percentage of negative examinations in females implies that an improvement in current practice is needed. The indiscriminate use of CT KUB in all female patients with flank pain should be avoided, and it is suggested that they should be initially evaluated with ultrasound to detect the presence of hydronephrosis. PMID:22496069

Patatas, K; Panditaratne, N; Wah, T M; Weston, M J; Irving, H C

2012-01-01

134

Developing and evaluating an automated appendicitis risk stratification algorithm for pediatric patients in the emergency department  

PubMed Central

Objective To evaluate a proposed natural language processing (NLP) and machine-learning based automated method to risk stratify abdominal pain patients by analyzing the content of the electronic health record (EHR). Methods We analyzed the EHRs of a random sample of 2100 pediatric emergency department (ED) patients with abdominal pain, including all with a final diagnosis of appendicitis. We developed an automated system to extract relevant elements from ED physician notes and lab values and to automatically assign a risk category for acute appendicitis (high, equivocal, or low), based on the Pediatric Appendicitis Score. We evaluated the performance of the system against a manually created gold standard (chart reviews by ED physicians) for recall, specificity, and precision. Results The system achieved an average F-measure of 0.867 (0.869 recall and 0.863 precision) for risk classification, which was comparable to physician experts. Recall/precision were 0.897/0.952 in the low-risk category, 0.855/0.886 in the high-risk category, and 0.854/0.766 in the equivocal-risk category. The information that the system required as input to achieve high F-measure was available within the first 4?h of the ED visit. Conclusions Automated appendicitis risk categorization based on EHR content, including information from clinical notes, shows comparable performance to physician chart reviewers as measured by their inter-annotator agreement and represents a promising new approach for computerized decision support to promote application of evidence-based medicine at the point of care. PMID:24130231

Deleger, Louise; Brodzinski, Holly; Zhai, Haijun; Li, Qi; Lingren, Todd; Kirkendall, Eric S; Alessandrini, Evaline; Solti, Imre

2013-01-01

135

Novel effects-based monitoring approaches to evaluate chemicals of emerging concern in the St. Louis River estuary  

EPA Science Inventory

As part of an on-going program of research in support of the Great Lakes Restoration Initiative, the US EPA MED laboratory has been developing effects-based biomonitoring tools to evaluate the occurrence and potential hazards associated with Chemicals of Emerging Concern (CECs). ...

136

EVALUATION OF DEMONSTRATED AND EMERGING TECHNOLOGIES FOR THE TREATMENT AND CLEAN-UP OF CONTAMINATED LAND AND GROUNDWATER  

EPA Science Inventory

This article provides an overview of the Phase III Pilot Study on the Evaluation of Demonstrated and Emerging Technologies for Treatment and Clean Up of Contaminated Land and Groundwater. It also contains the key conclusions of the Pilot Study and recommendations for further act...

137

Probabilistic Linkage of Computerized Ambulance and Inpatient Hospital Discharge Records: A Potential Tool for Evaluation of Emergency Medical Services  

Microsoft Academic Search

Study objectives: Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database from ambulance and inpatient data and demonstrate the potential for linkage to

J. Michael Dean; Donald D. Vernon; Larry Cook; Patricia Nechodom; James Reading; Anthony Suruda

2001-01-01

138

Evaluating Crisis Intervention Services for Youth within an Emergency Department: A View from within  

ERIC Educational Resources Information Center

An innovative crisis intervention programme was created at the Children's Hospital of Eastern Ontario in Canada in order to provide emergency assessments for youth presenting with mental health crises. The current investigation presents an overview of the programme and examines the emergency staff's perception and satisfaction with it.…

Dion, Jacinthe; Kennedy, Allison; Cloutier, Paula; Gray, Clare

2010-01-01

139

Identifying Preschool Children at Risk of Later Reading Difficulties: Evaluation of Two Emergent Literacy Screening Tools  

ERIC Educational Resources Information Center

Emergent literacy skills are predictive of children's early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to effective emergent

Wilson, Shauna B.; Lonigan, Christopher J.

2010-01-01

140

Radiology Resident Evaluation of Head CT Scan Orders in the Emergency Department  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Prior studies have revealed little difference in residents' abilities to interpret cranial CT scans. The purpose of this study was to assess the performance of radiology residents at different levels of training in the interpretation of emergency head CT images. METHODS: Radiology residents prospectively interpreted 1324 consecutive head CT scans ordered in the emergency department at the

William K. Erly; William G. Berger; Elizabeth Krupinski; Joachim F. Seeger; John A. Guisto

141

Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures.  

PubMed

This clinical policy from the American College of Emergency Physicians is the revision of a 2004 policy on critical issues in the evaluation and management of adult patients with seizures in the emergency department. A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) In patients with a first generalized convulsive seizure who have returned to their baseline clinical status, should antiepileptic therapy be initiated in the emergency department to prevent additional seizures? (2) In patients with a first unprovoked seizure who have returned to their baseline clinical status in the emergency department, should the patient be admitted to the hospital to prevent adverse events? (3) In patients with a known seizure disorder in which resuming their antiepileptic medication in the emergency department is deemed appropriate, does the route of administration impact recurrence of seizures? (4) In emergency department patients with generalized convulsive status epilepticus who continue to have seizures despite receiving optimal dosing of a benzodiazepine, which agent or agents should be administered next to terminate seizures? A literature search was performed, the evidence was graded, and recommendations were given based on the strength of the available data in the medical literature. PMID:24655445

Huff, J Stephen; Melnick, Edward R; Tomaszewski, Christian A; Thiessen, Molly E W; Jagoda, Andy S; Fesmire, Francis M

2014-04-01

142

Realistic Monte Carlo simulation of Ga67 SPECT imaging  

Microsoft Academic Search

Describes a comprehensive Monte Carlo program tailored for efficient simulation of realistic Ga-67 SPECT imaging through the entire range of photon emission energies. The authors' approach incorporates several new features developed by them and by others. It is now being used to optimize and evaluate the performance of various methods of compensating for photon scatter, attenuation, and nonstationary distance- and

Stephen C. Moore; G. El Fakhri

2001-01-01

143

Analyses of several realistic exposure scenarios near cellular base stations  

Microsoft Academic Search

This paper contains the results of computer simulations performed for several realistic scenarios of electromagnetic (EM) field evaluation near the cellular base station (CBS) and some analysis of obtained results. The motivation of this study is exposure assessment of EM energy on biological objects. There are scenarios of field distribution indoors, near the hill, obstacle like a wall and finally

R. Zaridze; D. Kakulia; G. Kajaia; D. Mazmanov; L. Manukyan; N. Jejelava; T. Gogua

2006-01-01

144

Realistic 3D Human Facial Animation  

Microsoft Academic Search

Construction and animation of realistic human facial models is an important research field in computer graphics. How to simulate the motions of human faces on 3D facial models in real-time to generate realistic facial expressions is still a challenge. In this paper, a technique to simulate the human facial animation realistically in real-time is presented. First of all, the 3D

ZHANG Qing-Shan; CHEN Guo-Liang

2003-01-01

145

An evidence-based approach to the evaluation and treatment of low back pain in the emergency department.  

PubMed

Low back pain is the most common musculoskeletal complaint that results in a visit to the emergency department, and it is 1 of the top 5 most common complaints in emergency medicine. Estimates of annual healthcare expenditures for low back pain in the United States exceed $90 billion annually, not even taking lost productivity and business costs into account. This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for patients, and help manage healthcare resources and costs. PMID:24044786

Borczuk, Pierre

2013-07-01

146

Standards for clinical evaluation and documentation by the emergency medicine provider.  

PubMed

Pediatric emergency medicine is full of challenges. When a pediatric patient has a poor outcome after treatment in an emergency department (ED), a malpractice lawsuit is likely to result. Pediatric emergency medicine (PEM) physicians might sometimes alter their medical care and practice "defensive medicine" in hopes of avoiding a malpractice lawsuit. Radiographs and other diagnostic studies might be ordered without true indications to "completely rule out" a diagnosis. This can result in excess radiation for a child. On the other hand, failure to order the appropriate study or misinterpretation of a radiographic study by a radiologist or an emergency physician can result in a malpractice lawsuit. PEM physicians must work cooperatively with radiologists to improve the care for children in the ED. Together these specialists can decide on appropriate studies for children in the ED, keep radiation exposure to a minimum and ensure proper management based on these studies. PMID:18810419

Selbst, Steven M

2008-11-01

147

76 FR 72431 - Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness...  

Federal Register 2010, 2011, 2012, 2013

...and Preparedness in Support of Nuclear Power Plants, NUREG-0654/FEMA-REP-1...and Preparedness in Support of Nuclear Power Plants,'' NUREG-0654/FEMA-REP...emergency preparedness plans of nuclear power plant owners, operators and...

2011-11-23

148

Vibration signaling in mobile devices for emergency alerting: a study with deaf evaluators.  

PubMed

In the United States, a nationwide Commercial Mobile Alert Service (CMAS) is being planned to alert cellular mobile device subscribers to emergencies occurring near the location of the mobile device. The plan specifies a unique audio attention signal as well as a unique vibration attention signal (for mobile devices set to vibrate) to identify that the incoming message pertains to an emergency. Ratings of vibration signals of varying lengths and patterns were obtained from 44 deaf users of mobile devices for the perceived effectiveness of the signal in getting their attention in an emergency situation. Longer signals received higher ratings than shorter ones, and three signals with temporal on-off patterns were rated significantly better than a constant vibration. The U.S. government's recommended vibration signal for the CMAS, an important feature for access to emergency alerts by deaf persons, is supported by the results of the study. PMID:20511351

Harkins, Judith; Tucker, Paula E; Williams, Norman; Sauro, Jeff

2010-01-01

149

Systems approach to detect and evaluate contaminants of emerging concern in the Great Lakes  

EPA Science Inventory

The release of chemicals of emerging concern threatens near shore health in the Great Lakes, particularly in regions already suffering from degradation of water and environmental quality due to past and present anthropogenic activities. Critical issues remain in delisting Areas ...

150

Echocardiography, nuclear scintigraphy, and stress testing in the emergency department evaluation of acute coronary syndrome.  

PubMed

There are between 3 and 5 million visits to EDs each year for complaints of chest pain. Of these, about one half of the patients have a noncardiac cause for their chest pain. Of the remainder, about 30% to 50% have significant coronary disease. It is quite clear that patients who are at high risk for a coronary event should be admitted to the hospital. For the low-to-moderate risk patients, the decision to admit or discharge the patient from the ED is not quite so easy. The emergency physician has to decide which tests can be helpful in the decision-making process, this can be undertaken in conjunction with a consultative cardiologist. It can be argued that if a patient does not have a normal test result whichever that evaluatory test is), then the patient should be admitted for further work-up and evaluation. The easiest test to perform in the ED setting is an echocardiogram. The images can be sent by telecommunication to a qualified echocardiogram reader for interpretation. This also has a reasonable NPV, although not necessarily as good as some of the other modalities available, unless interpreted in light of cardiac enzyme test results. If the index of suspicion is still high, then a stress echocardiogram can be considered. This has an excellent NPV and can be easily performed in [table: see text] most patients. This should not be undertaken in the face of an evolving MI, and patients should be observed for at least 8 hours after their initial presentation to the ED prior to undergoing a provocative test. Nuclear scintigraphy, another modality available for cardiac risk stratification, can be a logistical nightmare. The nuclear isotopes are strictly regulated by the Nuclear Regulatory Commission. The emergency physician may inject the isotopes, provided that he or she has undergone the necessary radiation training. Also, the patient must be removed from the ED to a radioisotope-approved area for the duration of the scan. One of the most difficult questions left open after review of all these analytical modalities is the duration of time these test results remain valid; when does an individual patient need to be reevaluated as to their specific pretest probability? The answer to this question lies in the presenting clinical scenario. If the patient presents with a similar inciting trigger for his or her symptoms, and the cardiac risk profile has not changed appreciably, then the previous study (whether a provocative stress test or even a cardiac catheterization) probably can be reliably counted. If the patient's risk profile has changed or the symptoms are new or more intense, the physician is compelled to pursue this encounter as a new, acute event. This can be true even in the setting of a previous cardiac catheterization that showed nonobstructive coronary disease, because plaque rupture can be acute and unpredictable. Ultimately, optimal care calls for each institution to develop a specific approach, in conjunction with their consultative cardiologist or critical care specialist, to enhance patient care, safety, and diagnostic outcome, while maintaining cost efficiency. PMID:11373982

Mather, P J; Shah, R

2001-05-01

151

Learning realistic human actions from movies  

Microsoft Academic Search

The aim of this paper is to address recognition of natural human actions in diverse and realistic video settings. This challenging but important subject has mostly been ignored in the past due to several problems one of which is the lack of realistic and annotated video datasets. Our first contri- bution is to address this limitation and to investigate the

Ivan Laptev; Marcin Marszalek; Cordelia Schmid; Benjamin Rozenfeld

2008-01-01

152

Evaluation of the cytotoxicity, mutagenicity and antimutagenicity of emerging edible plants.  

PubMed

This study evaluates the toxic, mutagenic and antimutagenic effects of emerging edible plants that are consumed as new leafy vegetables in Taiwan. Among eight plant extracts, only the extracts of Sol (Solanum nigrum L.) showed cytotoxicity to Salmonella typhimurium TA100 in the absence of S9 mix. The toxicity of extracts from different parts of the Sol plant, such as leaf and stem, immature fruit and mature fruit, towards S. typhimurium TA100 and human lymphocytes was also assayed. The immature fruit extracts of Sol exhibited strong cytotoxicity with dose dependence and induced significant DNA damage in human lymphocytes based on the comet assay. However, no mutagenicity was found in eight plant extracts to TA98 or TA100 either with or without the S9 mixture. Sol and Sec [Sechium edule (Jacq.) Swartz] extracts showed the strongest inhibitory effect towards the mutagenicity of 2-amino-3-methyl-imidazo[4,5-f]quinoline (IQ) in S. typhimurium TA98 and TA100; the ID(50) was less then 1 mg/plate. Cra [Crassocephalum creidioides (Benth.) S. Moore] extracts also expressed moderate antimutagenic activities towards IQ and benzo[a]pyrene (B[a]P) either in TA98 or in TA100; the ID(50) was 1.63-2.41 mg/plate. The extracts from Bas (Basella alba L.), Bou (Boussingaultia gracilis Miers var. pseudobaselloides Bailey), Cen (Centella asiatica L. Urban), Cor (Corchorus olitorius L.) and Por (Portulaca oleracea L.) showed weak to moderate inhibition of mutagenicity of IQ. However, the potential antimutagenicity of these plant extracts towards B[a]P was weaker than that towards IQ. For a direct mutagen, 4-nitroquinoline-N-oxide (NQNO), only the Sol extracts showed strong inhibitory effects in the TA100 system. The antimutagenic activity of water extracts of Sec was partly reduced by heating at 100 degrees C for 20 min. The heat-stable antimutagens in Sec extracts could be produced in the plant extract preparation process. Fractions with molecular weights above 30,000 showed the strongest antimutagenicity and peroxidase activity in all the fractions of the Sec extracts. PMID:11527563

Yen, G C; Chen, H Y; Peng, H H

2001-11-01

153

Evaluation of an Asynchronous Physician Voice Mail Sign-out for Emergency Department Admissions  

PubMed Central

Background Communication failures contribute to errors in the transfer of patients from the emergency department (ED) to inpatient medicine units. Oral (synchronous) communication has numerous benefits but is costly and time-consuming. Taped (asynchronous) communication may be more reliable and efficient, but lacks interaction. We evaluated a new asynchronous physician-physician sign-out compared to the traditional synchronous sign-out. Methods A voicemail-based, semi-structured sign-out for routine ED admissions to internal medicine was implemented in October, 2007 at an urban, academic medical center. Outcomes were obtained by pre- and post-intervention surveys of ED and IM housestaff, physician assistants and hospitalist attendings; and by examination of access logs and administrative data. Outcome measures included utilization; physician perceptions of ease, accuracy, content, interaction and errors; and rate of transfers to intensive care from the floor within 24 hours of ED admission. Results were analyzed both quantitatively, and qualitatively using standard qualitative analytic techniques. Results During September-October, 2008 (one year post-intervention), voicemails were recorded regarding 90.5% of medicine admissions; 69.7% of these were accessed at least once by admitting physicians. The median length of each sign-out was 2.6 minutes (IQR 1.9 to 3.5). We received 117/197 responses (59%) to the pre-intervention survey and 113/206 responses (55%) to the post-intervention survey. A total of 73/101 (72%) respondents reported dictated sign-out was easier than oral sign-out and 43/101 (43%) reported it was more accurate. However, 70/101 (69%) reported interaction among participants was worse. There was no change in the rate of ICU transfer within 24 hours of admission from the ED in April-June, 2007 (65/6,147; 1.1%) versus April-June 2008 (70/6,263; 1.1%); difference of 0%, 95% CI, ?0.4% to 0.3%. The proportion of internists reporting at least one perceived adverse event relating to transfer from the ED decreased a non-significant 10% after the intervention (95% CI, ?27% to 6%), from 44% pre-intervention (32/72) to 34% post-intervention (23/67). Conclusion Voicemail sign-out for ED-internal medicine communication was easier than oral sign-out without any change in early ICU transfers or the perception of major adverse events. However, interaction among participants was reduced. Voicemail sign-out may be an efficient means of improving sign-out communication for stable ED admissions. PMID:19282064

Horwitz, Leora I.; Parwani, Vivek; Shah, Nidhi R.; Schuur, Jeremiah D.; Meredith, Thom; Jenq, Grace Y.; Kulkarni, Raghavendra G.

2009-01-01

154

Strategies to Evaluate Synchronous Carcinomas of the Colon and Rectum in Patients That Present for Emergent Surgery  

PubMed Central

It is not always possible to evaluate patients that present acutely with carcinoma of the colon and rectum for synchronous lesions. Patients that require emergent surgery necessitate urgent and efficient operation. Patients with lower gastrointestinal bleeding, perforation, or obstruction represent a challenging subset of patients with colorectal cancer. An organized approach to these patients in the effort not to overlook a synchronous carcinoma is important. The present paper provides an evidenced-based approach to this special situation. PMID:23476758

Agnew, Jennifer L.; Abbadessa, Benjamin; Leitman, I. Michael

2013-01-01

155

Thallium myocardial scanning in the emergency department evaluation of chest pain  

SciTech Connect

Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive.

Mace, S.E.

1989-05-01

156

Characterization and Monitoring Data for Evaluating Constructed Emergent Sandbar Habitat in the Missouri River Mainstem  

Microsoft Academic Search

Emergent sandbar habitat (ESH) in the Missouri River Mainstem System is a critical habitat element for several federally listed bird species: the endangered interior least tern (Sterna antillarum) and the threatened Northern Great Plains piping plover (Charadrius melodus). The Army Corps of Engineers (Corps) provides the primary operational management of the Missouri River and is responsible under the Endangered Species

Corey A. Duberstein; Janelle L. Downs

2008-01-01

157

A GENERAL METHOD FOR EVALUATING CONTAINMENT SHIELDING UNDER NORMAL AND EMERGENCY CONDITIONS  

Microsoft Academic Search

For the porpose of reducing costs some reactor installations are using ; external shielding around a containment vessel rather than localized shielding. ; Such shielding can be designed to be adequete both under normal and emergency ; conditions. In view of this a generalized treatment of such shielding has been ; attempted. Analytical dosage calculations may at present be performed

L. Geller; R. H. Epstein

1958-01-01

158

Prospective, randomized evaluation of a personal digital assistant-based research tool in the emergency department  

Microsoft Academic Search

BACKGROUND: Personal digital assistants (PDA) offer putative advantages over paper for collecting research data. However, there are no data prospectively comparing PDA and paper in the emergency department. The aim of this study was to prospectively compare the performance of PDA and paper enrollment instruments with respect to time required and errors generated. METHODS: We randomized consecutive patients enrolled in

Morris L Rivera; Jason Donnelly; Blair A Parry; Anthony Dinizio; Charles L Johnson; Jeffrey A Kline; Christopher Kabrhel

2008-01-01

159

Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes  

ERIC Educational Resources Information Center

Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

2010-01-01

160

An evaluation of a logbook for trainees in accident and emergency medicine in the United Kingdom.  

PubMed Central

The ideal requirements of a logbook for trainees in accident and emergency medicine in the United Kingdom were sought by means of a postal survey of 100 Senior Registrars and recently-appointed Consultants in the specialty. Sixty-two replies were received. An overwhelming majority supported ACLS and ATLS certification, as well as formal training in Management/Clinical Budgeting skills, the use of Information Technology, dealing with medicolegal issues and Disaster Planning. Secondments to General Practice, Regional Poisons Centres and the Emergency Services were similarly recommended. A total of 71% (42 responders) approved of a minimum of 3 years experience in an A&E Department before appointment as a Senior Registrar in the specialty. The majority of responders disapproved of acquiring laboratory-based skills. The results of the survey are discussed and suggestions for the possible role of a logbook are made. PMID:1888408

Luke, C; Kadzombe, E; Armstrong, A; Gorman, D; Horner, J

1991-01-01

161

A comparative evaluation of the process of developing and implementing an emergency department HIV testing program  

Microsoft Academic Search

Background  The 2006 Centers for Disease Control and Prevention (CDC) HIV testing guidelines recommend screening for HIV infection in\\u000a all healthcare settings, including the emergency department (ED). In urban areas with a high background prevalence of HIV,\\u000a the ED has become an increasingly important site for identifying HIV infection. However, this public health policy has been\\u000a operationalized using different models. We

Katerina A Christopoulos; Kim Koester; Sheri Weiser; Janet J Myers; Stephen F Morin

2011-01-01

162

Evaluating the effects of increasing surgical volume on emergency department patient access  

Microsoft Academic Search

AimTo determine how increases in surgical patient volume will affect emergency department (ED) access to inpatient cardiac services. To compare how strategies to increase cardiology inpatient throughput can either accommodate increases in surgical volume or improve ED patient access.MethodsA stochastic discrete event simulation was created to model patient flow through a cardiology inpatient system within a US, urban, academic hospital.

S Levin; R Dittus; D Aronsky; M Weinger

2011-01-01

163

Evaluation of Emergency-Locator-Transmitter performance in real and simulated crash tests  

NASA Technical Reports Server (NTRS)

Emergency locator transmitter (ELT) activation problems were investigated by testing a sampling of ELT units in actual crashes and in a special test apparatus which simulated longitudinal crash pulses with superimposed local structural resonances. The probable causes of excessive false alarms and nonactivation of ELT's during crash situations were determined. Solutions to operational and technical problems were also examined as well as the sensitivity of ELT impact switches to orientation and to local structural vibrations.

Carden, H. D.

1981-01-01

164

Emergency evacuation/transportation plan update: Traffic model development and evaluation of early closure procedures. Final report  

SciTech Connect

Prolonged delays in traffic experienced by Laboratory personnel during a recent early dismissal in inclement weather, coupled with reconstruction efforts along NM 502 east of the White Rock Wye for the next 1 to 2 years, has prompted Los Alamos National Laboratory (LANL) to re-evaluate and improve the present transportation plan and its integration with contingency plans maintained in other organizations. Facilities planners and emergency operations staff need to evaluate the transportation system`s capability to inefficiently and safely evacuate LANL under different low-level emergency conditions. A variety of potential procedures governing the release of employees from the different technical areas (TAs) requires evaluation, perhaps with regard to multiple emergency-condition scenarios, with one or more optimal procedures ultimately presented for adoption by Lab Management. The work undertaken in this project will hopefully lay a foundation for an on-going, progressive transportation system analysis capability. It utilizes microscale simulation techniques to affirm, reassess and validate the Laboratory`s Early Dismissal/Closure/Delayed Opening Plan. The Laboratory is required by Federal guidelines, and compelled by prudent practice and conscientious regard for the welfare of employees and nearby residents, to maintain plans and operating procedures for evacuation if the need arises. The tools developed during this process can be used outside of contingency planning. It is anticipated that the traffic models developed will allow site planners to evaluate changes to the traffic network which could better serve the normal traffic levels. Changes in roadway configuration, control strategies (signalization and signing), response strategies to traffic accidents, and patterns of demand can be modelled using the analysis tools developed during this project. Such scenarios typically are important considerations in master planning and facilities programming.

NONE

1993-10-28

165

Realistic Human Walking Paths David C. Brogan  

E-print Network

development for entertainment applications and many classes of simulations. We present a novel behav- ioral- served paths in black on the floor. A library exit (a) and a university hallway (b). A realistic walking

Brogan, David

166

Looking at terrorism through left realist lenses  

Microsoft Academic Search

While terrorism has moved into the spotlight of criminological study, including critical criminology, it has yet to be thoroughly\\u000a explored from a left realist perspective. Left realism addresses four aspects of crime: causes of offending, impact on the\\u000a victims, and both official and public responses to crime. A left realist approach to terrorism would argue that similar to\\u000a those who

Jennifer C. Gibbs

2010-01-01

167

Using DEMs to evaluate morphological change around an emergent vegetation patch over repeated hydrographs  

NASA Astrophysics Data System (ADS)

Flume experiments tested a sand-gravel sediment mixture and two model emergent vegetation patches of varying stem density to explore changes in bed morphology around a patch when subjected to a series of repeated hydrographs. The wake area downstream of emergent vegetation patches is typically considered a region of sediment accumulation. However, the extent to which mixed size sediment transports and deposits around emergent vegetation patches remains poorly defined. This uncertainty is heightened by changes in bed morphology over large temporal scales and unsteady flow conditions. In these experiments unsteady flow hydrographs were discretized with 17 four-minute constant flow intervals with magnitudes modeled to fit the asymmetrical shape of the NRCS dimensionless unit hydrograph. Hydrographs were applied to a channel of mixed gravel and sand sediment in which a patch of emergent vegetation was fixed. The same hydrograph was repeated in each experiment and between hydrographs, a 2-hour baseflow was run to simulate lower flow periods and provide a flow history to the channel. Suspended and bedload sediment transport rates were measured during every flow interval of each hydrograph. After each hydrograph a detailed digital elevation model (DEM) was created to map the bed morphology and allow for DEM differencing. A unit bed adjustment parameter, ?b, is introduced to quantify the amount of reach-averaged channel change and monitor morphological stability over the scales of multiple hydrographs. Flow and sediment conditions were repeated for patches with sparse and dense stem densities. Results indicated that the total sediment yield over each hydrograph was reduced for both the sparse and dense model patches relative to unvegetated channel conditions. In the case of the sparse patch, the channel reached a dynamically stable state in one fewer hydrograph than when there was no patch present. A characteristic morphology developed downstream of the patch, with a mound of sediment accumulation forming within 10 patch diameters and significant ripple formation beyond this point farther downstream. The channel bed adjusted in a similar fashion for the dense patch, though the sediment mound was locally higher just downstream of the patch, not as extensive laterally, and dune formation was somewhat delayed and not as regular as for the sparse patch. More erosion was observed adjacent to the dense patch than for the sparse, consistent with flow acceleration due to increased channel blockage. Overall, the dense patch appeared to introduce more variability in the channel bed morphology, reflected by a larger range and standard deviation of bed elevations for the series of DEMs.

Waters, K. A.; Curran, J. C.

2013-12-01

168

Real-use evaluation of effects: emergency departments aiming for 'Warm Hands'  

Microsoft Academic Search

Embracing real use in an iterative approach calls for systematic formative evaluation. Effects-driven IT Development has been suggested as a way of supporting a Participatory Design (PD) process involving implementations that expose mature prototypes to real work practices. This is followed by evaluations of how specified and desired effects are obtained. We present results from a project where high-level political

Jesper Simonsen; Morten Hertzum

2012-01-01

169

Evaluation of a New Nonnvasive Device in Determining Hemoglobin Levels in Emergency Department Patients  

PubMed Central

Introduction: The Masimo Radical-7 Pulse CO-Oximeter is a medical device recently approved by the US Food and Drug Administration that performs noninvasive oximetry and estimated venous or arterial hemoglobin measurements. A portable, noninvasive device that rapidly measures hemoglobin concentration could be useful in both austere and modern hospital settings. The objective of this study is to determine the degree of variation between the device's estimated hemoglobin measurement and the actual venous hemoglobin concentration in undifferentiated emergency department (ED) patients. Methods: We conducted a prospective, observational, cross-sectional study of adult patients presenting to the ED. The subjects consisted of a convenience sample of adult ED patients who required a complete blood count as part of their care in the ED. A simultaneous probe hemoglobin was obtained and recorded. Results: Bias between probe and laboratory hemoglobin measurements was –0.5 (95% confidence interval, – 0.8 to –0.1) but this was not statistically significant from 0 (t0.05,124 = 0.20, P > 0.5). The limits of agreement were –4.7 and 3.8, beyond the clinically relevant standard of equivalency of ± 1 g/dL. Conclusion: These data suggest that noninvasive hemoglobin determination is not sufficiently accurate for emergency department use. PMID:23687550

Knutson, Tristan; Della-Giustina, David; Tomich, Eric; Wills, Brandon; Luerssen, Emily; Reynolds, Penny

2013-01-01

170

Improving access to diagnostics: an evaluation of a satellite laboratory service in the emergency department  

PubMed Central

Objectives: To measure the impact of a satellite laboratory upon laboratory result turnaround times and clinical decision making times. Design: A prospective cohort study, the intervention group had blood tests sent Monday to Friday 12 noon to 8 pm and the control group had blood tests sent outside these hours. The data were collected over a six week period before the laboratory was opened, and a subsequent six week period. Setting: An urban teaching hospital emergency department. Participants: 1065 patients requiring blood tests. Main outcome measure: Time from the blood sample being sent to the laboratory to the results being available on the clinician's computer. Results: The time to haematology (blood count) results in the intervention group decreased by 47.2 minutes (95% CI 38.3 to 56.1, p<0.001) after the laboratory was opened. The corresponding control group times were unchanged (0.6 minutes; –13.8 to 15.0, p = 0.94). Similar sized differences were also seen for haemostasis (D-dimer) testing 66.1 (41.8 to 90.4) minutes compared with –14.2 (–47.1 to 18.7) and chemistry 41.3 (30.3 to 52.2) compared with –4.2 (–17.4 to 8.9) testing. Decisions to discharge patients were significantly faster (28.2 minutes, 13.5 to 42.8, p<0.0001) in the intervention group after the laboratory was opened (controls; –2.6 minutes –27.0 to 21.7). No change was seen with decisions to admit patients. There was a trend for earlier laboratory results modifying intravenous drug or fluids orders, or both (p = 0.06) Conclusion: A comprehensive satellite laboratory service is an important adjunct to improve the timeliness of care in the emergency department. PMID:15208229

Leman, P; Guthrie, D; Simpson, R; Little, F

2004-01-01

171

Thruster Options for Microspacecraft: A Review and Evaluation of State-of-the-Art and Emerging Technologies  

NASA Astrophysics Data System (ADS)

Introduction Recent Microspacecraft Developments Background and Motivation Recent Microspacecraft Design Trends Preliminary Set of Micropropulsion Requirements for Microspacecraft System Integration Requirements Minimum Impulse Bit and Thrust Requirements Review of Chemical Propulsion Technologies Bipropellant Engines Monopropellant Thrusters: Hydrazine Monopropellant Thrusters: HAN-Based Monopropellant Thrusters: Hydrogen Peroxide Cold Gas Thrusters Tripropellant and Other Warm Gas Thrusters Solid Rocket Motors Hybrid Rocket Motors Review of Electric Propulsion Technologies Ion Engines Hall Thrusters FEEP Colloid Thrusters Pulsed Plasma Thrusters (PPTs) Resistojets Emerging Technologies: MEMS and MEMS-Hybrid Propulsion Concepts Case for MEMS Propulsion and Its Challenges Brief History of MEMS Propulsion MEMS-Based FEEP and Colloid Thruster Concepts Micro-Ion Engine Concepts MEMS-Based Microresistojet Concepts MEMS-Based Subliming Solid Microthruster Concept MEMS-Based Cold Gas Thruster Concept MEMS-Based Bipropellant Thruster Concept Digital Microthruster Array Concepts Evaluation of Existing Propulsion Technologies and Identification - of Future Technology Needs Evaluation of Existing Propulsion Technologies Identification of Technology Needs Conclusions References

Mueller, Juergen

172

Identification and evaluation of competencies of health professionals in the hospital emergency management of the radiation accident victim  

SciTech Connect

A preliminary list of ten competency and forty-six sub-competency statements derived from literature and consultation with experts and based on the general areas of clinical performance defined by the National Board of Medical Examiners were the concern of Phase I of this study. Forty-eight experts in nuclear medicine, radiology, radiotherapy, health physics, medical physics, radiation biology, public and occupational health, surgery, and emergency medicine and nursing considered this preliminary list of competencies and sub-competencies to determine which were essential for health professionals who may be caring for radiation accident victims in hospital emergency departments. Eight competencies and thirty-three sub-competencies were rated as Essential competencies. Competencies dealing with establishing priorities in patient care and initiating treatment, assessment, contamination control, and decontamination were highly rated. In the second part of this study, the Essential competencies were utilized in the development of an original evaluation instrument designed to identify deficiencies and continuing education needs during radiation accident drills or exercises. The instrument was designed for use in sixteen possible patient care situations in which the radiation accident victims have varying medical and radiological conditions. Development of the evaluation instrument was described.

Berger, M.E.

1982-01-01

173

Research on ultra-realistic communications  

NASA Astrophysics Data System (ADS)

A future communication method enabled by information communications technology- ultra-realistic communication - is now being investigated in Japan and research and development of the various technologies required for its realization is being conducted, such as ultra-high definition TV, 3DTV, super surround sound reproduction and multi-sensory communication including touch and smell. An organization called the Ultra-Realistic Communications Forum (URCF) was also established for the effective promotion of R&D and the standardization of relating technologies. This document explains the activities of the URCF by industry, academia and government, and introduces researches on ultra-realistic communications in the National Institute of Information and Communications Technology (NICT).

Enami, Kazumasa

2009-05-01

174

Imaging-Based Tumor Treatment Response Evaluation: Review of Conventional, New, and Emerging Concepts  

PubMed Central

Tumor response may be assessed readily by the use of Response Evaluation Criteria in Solid Tumor version 1.1. However, the criteria mainly depend on tumor size changes. These criteria do not reflect other morphologic (tumor necrosis, hemorrhage, and cavitation), functional, or metabolic changes that may occur with targeted chemotherapy or even with conventional chemotherapy. The state-of-the-art multidetector CT is still playing an important role, by showing high-quality, high-resolution images that are appropriate enough to measure tumor size and its changes. Additional imaging biomarker devices such as dual energy CT, positron emission tomography, MRI including diffusion-weighted MRI shall be more frequently used for tumor response evaluation, because they provide detailed anatomic, and functional or metabolic change information during tumor treatment, particularly during targeted chemotherapy. This review elucidates morphologic and functional or metabolic approaches, and new concepts in the evaluation of tumor response in the era of personalized medicine (targeted chemotherapy). PMID:22778559

Kang, Hee; Lee, Kyung Soo; Kim, Jae-Hun

2012-01-01

175

Evaluation of sensor types and environmental controls on mapping biomass of coastal marsh emergent vegetation  

USGS Publications Warehouse

There is a need to quantify large-scale plant productivity in coastal marshes to understand marsh resilience to sea level rise, to help define eligibility for carbon offset credits, and to monitor impacts from land use, eutrophication and contamination. Remote monitoring of aboveground biomass of emergent wetland vegetation will help address this need. Differences in sensor spatial resolution, bandwidth, temporal frequency and cost constrain the accuracy of biomass maps produced for management applications. In addition the use of vegetation indices to map biomass may not be effective in wetlands due to confounding effects of water inundation on spectral reflectance. To address these challenges, we used partial least squares regression to select optimal spectral features in situ and with satellite reflectance data to develop predictive models of aboveground biomass for common emergent freshwater marsh species, Typha spp. and Schoenoplectus acutus, at two restored marshes in the Sacramento–San Joaquin River Delta, California, USA. We used field spectrometer data to test model errors associated with hyperspectral narrowbands and multispectral broadbands, the influence of water inundation on prediction accuracy, and the ability to develop species specific models. We used Hyperion data, Digital Globe World View-2 (WV-2) data, and Landsat 7 data to scale up the best statistical models of biomass. Field spectrometer-based models of the full dataset showed that narrowband reflectance data predicted biomass somewhat, though not significantly better than broadband reflectance data [R2 = 0.46 and percent normalized RMSE (%RMSE) = 16% for narrowband models]. However hyperspectral first derivative reflectance spectra best predicted biomass for plots where water levels were less than 15 cm (R2 = 0.69, %RMSE = 12.6%). In species-specific models, error rates differed by species (Typha spp.: %RMSE = 18.5%; S. acutus: %RMSE = 24.9%), likely due to the more vertical structure and deeper water habitat of S. acutus. The Landsat 7 dataset (7 images) predicted biomass slightly better than the WV-2 dataset (6 images) (R2 = 0.56, %RMSE = 20.9%, compared to R2 = 0.45, RMSE = 21.5%). The Hyperion dataset (one image) was least successful in predicting biomass (R2 = 0.27, %RMSE = 33.5%). Shortwave infrared bands on 30 m-resolution Hyperion and Landsat 7 sensors aided biomass estimation; however managers need to weigh tradeoffs between cost, additional spectral information, and high spatial resolution that will identify variability in small, fragmented marshes common to the Sacramento–San Joaquin River Delta and elsewhere in the Western U.S.

Byrd, Kristin B.; O'Connell, Jessica L.; Di Tommaso, Stefania; Kelly, Maggi

2014-01-01

176

Resonant scattering by realistic impurities in graphene.  

PubMed

We develop a first-principles theory of resonant impurities in graphene and show that a broad range of typical realistic impurities leads to the characteristic sublinear dependence of the conductivity on the carrier concentration. By means of density functional calculations various organic groups as well as adatoms such as H absorbed to graphene are shown to create midgap states within ±0.03??eV around the neutrality point. A low energy tight-binding description is mapped out. Boltzmann transport theory as well as a numerically exact Kubo formula approach yield the conductivity of graphene contaminated with these realistic impurities in accordance with recent experiments. PMID:20867944

Wehling, T O; Yuan, S; Lichtenstein, A I; Geim, A K; Katsnelson, M I

2010-07-30

177

Introducing PCTRAN as an evaluation tool for nuclear power plant emergency responses  

Microsoft Academic Search

Protecting the public from radiation exposure is important if a nuclear power plant (NPP) accident occurs. Deciding appropriate protective actions in a timely and effective manner can be fulfilled by using an effective accident evaluation tool. In our earlier work, we have integrated PCTRAN (Personal Computer Transient Analyzer) with the off-site dose calculation model. In this study, we introduce PCTRAN

Yi-Hsiang Cheng; Chunkuan Shih; Show-Chyuan Chiang; Tung-Li Weng

178

Evaluating Emerging Software Development Technologies: Lessons Learned from Assessing Aspect-oriented Programming  

Microsoft Academic Search

Two of the most important and most difficult questions one can ask about a newsoftware development technique are whether the technique is useful and whether thetechnique is usable. Various flavours of empirical study are available to evaluate thesequestions, including surveys, case studies, and experiments. These different approacheshave been used extensively in a number of domains, including management science andhuman-computer interaction.

Gail C. Murphy; Robert J. Walker

1998-01-01

179

Essential issues for the Design of Open Learning Environments emerging from a field evaluation study  

Microsoft Academic Search

This study presents a framework for the evaluation of open learning environments integrating methodologies both from Education and from Human Computer Interaction. This framework emphasize, the role of field studies using real students, the formation of hypotheses using qualitative methodologies to analyze the field data and task analytic methodologies namely: Hierarchical Task Analysis (HTA) and Goals, Operators, Methods and Selection

Maria Kordaki; Nikolaos Avouris

180

Overview and Evaluation of Bluetooth Low Energy: An Emerging Low-Power Wireless Technology  

PubMed Central

Bluetooth Low Energy (BLE) is an emerging low-power wireless technology developed for short-range control and monitoring applications that is expected to be incorporated into billions of devices in the next few years. This paper describes the main features of BLE, explores its potential applications, and investigates the impact of various critical parameters on its performance. BLE represents a trade-off between energy consumption, latency, piconet size, and throughput that mainly depends on parameters such as connInterval and connSlaveLatency. According to theoretical results, the lifetime of a BLE device powered by a coin cell battery ranges between 2.0 days and 14.1 years. The number of simultaneous slaves per master ranges between 2 and 5,917. The minimum latency for a master to obtain a sensor reading is 676 ?s, although simulation results show that, under high bit error rate, average latency increases by up to three orders of magnitude. The paper provides experimental results that complement the theoretical and simulation findings, and indicates implementation constraints that may reduce BLE performance.

Gomez, Carles; Oller, Joaquim; Paradells, Josep

2012-01-01

181

The practical challenges of evaluating a blanket emergency feeding programme in northern Kenya.  

PubMed

A blanket supplementary feeding programme for young children was implemented for four months in five northern districts of Kenya from January 2010 because of fears of food insecurity exacerbated by drought. An attempt to evaluate the impact of the food on children's anthropometric status was put in place in three districts. The main aim of the analysis was to assess the quality of the data on the cohort of children studied in the evaluation and to propose methods by which it could be improved to evaluate future blanket feeding programmes. Data on the name, age, sex, weight and height of a systematic sample of children recruited at 61 food distribution sites were collected at the first, second and third rounds and again at an extra, fifth food distribution, offered only to the evaluation subjects. Of the 3,544 children enrolled, 483 (13.63%) did not collect a fifth ration. Of the 2,640 children who were considered by their name to be the same at the first and fifth food distribution (13% were different), data on only 902 children (34.17%) were considered acceptable based on their age (an arbitrary ±3 months different) and their length or height (between >-1 or ?4 cm different) at the two instances they were seen. Data on nearly two thirds of children were of questionable quality. The main reasons for the poor quality data were inconsistencies in estimating age or because caretakers may have brought different children. Recommendations are made about how to improve data quality including ensuring that entry to a blanket feeding programme is clearly based on height, not age, to avoid misreporting age; careful identification of subjects at all contacts; and using well-trained, specialist evaluation staff. PMID:22073119

Hall, Andrew; Oirere, Moragwa; Thurstans, Susan; Ndumi, Assumpta; Sibson, Victoria

2011-01-01

182

[Complex evaluation of the impact of emerging mining industries in Northern regions on public health].  

PubMed

The studies covered public health state in vicinity of concentration enterprise being built in Far North, with selecting a cohort of workers extracting diamonds in Yakutia, conducting a primary standardized health screening in accordance with WHO program. The public health state is characterized in connection with ecologic, social and economic circumstances. The authors necessitate complex evaluation of influence caused by industrial enterprises on health of workers and general population. PMID:11530518

Mitrofanov, I M; Nikolaev, Iu A; Ke?l', V R; Kuznetsova, I Iu; Shurgaia, A M; Seliatitskaia, V G

2001-01-01

183

The Role of CT and MRI in the Emergency Evaluation of Persons with Suspected Stroke  

Microsoft Academic Search

As a growing number of therapeutic treatment options for acute stroke are being introduced, multimodal acute neuroimaging\\u000a is assuming a growing role in the initial evaluation and management of patients. Multimodal neuroimaging, using either a CT\\u000a or MRI approach, can identify the type, location, and severity of the lesion (ischemia or hemorrhage); the status of the cerebral\\u000a vasculature; the status

Chelsea S. Kidwell; Max Wintermark

2010-01-01

184

Evaluation of California's Alcohol and Drug Screening and Brief Intervention Project for Emergency Department Patients  

PubMed Central

Introduction: Visits to settings such as emergency departments (EDs) may present a “teachable moment” in that a patient may be more open to feedback and suggestions regarding their risky alcohol and illicit drug-use behaviors. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an 'opportunistic' public health approach that targets low-risk users, in addition to those already dependent on alcohol and/or drugs. SBIRT programs provide patients with comprehensive screening and assessments, and deliver interventions of appropriate intensity to reduce risks related to alcohol and drug use. Methods: This study used a single group pre-post test design to assess the effect of the California SBIRT service program (i.e., CASBIRT) on 6 substance-use outcomes (past-month prevalence and number of days of binge drinking, illegal drug use, and marijuana use). Trained bilingual/bicultural Health Educators attempted to screen all adult patients in 12 EDs/trauma centers (regardless of the reason for the patient's visit) using a short instrument, and then delivered a brief motivational intervention matched to the patient's risk level. A total of 2,436 randomly selected patients who screened positive for alcohol and/or drug use consented to be in a 6-month telephone follow-up interview. Because of the high loss to follow-up rate, we used an intention-to-treat approach for the data analysis. Results: Results of generalized linear mixed models showed modest reductions in all 6 drug-and alcohol-use outcomes. Men (versus women), those at relatively higher risk status (versus lower risk), and those with only one substance of misuse (versus both alcohol and illicit drug misuse) tended to show more positive change. Conclusion: These results suggest that SBIRT services provided in acute care settings are associated with modest changes in self-reported recent alcohol and illicit drug use. PMID:23687546

Woodruff, Susan I.; Eisenberg, Kimberly; McCabe, Cameron T.; Clapp, John D.; Hohman, Melinda

2013-01-01

185

An Evaluation of a Dog Bite Prevention Intervention in the Pediatric Emergency Department  

PubMed Central

Objectives To determine the efficacy of a video-based dog bite prevention intervention at increasing child knowledge and describe any associated factors; and to assess the acceptability of providing this intervention in a pediatric emergency department (PED). Methods This cross-sectional, quasi experimental study enrolled a convenience sample of 5–9 year old patients and their parents, presenting to a PED with non-urgent complaints or dog bites. Children completed a 14-point simulated scenario test used to measure knowledge about safe dog interactions pre-/post- a video intervention. Based on previous research, a passing score (?11/14) was defined a priori. Parents completed surveys regarding sociodemographics, dog-related experiential history and the intervention. Results There were 120 child/parent pairs. Mean child age was 7 (SD 1) and 55% were male. Of parents, 70% were white, 2/3 had more than high school education, and half had incomes <$40,000. Current dog ownership was 77%; only 6% of children had received prior dog bite prevention education. Test pass rate was 58% pre-intervention; 90% post-intervention. Knowledge score increased in 83% of children; greatest increases were in questions involving stray dogs or dogs that were fenced or eating. Younger child age was the only predictor of failing the post-test (p<0.001). Nearly all parents found the intervention informative; 93% supported providing the intervention in the PED. Conclusions Child knowledge of dog bite prevention is poor. The video-based intervention we tested appears efficacious at increasing short-term knowledge in 5–9 year old children and is acceptable to parents. Parents strongly supported providing this education. PMID:24061505

Dixon, Cinnamon A.; Pomerantz, Wendy J.; Hart, Kimberly W.; Lindsell, Christopher J.; Mahabee-Gittens, E. Melinda

2013-01-01

186

The consumer quality index (CQ-index) in an accident and emergency department: development and first evaluation  

PubMed Central

Background Assessment of patients’ views are essential to provide a patient-centred health service and to evaluating quality of care. As no standardized and validated system for measuring patients’ experiences in accident and emergency departments existed, we have developed the Consumer Quality index for the accident and emergency department (CQI A&E). Methods Qualitative research has been undertaken to determine the content validity of the CQI A&E. In order to assess psychometric characteristics an 84-item questionnaire was sent to 653 patients who had attended a large A&E in the Netherlands. Also, fifty importance questions were added to determine relevance of the questions and for future calculations of improvement scores. Exploratory factor analysis was applied to detect the domains of the questionnaire. Results Survey data of 304 (47%) patients were used for the analysis. The first exploratory factor analysis resulted in three domains based on 13 items: ‘Attitude of the healthcare professionals’, ‘Environment and impression of the A&E’ and ‘Respect for and explanation to the patient’. The first two had an acceptable internal consistency. The second analysis, included 24 items grouped into 5 domains: ‘Attitude of the healthcare professionals’, ‘Information and explanation’, ‘Environment of the A&E’,’Leaving the A&E’ and ‘General information and rapidity of care’. All factors were internal consistent. According to the patients, the three most important aspects in healthcare performance in the A&E were: trust in the competence of the healthcare professionals, hygiene in the A&E and patients’ health care expectations. In general, the highest improvement scores concerned patient information. Conclusions The Consumer Quality index for the accident and emergency department measures patients’ experiences of A&E healthcare performance. Preliminary psychometric characteristics are sufficient to justify further research into reliability and validity. PMID:22929061

2012-01-01

187

Realistic, hardware-accelerated shading and lighting  

Microsoft Academic Search

With fast 3D graphics becoming more and more available even on low end platforms, the focus in hardware-accelerated rendering is beginning to shift towards higher quality rendering and additional functionality instead of simply higher performance implementa- tions based on the traditional graphics pipeline. In this paper we present techniques for realistic shading and lighting using computer graphics hardware. In particular,

Wolfgang Heidrich; Hans-Peter Seidel

1999-01-01

188

Spatial Visualization by Realistic 3D Views  

ERIC Educational Resources Information Center

In this study, the popular Purdue Spatial Visualization Test-Visualization by Rotations (PSVT-R) in isometric drawings was recreated with CAD software that allows 3D solid modeling and rendering to provide more realistic pictorial views. Both the original and the modified PSVT-R tests were given to students and their scores on the two tests were…

Yue, Jianping

2008-01-01

189

Synthesis of realistic oceanic Pn wave trains  

Microsoft Academic Search

The synthesis of realistic oceanic Pn phases was accomplished using wave number integration. Wave trains with duration of the order of 100 s following the initial compressional wave arrival were generated for a laterally homogeneous, vertically inhomogeneous oceanic lithosphere model. The excitation of these long wave trains is primarily a result of near-receiver water and sediment reverberations and does not

Thomas Sereno; John Orcutt

1985-01-01

190

Immersion Through Believability: Using Realistic Character  

E-print Network

behaviour ­The system is more flexible and responsive to the current state of the game ­It avoids exhaustiveImmersion Through Believability: Using Realistic Character Behaviours to Enhance Gameplay of Computer Science The University of Western Ontario #12;Presentation Title Goes In Here Outline 1

Katchabaw, Michael James

191

Satellite Maps Deliver More Realistic Gaming  

NASA Technical Reports Server (NTRS)

When Redwood City, California-based Electronic Arts (EA) decided to make SSX, its latest snowboarding video game, it faced challenges in creating realistic-looking mountains. The solution was NASA's ASTER Global Digital Elevation Map, made available by the Jet Propulsion Laboratory, which EA used to create 28 real-life mountains from 9 different ranges for its award-winning game.

2013-01-01

192

Realistic Behaviour Model for Bird Autonomous Agent  

E-print Network

Intelligence 1.3. Overview of Boid Model 1.4. Overview of the Tu's Mind/Brain model 2. Implementing agents to generate intentions and behave more realistically according to these intentions. To do this a way to integrate the Boid agent model with the behaviour/brain model by Xiaoyuan Tu and Demetri

Goodman, James R.

193

How realistic should knowledge diusion models be?  

Microsoft Academic Search

Knowledge diusion models typically involve two main features: an underlying social network topology on one side, and a particular design of interaction rules driving knowledge transmission on the other side. Ac- knowledging the need for realistic topologies and adop- tion behaviors backed by empirical measurements, it becomes unclear how accurately existing models ren- der real-world phenomena: if indeed both topology

Jean-Philippe Cointet; Camille Roth

194

Modeling realistic hybrid flexible flowshop scheduling problems  

Microsoft Academic Search

This paper aims to contribute to the recent research efforts to bridge the gap between the theory and the practice of scheduling by modelizing a realistic manufacturing environment and analyzing the effect of the inclusion of several characteristics in the problem formulation. There are several constraints and characteristics that affect the scheduling operations at companies. While these constraints are many

Rubén Ruiz; Funda Sivrikaya-serifoglu; Thijs Urlings

2008-01-01

195

On a realistic interpretation of quantum mechanics  

E-print Network

On a realistic interpretation of quantum mechanics Arnold Neumaier Institut fur Mathematik respecting the indeter- ministic nature of quantum mechanics, allows to speak of de#12;nite values for all], there are at least two levels of inter- preting quantum mechanics: the statistical interpretation in the narrower

Neumaier, Arnold

196

Accurate Synthetic Generation of Realistic Personal Information  

E-print Network

Accurate Synthetic Generation of Realistic Personal Information Agus Pudjijono and Peter Christen Department of Computer Science, The Australian National University, Canberra ACT 0200, Australia peter, or social security numbers. Privacy and confidentiality are of great concern when such data is being

Christen, Peter

197

Evaluation and improvement of doctor-patient communication competence for emergency neurosurgeons: a standardized family model  

PubMed Central

Disease treatments have been significantly influenced by the communications between patients, their families, and doctors the lack of which may lead to malpractice allegations and complaints. In particular, inadequate communication may delay diagnosis and treatment. Therefore, for doctors communication and interpersonal skills, are as important as clinical skills and medical knowledge. In this study we intended to develop two detailed communication content checklists and a modified interpersonal skills inventory, aiming to evaluate their integrity in the midst of communication skills assessments, to provide feedback for some participants, and to observe their communication competence in both aspects PMID:25018623

Wu, Xi; Wang, Zhinong; Hong, Bo; Shen, Shengjuan; Guo, Yan; Huang, Qinghai; Liu, Jianmin

2014-01-01

198

Out-of-hours emergency dental services--evaluation of the first year of a pilot project in Fife.  

PubMed

The Scottish Executive Health Department approved funding in 2001 for Fife NHS Board to pilot an integrated model of out-of-hours dental services based upon a dental nurse-led triage system during the evenings, weekends and some public holidays. After one year of the pilot project the activity was evaluated by analysing the triage database. Nearly 4,000 calls were received--Fridays and Saturdays were the most popular days to telephone which resulted in nearly half of all callers being referred to an emergency weekend clinic. Thirty-nine percent of callers received advice only or were advised to contact their own dentist during working hours. A further 12% who were not registered with a dentist (n=479) were offered a next-day appointment with a dentist in their area--around half of these callers subsequently attended for an appointment. Only two out of every 100 callers were deemed to require emergency out-of-hours attention and were referred to oral surgery staff in a local hospital. PMID:15731793

Topping, G V A

2005-02-26

199

Programmatic Cost Evaluation of Nontargeted Opt-Out Rapid HIV Screening in the Emergency Department  

PubMed Central

Background The Centers for Disease Control and Prevention recommends nontargeted opt-out HIV screening in healthcare settings. Cost effectiveness is critical when considering potential screening methods. Our goal was to compare programmatic costs of nontargeted opt-out rapid HIV screening with physician-directed diagnostic rapid HIV testing in an urban emergency department (ED) as part of the Denver ED HIV Opt-Out Trial. Methods This was a prospective cohort study nested in a larger quasi-experiment. Over 16 months, nontargeted rapid HIV screening (intervention) and diagnostic rapid HIV testing (control) were alternated in 4-month time blocks. During the intervention phase, patients were offered HIV testing using an opt-out approach during registration; during the control phase, physicians used a diagnostic approach to offer HIV testing to patients. Each method was fully integrated into ED operations. Direct program costs were determined using the perspective of the ED. Time-motion methodology was used to estimate personnel activity costs. Costs per patient newly-diagnosed with HIV infection by intervention phase, and incremental cost effectiveness ratios were calculated. Results During the intervention phase, 28,043 eligible patients were included, 6,933 (25%) completed testing, and 15 (0.2%, 95% CI: 0.1%–0.4%) were newly-diagnosed with HIV infection. During the control phase, 29,925 eligible patients were included, 243 (0.8%) completed testing, and 4 (1.7%, 95% CI: 0.4%–4.2%) were newly-diagnosed with HIV infection. Total annualized costs for nontargeted screening were $148,997, whereas total annualized costs for diagnostic HIV testing were $31,355. The average costs per HIV diagnosis were $9,932 and $7,839, respectively. Nontargeted HIV screening identified 11 more HIV infections at an incremental cost of $10,693 per additional infection. Conclusions Compared to diagnostic testing, nontargeted HIV screening was more costly but identified more HIV infections. More effective and less costly testing strategies may be required to improve the identification of patients with undiagnosed HIV infection in the ED. PMID:24391706

Haukoos, Jason S.; Campbell, Jonathan D.; Conroy, Amy A.; Hopkins, Emily; Bucossi, Meggan M.; Sasson, Comilla; Al-Tayyib, Alia A.; Thrun, Mark W.

2013-01-01

200

Near-realistic mobile exergames with wireless wearable sensors.  

PubMed

Exergaming is expanding as an option for sedentary behavior in childhood/adult obesity and for extra exercise for gamers. This paper presents the development process for a mobile active sports exergame with near-realistic motions through the usage of body-wearable sensors. The process begins by collecting a dataset specifically targeted to mapping real-world activities directly to the games, then, developing the recognition system in a fashion to produce an enjoyable game. The classification algorithm in this paper has precision and recall of 77% and 77% respectively, compared with 40% and 19% precision and recall on current activity monitoring algorithms intended for general daily living activities. Aside from classification, the user experience must be strong enough to be a successful system for adoption. Indeed, fast and intense activities as well as competitive, multiplayer environments make for a successful, enjoyable exergame. This enjoyment is evaluated through a 30 person user study. Multiple aspects of the exergaming user experience trials have been merged into a comprehensive survey, called ExerSurvey. All but one user thought the motions in the game were realistic and difficult to cheat. Ultimately, a game with near-realistic motions was shown to be an enjoyable, active video exergame for any environment. PMID:24608050

Mortazavi, Bobak; Nyamathi, Suneil; Lee, Sunghoon Ivan; Wilkerson, Thomas; Ghasemzadeh, Hassan; Sarrafzadeh, Majid

2014-03-01

201

Training the powerful: issues that emerged during the evaluation of a communication skills training programme for senior cancer care professionals.  

PubMed

'Connected' is the name of the national advanced communication skills training programme developed in 2008 for cancer care professionals in the NHS. A 3-day training course combining didactic and experiential learning elements is run by two facilitators with course participants expected to engage fully in simulated consultations with trained actors. In 2011, and as a result of participant feedback on the length of the course and increasing pressures on budgets and clinical time, the Connected team developed and piloted an alternative 2-day training course. Before its roll-out in 2012, Birmingham City University was commissioned to evaluate the effectiveness and quality of the 2-day course vis-à-vis the 'traditional' 3-day one. This article is written by the two evaluators and it discusses some of the issues that emerged during the evaluation. We broadly grouped these issues into two overlapping categories: the mandatory nature of the course and the different professional background and seniority of participants. In our discussion we consider the implications these issues have for communication skills training policy and practice and put forward suggestions for further research. PMID:24373021

Bibila, S; Rabiee, F

2014-07-01

202

Comparative Analysis of the Effectiveness of Three Immunization Strategies in Controlling Disease Outbreaks in Realistic Social Networks  

PubMed Central

The high incidence of emerging infectious diseases has highlighted the importance of effective immunization strategies, especially the stochastic algorithms based on local available network information. Present stochastic strategies are mainly evaluated based on classical network models, such as scale-free networks and small-world networks, and thus are insufficient. Three frequently referred stochastic immunization strategies—acquaintance immunization, community-bridge immunization, and ring vaccination—were analyzed in this work. The optimal immunization ratios for acquaintance immunization and community-bridge immunization strategies were investigated, and the effectiveness of these three strategies in controlling the spreading of epidemics were analyzed based on realistic social contact networks. The results show all the strategies have decreased the coverage of the epidemics compared to baseline scenario (no control measures). However the effectiveness of acquaintance immunization and community-bridge immunization are very limited, with acquaintance immunization slightly outperforming community-bridge immunization. Ring vaccination significantly outperforms acquaintance immunization and community-bridge immunization, and the sensitivity analysis shows it could be applied to controlling the epidemics with a wide infectivity spectrum. The effectiveness of several classical stochastic immunization strategies was evaluated based on realistic contact networks for the first time in this study. These results could have important significance for epidemic control research and practice. PMID:24787718

Xu, Zhijing; Zu, Zhenghu; Zheng, Tao; Zhang, Wendou; Xu, Qing; Liu, Jinjie

2014-01-01

203

Spine care: evaluation of the efficacy and cost of emerging technology.  

PubMed

Over the last decade a number of new technologies have been introduced to the area of spine care. Although this recent explosion of innovation has brought advances to patient care, it has also brought concerns regarding overuse, increasing costs, and safety. A value-based approach to assessing and purchasing new technology depends on a shift toward comparative effectiveness analysis, transparency in pricing and potential conflicts of interest, and an alignment of incentives and goals among purchasers, consumers, and payers. How to assess the effectiveness of new technology in patient care is an unresolved issue for any cost-effectiveness analysis, as models traditionally used to assess medical therapies (ie, quality-adjusted life years) may not be directly applicable to analysis of surgical intervention. Spine surgeons must be involved in multidisciplinary collaborative efforts to develop models of efficacy analysis and to direct outcomes-based research to appropriately evaluate the benefits of surgical interventions and new technologies. PMID:19890182

Smith, Harvey E; Rihn, Jeffrey A; Brodke, Darrel S; Guyer, Richard; Coric, Dom; Lonner, Baron; Shelokov, Alexis P; Currier, Bradford L; Riley, Lee; Phillips, Frank M; Albert, Todd J

2009-01-01

204

Merits of random forests emerge in evaluation of chemometric classifiers by external validation.  

PubMed

Real-world applications will inevitably entail divergence between samples on which chemometric classifiers are trained and the unknowns requiring classification. This has long been recognized, but there is a shortage of empirical studies on which classifiers perform best in 'external validation' (EV), where the unknown samples are subject to sources of variation relative to the population used to train the classifier. Survey of 286 classification studies in analytical chemistry found only 6.6% that stated elements of variance between training and test samples. Instead, most tested classifiers using hold-outs or resampling (usually cross-validation) from the same population used in training. The present study evaluated a wide range of classifiers on NMR and mass spectra of plant and food materials, from four projects with different data properties (e.g., different numbers and prevalence of classes) and classification objectives. Use of cross-validation was found to be optimistic relative to EV on samples of different provenance to the training set (e.g., different genotypes, different growth conditions, different seasons of crop harvest). For classifier evaluations across the diverse tasks, we used ranks-based non-parametric comparisons, and permutation-based significance tests. Although latent variable methods (e.g., PLSDA) were used in 64% of the surveyed papers, they were among the less successful classifiers in EV, and orthogonal signal correction was counterproductive. Instead, the best EV performances were obtained with machine learning schemes that coped with the high dimensionality (914-1898 features). Random forests confirmed their resilience to high dimensionality, as best overall performers on the full data, despite being used in only 4.5% of the surveyed papers. Most other machine learning classifiers were improved by a feature selection filter (ReliefF), but still did not out-perform random forests. PMID:24139571

Scott, I M; Lin, W; Liakata, M; Wood, J E; Vermeer, C P; Allaway, D; Ward, J L; Draper, J; Beale, M H; Corol, D I; Baker, J M; King, R D

2013-11-01

205

Databases for lncRNAs: a comparative evaluation of emerging tools  

PubMed Central

The vast majority of the human transcriptome does not code for proteins. Advances in transcriptome arrays and deep sequencing are giving rise to a fast accumulation of large data sets, particularly of long noncoding RNAs (lncRNAs). Although it is clear that individual lncRNAs may play important and diverse biological roles, there is a large gap between the number of existing lncRNAs and their known relation to molecular/cellular function. This and related information have recently been gathered in several databases dedicated to lncRNA research. Here, we review the content of general and more specialized databases on lncRNAs. We evaluate these resources in terms of the quality of annotations, the reporting of validated or predicted molecular associations, and their integration with other resources and computational analysis tools. We illustrate our findings using known and novel cancer-related lncRNAs. Finally, we discuss limitations and highlight potential future directions for these databases to help delineating functions associated with lncRNAs. PMID:25323317

Fritah, Sabrina; Niclou, Simone P.

2014-01-01

206

Databases for lncRNAs: a comparative evaluation of emerging tools.  

PubMed

The vast majority of the human transcriptome does not code for proteins. Advances in transcriptome arrays and deep sequencing are giving rise to a fast accumulation of large data sets, particularly of long noncoding RNAs (lncRNAs). Although it is clear that individual lncRNAs may play important and diverse biological roles, there is a large gap between the number of existing lncRNAs and their known relation to molecular/cellular function. This and related information have recently been gathered in several databases dedicated to lncRNA research. Here, we review the content of general and more specialized databases on lncRNAs. We evaluate these resources in terms of the quality of annotations, the reporting of validated or predicted molecular associations, and their integration with other resources and computational analysis tools. We illustrate our findings using known and novel cancer-related lncRNAs. Finally, we discuss limitations and highlight potential future directions for these databases to help delineating functions associated with lncRNAs. PMID:25323317

Fritah, Sabrina; Niclou, Simone P; Azuaje, Francisco

2014-11-01

207

Triton binding energy with realistic statistical uncertainties  

NASA Astrophysics Data System (ADS)

We compute the binding energy of triton with realistic statistical errors stemming from NN scattering data uncertainties and the deuteron and obtain Et=-7.638(15)MeV. Setting the numerical precision as ?Etnum?1keV we obtain the statistical error ?Etstat=15(1)keV which is mainly determined by the channels involving relative S waves. This figure reflects the uncertainty of the input NN data, more than two orders of magnitude larger than the experimental precision ?Etexp=0.1keV, and sets a limit on the realistic precision that can be reached. This suggests an important reduction in the numerical precision and hence in the computational effort.

Pérez, R. Navarro; Garrido, E.; Amaro, J. E.; Ruiz Arriola, E.

2014-10-01

208

Fast, Realistic Lighting for Video Games  

Microsoft Academic Search

Global lighting effects produced by diffuse interreflections are typically simulated using global illumination methods such as radiosity or ray tracing. Although diffuse interreflections are crucial to produce realistic images, radiosity-like methods are rarely used in production rendering because of slow performance, robustness problems and difficulty-to-control. We present a novel technology that produces natural-looking lighting effects in a much faster way

Andrei Iones; Anton Krupkin; Mateu Sbert; Sergey Zhukov

2003-01-01

209

Realistic model for radiation-matter interaction  

Microsoft Academic Search

This paper presents a realistic model that describes radiation-matter interactions. This is achieved by a generalization of first quantization, where the Maxwell equations are interpreted as the electromagnetic component of the Schroedinger equation. This picture is complemented by the consideration of electrons and photons as real particles in three-dimensional space, following guiding conditions derived from the particle-wave-functions to which they

Richard A. Pakula

2004-01-01

210

Realistic model for radiation-matter interaction  

Microsoft Academic Search

This paper presents a realistic model that describes radiation-matter\\u000ainteractions. This is achieved by a generalization of first quantization, where\\u000athe Maxwell equations are interpreted as the electromagnetic component of the\\u000aSchroedinger equation. This picture is complemented by the consideration of\\u000aelectrons and photons as real particles in three-dimensional space, following\\u000aguiding conditions derived from the particle-wave-functions to which they

Richard A. Pakula

2004-01-01

211

Creating Realistic Human Motions with PBSO  

Microsoft Academic Search

It is a difficult task to create a realistic human animation because of the high complexity of human motion. To address this problem, a new method is presented for producing physically valid motion with example motions. The core of our method is physics-based space-time optimization (PBSO). PBSO introduces physical constraints into conventional space-time optimization and then ensure the physical reality

Zhihua Chen; Shengxi Wu; Hong Zheng; Wei Meng; Xin Xu

2009-01-01

212

Evaluating legacy contaminants and emerging chemicals in marine environments using adverse outcome pathways and biological effects-directed analysis.  

PubMed

Natural and synthetic chemicals are essential to our daily lives, food supplies, health care, industries and safe sanitation. At the same time protecting marine ecosystems and seafood resources from the adverse effects of chemical contaminants remains an important issue. Since the 1970s, monitoring of persistent, bioaccumulative and toxic (PBT) chemicals using analytical chemistry has provided important spatial and temporal trend data in three important contexts; relating to human health protection from seafood contamination, addressing threats to marine top predators and finally providing essential evidence to better protect the biodiversity of commercial and non-commercial marine species. A number of regional conventions have led to controls on certain PBT chemicals over several years (termed 'legacy contaminants'; e.g. cadmium, lindane, polycyclic aromatic hydrocarbons [PAHs] and polychlorinated biphenyls [PCBs]). Analytical chemistry plays a key role in evaluating to what extent such regulatory steps have been effective in leading to reduced emissions of these legacy contaminants into marine environments. In parallel, the application of biomarkers (e.g. DNA adducts, CYP1A-EROD, vitellogenin) and bioassays integrated with analytical chemistry has strengthened the evidence base to support an ecosystem approach to manage marine pollution problems. In recent years, however,the increased sensitivity of analytical chemistry, toxicity alerts and wider environmental awareness has led to a focus on emerging chemical contaminants (defined as chemicals that have been detected in the environment, but which are currently not included in regulatory monitoring programmes and whose fate and biological impacts are poorly understood). It is also known that natural chemicals (e.g. algal biotoxins) may also pose a threat to marine species and seafood quality. Hence complex mixtures of legacy contaminants, emerging chemicals and natural biotoxins in marine ecosystems represent important scientific, economic and health challenges. In order to meet these challenges and pursue cost-effective scientific approaches that can provide evidence necessary to support policy needs (e.g. the European Marine Strategy Framework Directive), it is widely recognised that there is a need to (i) provide marine exposure assessments for priority contaminants using a range of validated models, passive samplers and biomarkers; (ii) integrate chemical monitoring data with biological effects data across spatial and temporal scales (including quality controls); and (iii) strengthen the evidence base to understand the relationship between exposure to complex chemical mixtures, biological and ecological impacts through integrated approaches and molecular data (e.g. genomics, proteomics and metabolomics). Additionally, we support the widely held view that (iv) that rather than increasing the analytical chemistry monitoring of large number of emerging contaminants, it will be important to target analytical chemistry towards key groups of chemicals of concern using effects-directed analysis. It is also important to evaluate to what extent existing biomarkers and bioassays can address various classes of emerging chemicals using the adverse outcome pathway (AOP) approach now being developed by the Organization for Economic Cooperation and Development (OECD) with respect to human toxicology and ecotoxicology. PMID:23820191

Hutchinson, Thomas H; Lyons, Brett P; Thain, John E; Law, Robin J

2013-09-30

213

Evaluation of Publicly Financed and Privately Delivered Model of Emergency Referral Services for Maternal and Child Health Care in India  

PubMed Central

Background Emergency referral services (ERS) are being strengthened in India to improve access for institutional delivery. We evaluated a publicly financed and privately delivered model of ERS in Punjab state, India, to assess its extent and pattern of utilization, impact on institutional delivery, quality and unit cost. Methods Data for almost 0.4 million calls received from April 2012 to March 2013 was analysed to assess the extent and pattern of utilization. Segmented linear regression was used to analyse month-wise data on number of institutional deliveries in public sector health facilities from 2008 to 2013. We inspected ambulances in 2 districts against the Basic Life Support (BLS) standards. Timeliness of ERS was assessed for determining quality. Finally, we computed economic cost of implementing ERS from a health system perspective. Results On an average, an ambulance transported 3–4 patients per day. Poor and those farther away from the health facility had a higher likelihood of using the ambulance. Although the ERS had an abrupt positive effect on increasing the institutional deliveries in the unadjusted model, there was no effect on institutional delivery after adjustment for autocorrelation. Cost of operating the ambulance service was INR 1361 (USD 22.7) per patient transported or INR 21 (USD 0.35) per km travelled. Conclusion Emergency referral services in Punjab did not result in a significant change in public sector institutional deliveries. This could be due to high baseline coverage of institutional delivery and low barriers to physical access. Choice of interventions for reduction in Maternal Mortality Ratio (MMR) should be context-specific to have high value for resources spent. The ERS in Punjab needs improvement in terms of quality and reduction of cost to health system. PMID:25360798

Prinja, Shankar; Bahuguna, Pankaj; Lakshmi, P. V. M.; Mokashi, Tushar; Aggarwal, Arun Kumar; Kaur, Manmeet; Reddy, K. Rahul; Kumar, Rajesh

2014-01-01

214

Large-System Transformation in Health Care: A Realist Review  

PubMed Central

Context An evidence base that addresses issues of complexity and context is urgently needed for large-system transformation (LST) and health care reform. Fundamental conceptual and methodological challenges also must be addressed. The Saskatchewan Ministry of Health in Canada requested a six-month synthesis project to guide four major policy development and strategy initiatives focused on patient- and family-centered care, primary health care renewal, quality improvement, and surgical wait lists. The aims of the review were to analyze examples of successful and less successful transformation initiatives, to synthesize knowledge of the underlying mechanisms, to clarify the role of government, and to outline options for evaluation. Methods We used realist review, whose working assumption is that a particular intervention triggers particular mechanisms of change. Mechanisms may be more or less effective in producing their intended outcomes, depending on their interaction with various contextual factors. We explain the variations in outcome as the interplay between context and mechanisms. We nested this analytic approach in a macro framing of complex adaptive systems (CAS). Findings Our rapid realist review identified five “simple rules” of LST that were likely to enhance the success of the target initiatives: (1) blend designated leadership with distributed leadership; (2) establish feedback loops; (3) attend to history; (4) engage physicians; and (5) include patients and families. These principles play out differently in different contexts affecting human behavior (and thereby contributing to change) through a wide range of different mechanisms. Conclusions Realist review methodology can be applied in combination with a complex system lens on published literature to produce a knowledge synthesis that informs a prospective change effort in large-system transformation. A collaborative process engaging both research producers and research users contributes to local applications of universal principles and mid-range theories, as well as to a more robust knowledge base for applied research. We conclude with suggestions for the future development of synthesis and evaluation methods. PMID:22985277

Best, Allan; Greenhalgh, Trisha; Lewis, Steven; Saul, Jessie E; Carroll, Simon; Bitz, Jennifer

2012-01-01

215

Realistic and efficient 2D crack simulation  

NASA Astrophysics Data System (ADS)

Although numerical algorithms for 2D crack simulation have been studied in Modeling and Simulation (M&S) and computer graphics for decades, realism and computational efficiency are still major challenges. In this paper, we introduce a high-fidelity, scalable, adaptive and efficient/runtime 2D crack/fracture simulation system by applying the mathematically elegant Peano-Cesaro triangular meshing/remeshing technique to model the generation of shards/fragments. The recursive fractal sweep associated with the Peano-Cesaro triangulation provides efficient local multi-resolution refinement to any level-of-detail. The generated binary decomposition tree also provides efficient neighbor retrieval mechanism used for mesh element splitting and merging with minimal memory requirements essential for realistic 2D fragment formation. Upon load impact/contact/penetration, a number of factors including impact angle, impact energy, and material properties are all taken into account to produce the criteria of crack initialization, propagation, and termination leading to realistic fractal-like rubble/fragments formation. The aforementioned parameters are used as variables of probabilistic models of cracks/shards formation, making the proposed solution highly adaptive by allowing machine learning mechanisms learn the optimal values for the variables/parameters based on prior benchmark data generated by off-line physics based simulation solutions that produce accurate fractures/shards though at highly non-real time paste. Crack/fracture simulation has been conducted on various load impacts with different initial locations at various impulse scales. The simulation results demonstrate that the proposed system has the capability to realistically and efficiently simulate 2D crack phenomena (such as window shattering and shards generation) with diverse potentials in military and civil M&S applications such as training and mission planning.

Yadegar, Jacob; Liu, Xiaoqing; Singh, Abhishek

2010-04-01

216

Any realistic model of a physical system must be computationally realistic  

E-print Network

It is argued that any possible definition of a realistic physics theory -- i.e., a mathematical model representing the real world -- cannot be considered comprehensive unless it is supplemented with requirement of being computationally realistic. That is, the mathematical structure of a realistic model of a physical system must allow the collection of all the system's physical quantities to compute all possible measurement outcomes on some computational device not only in an unambiguous way but also in a reasonable amount of time. In the paper, it is shown that a deterministic quantum model of a microscopic system evolving in isolation should be regarded as realistic since the NP-hard problem of finding the exact solution to the Schrodinger equation for an arbitrary physical system can be surely solved in a reasonable amount of time in the case, in which the system has just a small number of degrees of freedom. In contrast to this, the deterministic quantum model of a truly macroscopic object ought to be considered as non-realistic since in a world of limited computational resources the intractable problem possessing that enormous amount of degrees of freedom would be the same as mere unsolvable.

Arkady Bolotin

2014-05-14

217

Inflation with realistic supersymmetric SO(10)  

SciTech Connect

We implement inflation within a realistic supersymmetric SO(10) model in which the doublet-triplet splitting is realized through the Dimopoulos-Wilczek mechanism, the MSSM {mu} problem is resolved, and Higgsino mediated dimension five nucleon decay is heavily suppressed. The cosmologically unwanted topological defects are inflated away, and from {delta}T/T, the B-L breaking scale is estimated to be of order 10{sup 16}-10{sup 17} GeV. Including supergravity corrections, the scalar spectral index n{sub s}=0.99{+-}0.01, with vertical bar dn{sub s}/dlnk vertical bar < or approx. 10{sup -3}.

Kyae, Bumseok [School of Physics, Korea Institute for Advanced Study, 207-43, Cheongnyangni-Dong, Dongdaemun-Gu, Seoul 130-722 (Korea, Republic of); Shafi, Qaisar [Bartol Research Institute, University of Delaware, Newark, Delaware 19716 (United States)

2005-09-15

218

Radiative Tail of Realistic Rotating Gravitational Collapse  

NASA Astrophysics Data System (ADS)

An astrophysically realistic model of wave dynamics in black-hole spacetimes must involve a nonspherical background geometry with angular momentum. We consider the evolution of gravitational (and electromagnetic) perturbations in rotating Kerr spacetimes. We show that a rotating Kerr black hole becomes ``bald'' slower than the corresponding spherically symmetric Schwarzschild black hole. Moreover, our results turn over the traditional belief (which has been widely accepted during the last three decades) that the late-time tail of gravitational collapse is universal. Our results are also of importance both to the study of the no-hair conjecture and the mass-inflation scenario (stability of Cauchy horizons).

Hod, Shahar

2000-01-01

219

Parallel Quality Assessment of Emergency Departments by European Foundation for Quality Management Model and Iranian National Program for Hospital Evaluation  

PubMed Central

Background European Foundation for Quality Management (EFQM) model is a widely used quality management system (QMS) worldwide, including Iran. Current study aims to verify the quality assessment results of Iranian National Program for Hospital Evaluation (INPHE) based on those of EFQM. Methods: This cross-sectional study was conducted in 2012 on a sample of emergency departments (EDs) affiliated with Tehran University of Medical Sciences (TUMS), Iran. The standard questionnaire of EFQM (V-2010) was used to gather appropriate data. The results were compared with those of INPHE. MS Excel was used to classify and display the findings. Results: The average assessment score of the EDs based on the INPHE and EFQM model were largely different (i.e. 86.4% and 31%, respectively). In addition, the variation range among five EDs’ scores according to each model was also considerable (22% for EFQM against 7% of INPHE), especially in the EDs with and without prior record of applying QMSs. Conclusion: The INPHE’s assessment results were not confirmed by EFQM model. Moreover, the higher variation range among EDs’ scores using EFQM model could allude to its more differentiation power in assessing the performance comparing with INPHE. Therefore, a need for improvement in the latter drawing on other QMSs’ (such as EFQM) strengths, given the results emanated from its comparison with EFQM seems indispensable. PMID:23967429

IMANI NASAB, Mohammad Hasan; MOHAGHEGH, Bahram; KHALESI, Nader; JAAFARIPOOYAN, Ebrahim

2013-01-01

220

Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program  

ERIC Educational Resources Information Center

Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

Roelandt, James P.

2012-01-01

221

Evaluation of a diabetes referral pathway for the management of hypoglycaemia following emergency contact with the ambulance service to a diabetes specialist nurse team  

Microsoft Academic Search

Objectives: To evaluate the effectiveness of ambulance crew referral of patients treated for acute hypoglycaemia, to a diabetes specialist nurse (DSN) team. Patients were assessed by the ambulance service and did not attend an emergency department.Methods: For a 3 month period patients were referred from two areas of West Yorkshire by the ambulance service to specialist diabetes teams. The DSNs

A Walker; C James; M Bannister; E Jobes

2006-01-01

222

Promoting the development of preschool children’s emergent literacy skills: a randomized evaluation of a literacy-focused curriculum and two professional development models  

Microsoft Academic Search

To date, there have been few causally interpretable evaluations of the impacts of preschool curricula on the skills of children\\u000a at-risk for academic difficulties, and even fewer studies have demonstrated statistically significant or educationally meaningful\\u000a effects. In this cluster-randomized study, we evaluated the impacts of a literacy-focused preschool curriculum and two types\\u000a of professional development on the emergent literacy skills

Christopher J. Lonigan; JoAnn M. Farver; Beth M. Phillips; Jeanine Clancy-Menchetti

2011-01-01

223

Realistic Mobility Modeling for Vehicular Ad Hoc Networks  

NASA Astrophysics Data System (ADS)

Simulations used for evaluating the performance of routing protocols for Vehicular Ad Hoc Networks (VANET) are mostly based on random mobility and fail to consider individual behaviors of the vehicles. Unrealistic assumptions about mobility produce misleading results about the behavior of routing protocols in real deployments. In this paper, a realistic mobility modeling tool, Mobility for Vehicles (MOVE), which considers the basic mobility behaviors of vehicles, is proposed for a more accurate evaluation. The proposed model is tested against the Random Waypoint (RWP) model using AODV and OLSR protocols. The results show that the mobility model significantly affects the number of nodes within the transmission range of a node, the volume of control traffic, and the number of collisions. It is shown that number of intersections, grid size, and node density are important parameters when dealing with VANET performance.

Akay, Hilal; Tugcu, Tuna

2009-08-01

224

Support for Realist Foreign Policy: Reality Attunement or Ignorance?  

E-print Network

Social discourse often considers realist foreign policy to be the most pragmatic and rational approach to international relations. The present research tests the widespread belief that realist foreign policy reflects ...

Snider, Danielle

2012-05-31

225

Active Sensing by Unmanned Aircraft Systems in Realistic Communication  

E-print Network

Active Sensing by Unmanned Aircraft Systems in Realistic Communication Environments Eric W. Frew-theoretic framework for active sensing by unmanned aircraft systems in realistic communication environments of the active sensing framework. Keywords: active sensing, unmanned aircraft systems, stochastic approximation

Frew, Eric W.

226

Characterization and Monitoring Data for Evaluating Constructed Emergent Sandbar Habitat in the Missouri River Mainstem 2004-2009  

Microsoft Academic Search

The U.S. Army Corps of Engineers (Corps) provides the primary operational management of the Missouri River Main Stem Reservoir System. Management of the Missouri River has generally reduced peak river flows that form and maintain emergent sandbar habitat. Emergent sandbars provide non-vegetated nesting habitat for the endangered interior least tern (Sternula antillarum athalassos) and the threatened Northern Great Plains piping

Duberstein; Corey A

2011-01-01

227

Children Gifted in Drawing: Precocious Realists vs. Autism Spectrum Disorder  

ERIC Educational Resources Information Center

Individuals differ in their ability to draw realistically and these differences can be seen in early childhood, prior to any formal instruction. Some children, considered precocious realists, are able to draw far more realistically than their peers, even if they have never received formal instruction. In this article, the authors describe some of…

Drake, Jennifer E.; Winner, Ellen

2010-01-01

228

EMERGENCY PREPAREDNESS & SAFETY GUIDE EMERGENCIES  

E-print Network

& Communications Motorist Assist Program Other: EMERGENCY CONTACT INFO continued 617-496-NEWS 617-495-1585 617EMERGENCY PREPAREDNESS & SAFETY GUIDE EMERGENCY CONTACTS REPORTING EMERGENCIES MEDICAL EMERGENCIES Health & Safety (EH&S) EMERGENCY CONTACT INFORMATION 911 617-495-1212 617-495-5560 617-432-1901 617

229

Effect of realistic vegetation variability on seasonal forecasts  

NASA Astrophysics Data System (ADS)

A real predictability hindcast experiment with prescribed Leaf Area Index (LAI) has been performed using the state-of-the-art Earth System Model EC-Earth. LAI input to the climate model has been prescribed using a novel observational dataset based on the third generation GIMMS and MODIS satellite data. The LAI dataset has been pre-processed (monthly averaged, interpolated, gap-filled) to use it in the land surface scheme of EC-Earth (HTESSEL). The vegetation density is modeled by an exponential dependence on LAI, based on the Lambert-Beer formulation. Retrospective hindcasts have been performed with the following model setup: 7 months forecast length, 2 start dates (1st May and 1st November), 10 members, 28 years (1982-2009). Initial conditions were produced at IC3, based on ERA-40/ERA-Interim (atmosphere and land-surface) and NEMOVAR-ORAS4 (ocean and sea-ice) data. Model resolution is T159L62 for the atmosphere and the ORCA1 grid for the ocean. The effect of the realistic LAI prescribed from observation is evaluated with respect to a control experiment where LAI does not vary. Results of the retrospective hindcast experiment demonstrate that a realistic representation of vegetation has a significant effect on evaporation, temperature and precipitation. An improvement of model sensitivity to vegetation variability on the seasonal scale is also evidenced, especially during boreal winter. This may be attributed in particular to the effect of the high vegetation component on the snow cover.

Catalano, Franco; Alessandri, Andrea; De Felice, Matteo; Doblas-Reyes, Francisco J.

2014-05-01

230

Are Bogs Reservoirs for Emerging Disease Vectors? Evaluation of Culicoides Populations in the Hautes Fagnes Nature Reserve (Belgium)  

PubMed Central

Several species of Culicoides (Diptera: Ceratopogonidae) biting midges serve as biological vectors for the bluetongue virus (BTV) and the recently described Schmallenberg virus (SBV) in northern Europe. Since their recent emergence in this part of the continent, these diseases have caused considerable economic losses to the sheep and cattle industries. Much data is now available that describe the distribution, population dynamics, and feeding habits of these insects. However, little is known regarding the presence of Culicoides in unusual habitats such as peaty marshes, nor their potential vector capacity. This study evaluated Culicoides biting midges present in the bogs of a Belgian nature reserve compared to those residing at a nearby cattle farm. Culicoides were trapped in 2011 at four different sites (broadleaved and coniferous forested areas, open environments, and at a scientific station) located in the Hautes Fagnes Nature Reserve (Belgium). An additional light trap was operated on a nearby cattle farm. Very high numbers of biting midges were captured in the marshy area and most of them (70 to 95%) were Culicoides impunctatus, a potential vector of BTV and other pathogens. In addition, fewer numbers of C. obsoletus/C. scoticus species, C. chiopterus, and C. dewulfi were observed in the bogs compared to the farm. The wet environment and oligotrophic nature of the soil were probably responsible for these changes in the respective populations. A total of 297,808 Culicoides midges belonging to 27 species were identified during this study and 3 of these species (C. sphagnumensis, C. clintoni and C. comosioculatus) were described in Belgium for the first time. PMID:23799137

Zimmer, Jean-Yves; Smeets, Francois; Simonon, Gregory; Fagot, Jean; Haubruge, Eric; Francis, Frederic; Losson, Bertrand

2013-01-01

231

Noninvasive continuous versus intermittent arterial pressure monitoring: evaluation of the vascular unloading technique (CNAP device) in the emergency department  

PubMed Central

Background Monitoring cardiovascular function in acutely ill patients in the emergency department (ED) is of paramount importance. Arterial pressure (AP) is usually monitored using intermittent oscillometric measurements with an upper arm cuff. The vascular unloading technique (VUT) allows continuous noninvasive AP monitoring. In this study, we compare continuous AP measurements obtained by VUT with intermittent oscillometric AP measurements in ED patients. In addition, we aimed to investigate whether continuous noninvasive AP monitoring allows detection of relevant hypotensive episodes that might be missed with intermittent AP monitoring. Methods In a German university hospital, 130 ED patients who required AP monitoring were analyzed in this prospective method comparison study. Continuous AP monitoring was performed using VUT (CNAP technology; CNSystems Medizintechnik AG, Graz, Austria) over a 2-hour period. The oscillometric AP values were recorded simultaneously every 15 minutes for the comparison of both methods. For statistical evaluation, Bland-Altman plots accounting for repeated AP measurements per individual were used. Results The mean difference (±standard deviation) between AP measurements obtained by VUT and oscillometric AP measurements was -5 mmHg (±22 mmHg) for systolic AP (SAP), -2 mmHg (±15 mmHg) for diastolic AP (DAP), and -6 mmHg (±16 mmHg) for mean AP (MAP), respectively. In the interval between two oscillometric measurements, the VUT device detected hypotensive episodes (?4 minutes) defined as either SAP <90 mmHg or MAP <65 mmHg in 30 patients and 16 patients, respectively. In 11 (SAP <90 mmHg) and 6 (MAP <65 mmHg) of these patients, hypotension was also detected by the subsequent intermittent oscillometric AP measurement. Conclusions VUT using the CNAP system for noninvasive continuous AP measurement shows reasonable agreement with intermittent oscillometric measurements in acutely ill ED patients. Continuous AP monitoring allows immediate recognition of clinically relevant hypotensive episodes, which are missed or only belatedly recognized with intermittent AP measurement. PMID:24472659

2014-01-01

232

Primary care in London: an evaluation of general practitioners working in an inner city accident and emergency department.  

PubMed Central

OBJECTIVE: To determine the characteristics of primary care attenders to St Mary's Hospital accident and emergency (A&E) department, evaluate the effects of the introduction of general practitioners (GPs) on patient care in A&E, and make recommendations for the provision of GPs in appropriate A&E departments. DESIGN: Prospective survey over a six week period. METHODS: Data collected from the attendances of 970 consecutive patients triaged with "minor" primary care problems, whether seen by A&E doctors or by GPs working in A&E, were analysed. RESULTS: During the study period 1078 patients (16.6%) were triaged as suitable for primary care. The A&E GPs saw 58.4% of these patients. The majority of primary care patients were young British residents, 71.1% of whom were registered with a GP. Sixty per cent of patients lived within St Mary's catchment area. Of those registered patients asked why they attended A&E, 27.1% thought their problem inappropriate for their GP. A&E doctors were more likely to investigate patients and arrange hospital follow up than GPs, who arranged community follow up in 80% of patients needing further care. CONCLUSIONS: The demand for primary care at St Mary's necessitates the provision of a primary care service, albeit for the first visit only. This can be provided by GPs in A&E. The features of the patients using the service suggests that discouraging first attendance is unrealistic, but using the visit to educate patients and return them to the care of the community is not. PMID:8821216

Ward, P; Huddy, J; Hargreaves, S; Touquet, R; Hurley, J; Fothergill, J

1996-01-01

233

HELIOSEISMOLOGY OF A REALISTIC MAGNETOCONVECTIVE SUNSPOT SIMULATION  

SciTech Connect

We compare helioseismic travel-time shifts measured from a realistic magnetoconvective sunspot simulation using both helioseismic holography and time-distance helioseismology, and measured from real sunspots observed with the Helioseismic and Magnetic Imager instrument on board the Solar Dynamics Observatory and the Michelson Doppler Imager instrument on board the Solar and Heliospheric Observatory. We find remarkable similarities in the travel-time shifts measured between the methodologies applied and between the simulated and real sunspots. Forward modeling of the travel-time shifts using either Born or ray approximation kernels and the sound-speed perturbations present in the simulation indicates major disagreements with the measured travel-time shifts. These findings do not substantially change with the application of a correction for the reduction of wave amplitudes in the simulated and real sunspots. Overall, our findings demonstrate the need for new methods for inferring the subsurface structure of sunspots through helioseismic inversions.

Braun, D. C.; Birch, A. C. [Northwest Research Associates, 3380 Mitchell Lane, Boulder, CO 80301 (United States); Rempel, M. [National Center for Atmospheric Research, HAO Division, 3080 Center Green Drive, Boulder, CO 80301 (United States); Duvall, T. L. Jr., E-mail: dbraun@cora.nwra.com, E-mail: aaronb@cora.nwra.com, E-mail: renpel@ucar.edu, E-mail: Thomas.L.Duvall@nasa.gov [Solar Physics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States)

2012-01-01

234

EMERGENCY PHONE NUMBERS Medical Emergency  

E-print Network

EMERGENCY PHONE NUMBERS Medical Emergency 911 Harvard University Police Department (617) 495. Describe the type of emergency (fire, medical, utility disruption, public safety, etc). Give the phone can be utilized in all situations. Report emergencies to: Medical Emergency 911 · Injury · Illness

Chou, James

235

Body Tides of a Realistic Earth  

NASA Astrophysics Data System (ADS)

A precise modelling of the Earth tides is necessary to correct the space gravimetry observations, from satellites such as GRACE and GOCE. It is also useful to correct ground measurements, and even more important for superconducting gravimeters, which have a 10 nGal precision. The Earth response (deformation and gravity) to tides or atmospheric load is generally computed assuming radial symmetry in stratified Earth models, at the hydrostatic equilibrium. Our study aims at providing a new Earth tide model, which accounts for the whole complexity of a more realistic Earth. Our model is based on a dynamically consistent equilibrium state which includes lateral variations in density and rheological parameters (shear and bulk moduli), and interface topographies. We use a finite element method and we solve numerically the gravito-elasticity equations. The deviation from the hydrostatic equilibrium has been taken into account as a first order perturbation. The equations are written in the Fourier domain, in order to allow degree one translational and rotational modes of the Earth. We investigate the impact on Earth tidal response of an equilibrium state different from hydrostatic and of the topography of the interfaces, for a simple model of lateral variation: a spherical anomaly in the mantle, which can represent plumes and superplumes. At the M2 frequency (semi-diurnal), we estimate the order of magnitude of the perturbation as a function of the radius and physical parameters of the anomaly.

Metivier, L.; Greff-Lefftz, M.; Diament, M.

2005-12-01

236

Comparing Realistic Subthalamic Nucleus Neuron Models  

NASA Astrophysics Data System (ADS)

The mechanism of action of clinically effective electrical high frequency stimulation is still under debate. However, recent evidence points at the specific activation of GABA-ergic ion channels. Using a computational approach, we analyze temporal properties of the spike trains emitted by biologically realistic neurons of the subthalamic nucleus (STN) as a function of GABA-ergic synaptic input conductances. Our contribution is based on a model proposed by Rubin and Terman and exhibits a wide variety of different firing patterns, silent, low spiking, moderate spiking and intense spiking activity. We observed that most of the cells in our network turn to silent mode when we increase the GABAA input conductance above the threshold of 3.75 mS/cm2. On the other hand, insignificant changes in firing activity are observed when the input conductance is low or close to zero. We thus reproduce Rubin's model with vanishing synaptic conductances. To quantitatively compare spike trains from the original model with the modified model at different conductance levels, we apply four different (dis)similarity measures between them. We observe that Mahalanobis distance, Victor-Purpura metric, and Interspike Interval distribution are sensitive to different firing regimes, whereas Mutual Information seems undiscriminative for these functional changes.

Njap, Felix; Claussen, Jens C.; Moser, Andreas; Hofmann, Ulrich G.

2011-06-01

237

Quantifying introgression risk with realistic population genetics  

PubMed Central

Introgression is the permanent incorporation of genes from the genome of one population into another. This can have severe consequences, such as extinction of endemic species, or the spread of transgenes. Quantification of the risk of introgression is an important component of genetically modified crop regulation. Most theoretical introgression studies aimed at such quantification disregard one or more of the most important factors concerning introgression: realistic genetical mechanisms, repeated invasions and stochasticity. In addition, the use of linkage as a risk mitigation strategy has not been studied properly yet with genetic introgression models. Current genetic introgression studies fail to take repeated invasions and demographic stochasticity into account properly, and use incorrect measures of introgression risk that can be manipulated by arbitrary choices. In this study, we present proper methods for risk quantification that overcome these difficulties. We generalize a probabilistic risk measure, the so-called hazard rate of introgression, for application to introgression models with complex genetics and small natural population sizes. We illustrate the method by studying the effects of linkage and recombination on transgene introgression risk at different population sizes. PMID:23055068

Ghosh, Atiyo; Meirmans, Patrick G.; Haccou, Patsy

2012-01-01

238

All Health Care is Not Local: An Evaluation of the Distribution of Emergency Department Care Delivered in Indiana  

PubMed Central

The Emergency Department (ED) delivers a major portion of health care – often with incomplete knowledge about the patient. As such, EDs are particularly likely to benefit from a health information exchange (HIE). The Indiana Public Health Emergency Surveillance System (PHESS) sends real-time registration information for emergency department encounters. Over the three-year study period, we found 2.8 million patients generated 7.4 million ED visits. The average number of visits was 2.6 visits/patient (range 1–385). We found more than 40% of ED visits during the study period were for patients having data at multiple institutions. When examining the network density, we found nearly all EDs share patients with more than 80 other EDs. Our results help clarify future health care policy decisions regarding optimal NHIN architecture and discount the notion that ‘all healthcare is local’. PMID:22195094

Finnell, John T.; Overhage, J. Marc; Grannis, Shaun

2011-01-01

239

Evaluation of a stand-alone computer-aided detection system for acute intra-cranial hemorrhage in emergency environments  

NASA Astrophysics Data System (ADS)

Acute intra-cranial hemorrhage (AIH) may result from traumatic brain injury (TBI). Successful management of AIH depends heavily on the speed and accuracy of diagnosis. Timely diagnosis in emergency environments in both civilian and military settings is difficult primarily due to severe time restraints and lack of resources. Often, diagnosis is performed by emergency physicians rather than trained radiologists. As a result, added support in the form of computer-aided detection (CAD) would greatly enhance the decision-making process and help in providing faster and more accurate diagnosis of AIH. This paper discusses the implementation of a CAD system in an emergency environment, and its efficacy in aiding in the detection of AIH.

Fernandez, James; Deshpande, Ruchi; Wang, Ximing; Liu, Brent; Brazaitis, Michael; Munter, Fletcher; Liu, Margaret

2011-03-01

240

Environmentally realistic fingerprint-image generation with evolutionary filter-bank optimization  

E-print Network

Environmentally realistic fingerprint-image generation with evolutionary filter-bank optimization t i c l e i n f o Keywords: Fingerprint image generation Evolutionary algorithm Image filters Input pressure a b s t r a c t Constructing a fingerprint database is important to evaluate the performance

Cho, Sung-Bae

241

Preschoolers' Judgments Regarding Realistic and Cartoon-based Moral Transgressions in the US  

Microsoft Academic Search

This study was designed to evaluate young children's informational assumptions about realistic and cartoon-based moral transgressions. Seventy-two urban US preschoolers were presented with drawings of transgressions, such as hitting, pushing, stealing, and failing to share. Preschoolers were asked whether the transgressions were permissible and deserved punishment, and to assess the severity or level of harm caused by the transgression and

Kristen Peters Bierwirth; Fran C. Blumberg

2010-01-01

242

Development and evaluation of a leadership training program for public health emergency response: results from a Chinese study  

Microsoft Academic Search

BACKGROUND: Since the 9\\/11 attack and severe acute respiratory syndrome (SARS), the development of qualified and able public health leaders has become a new urgency in building the infrastructure needed to address public health emergencies. Although previous studies have reported that the training of individual leaders is an important approach, the systemic and scientific training model need further improvement and

Chongjian Wang; Sheng Wei; Hao Xiang; Jing Wu; Yihua Xu; Li Liu; Shaofa Nie

2008-01-01

243

Building Leadership Capacity: An Evaluation of the University of Cape Town's Emerging Student Leaders Programme  

ERIC Educational Resources Information Center

Universities worldwide are becoming increasingly interested in the importance of emerging co-curricula that focus on developing graduate attributes beyond specific academic disciplines. This is being influenced by industry demands for graduates with behavioural and cognitive skills aligned to the work they will do in their early careers. This…

Mukoza, Stella Kyobula; Goodman, Suki

2013-01-01

244

A realistic molecular model of cement hydrates  

PubMed Central

Despite decades of studies of calcium-silicate-hydrate (C-S-H), the structurally complex binder phase of concrete, the interplay between chemical composition and density remains essentially unexplored. Together these characteristics of C-S-H define and modulate the physical and mechanical properties of this “liquid stone” gel phase. With the recent determination of the calcium/silicon (C/S = 1.7) ratio and the density of the C-S-H particle (2.6 g/cm3) by neutron scattering measurements, there is new urgency to the challenge of explaining these essential properties. Here we propose a molecular model of C-S-H based on a bottom-up atomistic simulation approach that considers only the chemical specificity of the system as the overriding constraint. By allowing for short silica chains distributed as monomers, dimers, and pentamers, this C-S-H archetype of a molecular description of interacting CaO, SiO2, and H2O units provides not only realistic values of the C/S ratio and the density computed by grand canonical Monte Carlo simulation of water adsorption at 300 K. The model, with a chemical composition of (CaO)1.65(SiO2)(H2O)1.75, also predicts other essential structural features and fundamental physical properties amenable to experimental validation, which suggest that the C-S-H gel structure includes both glass-like short-range order and crystalline features of the mineral tobermorite. Additionally, we probe the mechanical stiffness, strength, and hydrolytic shear response of our molecular model, as compared to experimentally measured properties of C-S-H. The latter results illustrate the prospect of treating cement on equal footing with metals and ceramics in the current application of mechanism-based models and multiscale simulations to study inelastic deformation and cracking. PMID:19805265

Pellenq, Roland J.-M.; Kushima, Akihiro; Shahsavari, Rouzbeh; Van Vliet, Krystyn J.; Buehler, Markus J.; Yip, Sidney; Ulm, Franz-Josef

2009-01-01

245

Emergence of Anisotropy in Flock Simulations and Its Computational Analysis  

NASA Astrophysics Data System (ADS)

In real flocks, it was revealed that the angular density of nearest neighbors shows a strong anisotropic structure of individuals by very recent extensive field studies [Ballerini et al, Proceedings of the National Academy of Sciences USA 105, pp. 1232-1237 (2008)]. In this paper, we show that this structure of anisotropy also emerges in an artificial flock simulation, namely, Boid simulation by Reynolds [C.W. Reynolds, Flocks, Herds, and Schools: A Distributed Behavioral Model, Computer Graphics, 21, pp. 25-34 (1987)]. To quantify the anisotropy, we evaluate a useful statistics, that is to say, the so-called ?-value which is defined as an inner product between the vector in the direction of the lowest angular density of flocks and the vector in the direction of the flock is moving. Our results concerning the emergence of the anisotropy through the ?-value might enable us to judge whether an optimal flock simulation seems to be realistic or not.

Makiguchi, Motohiro; Inoue, Jun-Ichi

2010-03-01

246

An evaluation of the emerging interventions against Respiratory Syncytial Virus (RSV)-associated acute lower respiratory infections in children  

PubMed Central

Background Respiratory Syncytial Virus (RSV) is the leading cause of acute lower respiratory infections (ALRI) in children. It is estimated to cause approximately 33.8 million new episodes of ALRI in children annually, 96% of these occurring in developing countries. It is also estimated to result in about 53,000 to 199,000 deaths annually in young children. Currently there are several vaccine and immunoprophylaxis candidates against RSV in the developmental phase targeting active and passive immunization. Methods We used a modified CHNRI methodology for setting priorities in health research investments. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging vaccines against RSV relevant to 12 criteria of interest. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to the sensitive nature of their involvement in such exercises. They answered questions from the CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%. Results In the case of candidate vaccines for active immunization of infants against RSV, the experts expressed very low levels of optimism for low product cost, affordability and low cost of development; moderate levels of optimism regarding the criteria of answerability, likelihood of efficacy, deliverability, sustainability and acceptance to end users for the interventions; and high levels of optimism regarding impact on equity and acceptance to health workers. While considering the candidate vaccines targeting pregnant women, the panel expressed low levels of optimism for low product cost, affordability, answerability and low development cost; moderate levels of optimism for likelihood of efficacy, deliverability, sustainability and impact on equity; high levels of optimism regarding acceptance to end users and health workers. The group also evaluated immunoprophylaxis against RSV using monoclonal antibodies and expressed no optimism towards low product cost; very low levels of optimism regarding deliverability, affordability, sustainability, low implementation cost and impact on equity; moderate levels of optimism against the criteria of answerability, likelihood of efficacy, acceptance to end-users and health workers; and high levels of optimism regarding low development cost. They felt that either of these vaccines would have a high impact on reducing burden of childhood ALRI due to RSV and reduce the overall childhood ALRI burden by a maximum of about 10%. Conclusion Although monoclonal antibodies have proven to be effective in providing protection to high-risk infants, their introduction in resource poor settings might be limited by high cost associated with them. Candidate vaccines for active immunization of infants against RSV hold greatest promise. Introduction of a low cost vaccine against RSV would reduce the inequitable distribution of burden due to childhood ALRI and will most likely have a high impact on morbidity and mortality due to severe ALRI. PMID:21501449

2011-01-01

247

A chimeric virus-mouse model system for evaluating the function and inhibition of papain-like proteases of emerging coronaviruses.  

PubMed

To combat emerging coronaviruses, developing safe and efficient platforms to evaluate viral protease activities and the efficacy of protease inhibitors is a high priority. Here, we exploit a biosafety level 2 (BSL-2) chimeric Sindbis virus system to evaluate protease activities and the efficacy of inhibitors directed against the papain-like protease (PLpro) of severe acute respiratory syndrome coronavirus (SARS-CoV), a biosafety level 3 (BSL-3) pathogen. We engineered Sindbis virus to coexpress PLpro and a substrate, murine interferon-stimulated gene 15 (ISG15), and found that PLpro mediates removal of ISG15 (deISGylation) from cellular proteins. Mutation of the catalytic cysteine residue of PLpro or addition of a PLpro inhibitor blocked deISGylation in virus-infected cells. Thus, deISGylation is a marker of PLpro activity. Infection of alpha/beta interferon receptor knockout (IFNAR(-/-)) mice with these chimeric viruses revealed that PLpro deISGylation activity removed ISG15-mediated protection during viral infection. Importantly, administration of a PLpro inhibitor protected these mice from lethal infection, demonstrating the efficacy of a coronavirus protease inhibitor in a mouse model. However, this PLpro inhibitor was not sufficient to protect the mice from lethal infection with SARS-CoV MA15, suggesting that further optimization of the delivery and stability of PLpro inhibitors is needed. We extended the chimeric-virus platform to evaluate the papain-like protease/deISGylating activity of Middle East respiratory syndrome coronavirus (MERS-CoV) to provide a small-animal model to evaluate PLpro inhibitors of this recently emerged pathogen. This platform has the potential to be universally adaptable to other viral and cellular enzymes that have deISGylating activities. Importance: Evaluating viral protease inhibitors in a small-animal model is a critical step in the path toward antiviral drug development. We modified a biosafety level 2 chimeric virus system to facilitate evaluation of inhibitors directed against highly pathogenic coronaviruses. We used this system to demonstrate the in vivo efficacy of an inhibitor of the papain-like protease of severe acute respiratory syndrome coronavirus. Furthermore, we demonstrate that the chimeric-virus system can be adapted to study the proteases of emerging human pathogens, such as Middle East respiratory syndrome coronavirus. This system provides an important tool to rapidly assess the efficacy of protease inhibitors targeting existing and emerging human pathogens, as well as other enzymes capable of removing ISG15 from cellular proteins. PMID:25100850

Deng, Xufang; Agnihothram, Sudhakar; Mielech, Anna M; Nichols, Daniel B; Wilson, Michael W; StJohn, Sarah E; Larsen, Scott D; Mesecar, Andrew D; Lenschow, Deborah J; Baric, Ralph S; Baker, Susan C

2014-10-01

248

Role of point of care - ST2, Galectin-3 and adrenomedullin in the evaluation and treatment of emergency patients  

PubMed Central

There have been many technological advances improving the work up and treatment of patients in the emergency department (ED). Point of care testing (POCT) is becoming more common, especially in the time compressed clinically high-pressured environment of the emergency department. In present times, emphasis of POCT has spurred search of novel biomarkers which promise earlier and more specific detection of disease. This article reviews the role of ST2, Galectin-3 and Adrenomedullin in the acute care setting addressing the screening, diagnostic, and prognostic role of each marker for stratification of patients. Use of these markers has shown a strong correlation with early identification and efficient management in the ED. PMID:25337491

Siler-Fisher, Angela; Tucci, Veronica; Kalra, Sarathi; Galwankar, Sagar C; Khose, Swapnil D; Sanjeevani, S; Goel, Ashish; Peacock, Frank W

2014-01-01

249

TRUE REALISTIC 3D MODELS OF BUILDINGS IN URBAN AREAS  

Microsoft Academic Search

Developing realistic 3D models of cities provides designers, planners, the public, and the others with imagery closely coupled with the human expertise. This paper continues on the results of an earlier innovation in the field of texture creation for the construction of Virtually Realistic Model (VRM) of buildings in urban areas. Using a CCD camera mounted on a theodolite the

M. Varshosaz

250

Realistic Simulation of Urban Mesh Networks - Part I: Urban Mobility  

Microsoft Academic Search

It is a truism that simulations of mobile wireless networks are not realistic. There has been little effort in developing realistic mobility models. In urban areas, the mobility of vehicles and pedestrians is greatly influenced by the environement (e.g., the location of buildings) as well as by interaction with other nodes. For example, on a congested street of sidewalk, nodes

Jonghyun Kim; Vinay Sridhara; Stephan Bohacek

251

Comment on "Foundation of Statistical Mechanics under Experimentally Realistic Conditions"  

E-print Network

Reimann [Phys. Rev. Lett. 101, 190403 (2008)] claimed that generic isolated macroscopic quantum system will equilibrate under experimentally realistic conditions by proving a theorem. We here show that the proof is invalid for most many-body systems and is unable to demonstrate equilibration in realistic experiment.

Zhe-Xuan Gong; L. -M. Duan

2011-09-22

252

A New Realistic Mobility Model for Mobile Ad Hoc Networks  

Microsoft Academic Search

Accurately simulating user movements in mobile ad hoc networks (MANETs) is very important to the prediction of actual network and user performance. Therefore, using a realistic mobility model is a crucial factor in enhancing the confidence in the simulation results of these networks. In this paper, we present a new mobility model for MANETs, called realistic mobility model (RMM). In

Ahmed E. Kamal; Jamal N. Al-karaki

2007-01-01

253

REALISTIC SIMULATION OF OCEAN SURFACE USING WAVE SPECTRA  

E-print Network

REALISTIC SIMULATION OF OCEAN SURFACE USING WAVE SPECTRA Jocelyn Fr´echot LaBRI - Laboratoire CEDEX, France jocelyn.frechot@labri.fr Keywords: Natural phenomena, realistic ocean waves, procedural wave spectra are independent of the ocean model, Gerstner parametric equations and Fourier transform

Paris-Sud XI, Université de

254

Foundations of quantum physics: a general realistic and operational approach  

E-print Network

Foundations of quantum physics: a general realistic and operational approach Diederik Aerts FUND of quantum physics: a general realistic and operational approach", International Journal of Theoretical examples in detail in the light of this formalism: a classical deterministic entity and a quantum entity

Aerts, Diederik

255

Face Tracking and Realistic Animations for Telecommunicant Clones  

Microsoft Academic Search

Using realistic face models and photometric modeling techniques, we present a visual feedback loop that tracks a face, without any marker or controlled lighting, throughout a video sequence and precisely recovers the face position and orientation. We also propose animation techniques to embed realistic expressions in our 3D clones. Such face models permit automatic construction of appearance models

Stéphane Valente; Jean-luc Dugelay

2000-01-01

256

Click or Strike: Realistic Versus Standard Game Controls  

E-print Network

Click or Strike: Realistic Versus Standard Game Controls in Violent Video Games and Their Effects Interaction group. Results further corroborate the complexity of aggression-related effects in violent video-Remote� , motion detection technology, gesture recognition, realistic interaction, violent video games, aggression

Paris-Sud XI, Université de

257

Automatically Generating Realistic Test Input From Web Services Mustafa Bozkurt  

E-print Network

for software testers. Realistic test data generation for certain input types is hard to automate and therefore to a quadratic growth trend. FIGURE 1: Growth in papers on web service testing [9] A recent survey by Bozkurt etAutomatically Generating Realistic Test Input From Web Services Mustafa Bozkurt CREST Centre

Harman, Mark

258

Realistic Driving Trips For Location Privacy Microsoft Research  

E-print Network

, realistic driving speeds, and spatially varying GPS noise. Keywords: location privacy, location-based services, false trips, GPS 1 Trip Simulations For Privacy Some location-based services require usersRealistic Driving Trips For Location Privacy John Krumm Microsoft Research Microsoft Corporation

Krumm, John

259

Whites' opposition to busing: Symbolic racism or realistic group conflict?  

Microsoft Academic Search

The theory of symbolic racism contends that White individuals' opposition to busing springs from a basic underlying prejudiced or intolerant attitudinal predisposition toward Blacks, not self-interest or realistic group conflict motives. The present research argues that realistic group conflict motives do help explain Whites' opposition to busing. Two major criticisms of the symbolic racism approach are made: (a) that the

Lawrence Bobo

1983-01-01

260

Grammar-Based Testing using Realistic Domains in PHP  

E-print Network

Grammar-Based Testing using Realistic Domains in PHP Ivan Enderlin, Fr´ed´eric Dadeau, Alain-based testing in PHP. It relies on the notion of realistic domains, that make it possible to assign domains to data, by means of contract assertions written inside the source code of a PHP application. Then a test

Paris-Sud XI, Université de

261

An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil  

PubMed Central

OBJECTIVE: To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life. METHODS: Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil. RESULTS: Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p<0.01), worked exclusively in prehospital care (18.0 vs 7.7%; p<0.001), with workloads >48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams* (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU. CONCLUSIONS: The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital emergencies. A disrespectful labor scenario was also found; the evaluation of quality of life showed a notable presence of pain on the SF-36 among physicians at SAMU and especially among doctors who had worked for a longer length of time at SAMU.

Tallo, Fernando Sabia; de Campos Vieira Abib, Simone; Baitello, Andre Luciano; Lopes, Renato Delascio

2014-01-01

262

Keeping Friends Close and Enemies Closer: Classical Realist Statecraft and Economic Exchange in U.S. Interwar Strategy  

Microsoft Academic Search

This article addresses the relationship between economic exchange and grand strategy and explains why rival states exchange with each other. The theoretical debate among realists is defined, while a novel, yet classical, realist exchange theory is proffered and evaluated against the record of U.S.-Japanese exchange, 1918–41. In this particular case, the origins of Japan's oil dependency on the United States

Timothy C. Lehmann

2009-01-01

263

Oligonucleotides as antivirals: dream or realistic perspective?  

PubMed

Many reports have been published on antiviral activity of synthetic oligonucleotides, targeted to act either by a true antisense effect or via non-sequence specific interactions. This short review will try to evaluate the current status of the field by focusing on the effects as reported for inhibition of either HSV-1, HCMV or HIV-1. Following an introduction with a historical background and a brief discussion on the different types of constructs and mechanisms of action, the therapeutic potential of antisense oligonucleotides as antivirals, as well as possible pitfalls upon their evaluation will be discussed. PMID:16621039

Van Aerschot, Arthur

2006-09-01

264

Characterization and Monitoring Data for Evaluating Constructed Emergent Sandbar Habitat in the Missouri River Mainstem 2004-2009  

SciTech Connect

The U.S. Army Corps of Engineers (Corps) provides the primary operational management of the Missouri River Main Stem Reservoir System. Management of the Missouri River has generally reduced peak river flows that form and maintain emergent sandbar habitat. Emergent sandbars provide non-vegetated nesting habitat for the endangered interior least tern (Sternula antillarum athalassos) and the threatened Northern Great Plains piping plover (Charadrius melodus). Since 2000, piping plover nesting habitat within the Gavins Point Reach, Garrison Reach, Lake Oahe, and Lake Sakakawea has fledged the majority of piping plovers produced along the Missouri River system. Habitats within Lewis and Clark Lake have also recently become important plover production areas. Mechanical construction of emergent sandbar habitat (ESH) within some of these reaches within the Missouri River began in 2004. Through 2009, 11 sandbar complexes had been constructed (10 in Gavins Point Reach, 1 in Lewis and Clarke Lake) totaling about 543 ac of piping plover and interior least tern nesting habitat. ESH Construction has resulted in a net gain of tern and plover nesting habitat. Both terns and plovers successfully nest and fledge young on constructed sandbars, and constructed habitats were preferred over natural habitats. Natural processes may limit the viability of constructed sandbars as nesting habitat. Continued research is needed to identify if changes in constructed sandbar engineering and management increase the length of time constructed habitats effectively function as nesting habitat. However, the transfer of information from researchers to planners through technical research reports may not be timely enough to effectively foster the feedback mechanisms of an adaptive management strategy.

Duberstein, Corey A.

2011-04-01

265

Realistic simulation of flutter flight tests  

Microsoft Academic Search

In the framework of the FLITE 2 project, identification algorithms were developed in order to monitor the evolution of the aeroelastic modes of an aircraft during flutter flight tests. Simulated data were required to evaluate and compare the algorithms and also to test their ability to detect the onset of flutter. This paper describes how this simulation was carried out.

P. Vacher; A. Bucharles

266

Higher Education Institutional and Program Evaluations in Taiwan and the Emerging Roles of Higher Education Evaluation and Accreditation Council of Taiwan (HEEACT)  

ERIC Educational Resources Information Center

Post-secondary education institutions in Taiwan are divided into two tracks, general higher education (HE) and technological and vocational education (TVE). The evaluation of all universities/colleges is mandated by the University Act. Higher education institutions receive mandated institutional evaluation every six years and program evaluation

Lee, Lung-Sheng; Wei, Yen-Shun; Wang, Li-Yun

2013-01-01

267

Evolution of resource and energy management in biologically realistic gene regulatory network models.  

PubMed

We describe the use of computational models of evolution of artificial gene regulatory networks to understand the topologies of biological gene regulatory networks. We summarize results from three complementary approaches that explicitly represent biological processes of transcription, translation, metabolism and gene regulation: a fine-grained model that allows detailed molecular interactions, a coarse-grained model that allows rapid evolution of many generations, and a fixed-architecture model that allows for comparison of different hypotheses. In the first two cases, we are able to evolve networks towards the biological fitness objectives of survival and reproduction. A theme that emerges is that the control of cell energy and resources is a major driver of gene network topology and function. This is demonstrated in the fine-grained model with the emergence of biologically realistic mRNA and protein turnover rates that optimize energy usage and cell division time, and the evolution of basic repressor activities; in the fixed architecture model with a negative self-regulating gene evolving major efficiencies in mRNA usage; and in the coarse-grained model by the need for the inclusion of basal gene expression to obtain biologically plausible networks and the emergence of global regulators keeping all cellular systems under negative control. In summary, we demonstrate the value of biologically realistic computer evolution techniques, and the importance of energy and resource management in driving the topology and function of gene regulatory networks. PMID:22821464

Stekel, Dov J; Jenkins, Dafyd J

2012-01-01

268

Evaluation/disposition of observations no. 6-17, 6-18, and 6-22 from site electrical assessment report, 300 area powerhouse and emergency sys.  

SciTech Connect

Disposition of Observations 6-17, 6-18, 6-22 of Site Electrical Assessment Report. Application of generator differential protection, and synchro-check relay rewiring for generators of building 3621-D. In 1990, the WHC Site Electrical Task Group issued a Site Electrical Assessment Report, ``300 Area Powerhouse and Emergency System.`` This report included numerous findings and observations relating to observed deficiencies or opportunities for improvement in maintenance of the inspected electrical systems. The purpose of this letter report is to provide an evaluation and proposed disposition of Observations No. 6-1 7, 6-1 8, and 6-22 of the Site Electrical Assessment Report.

Ahola, E.L.

1996-09-30

269

Evaluation, modification and validation of a set of asthma illustrations in children with chronic asthma in the emergency department  

PubMed Central

OBJECTIVES: To test, modify and validate a set of illustrations depicting different levels of asthma control and common asthma triggers in pediatric patients (and/or their parents) with chronic asthma who presented to the emergency department at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario. METHODS: Semistructured interviews using guessability and translucency questionnaires tested the comprehensibility of 15 illustrations depicting different levels of asthma control and common asthma triggers in children 10 to 17 years of age, and parents of children one to nine years of age who presented to the emergency department. Illustrations with an overall guessability score <80% and/or translucency median score <6, were reviewed by the study team and modified by the study’s graphic designer. Modifications were made based on key concepts identified by study participants. RESULTS: A total of 80 patients were interviewed. Seven of the original 15 illustrations (47%) required modifications to obtain the prespecified guessability and translucency goals. CONCLUSION: The authors successfully developed, modified and validated a set of 15 illustrations representing different levels of asthma control and common asthma triggers. PRACTICE IMPLICATIONS: These illustrations will be incorporated into a child-friendly asthma action plan that enables the child to be involved in his or her asthma self-management care. PMID:22332128

Tulloch, Joanie; Vaillancourt, Régis; Irwin, Danica; Pascuet, Elena

2012-01-01

270

Evaluation of the Simplify D-dimer assay as a screening test for the diagnosis of deep vein thrombosis in an emergency department  

PubMed Central

Objectives: To evaluate the use in an emergency department of a new D-dimer assay (Simplify D-dimer) as a screening test for deep vein thrombosis (DVT). Methods: 187 outpatients with clinical features suspicious of acute DVT were entered into this study. A Simplify D-dimer test was performed in the emergency department on all patients. A SimpliRED D-dimer test and a semi-automated latex agglutination assay (Auto-D-dimer 700 on a Thromboscreen 400C analyser) were performed in the haematology laboratory. All patients were investigated with contrast venography to confirm or exclude the diagnosis of DVT. Results: The Simplify test had a sensitivity of 94.1% and a negative predictive value (NPV) of 94.8%. These results compared favourably with the SimpliRED test (sensitivity 74.5%, NPV 89.7%) and the latex agglutination assay (sensitivity 90.2%, NPV 92.2%). This increased sensitivity was at the cost of a lower specificity, the specificity of the three D-dimer tests being Simplify 40.4%, SimpliRED 83.1%, and latex agglutination 43.4%. Conclusions: Simplify proved to be a rapid and easy to use test and may be useful for use in the emergency department as part of a diagnostic algorithm for deep vein thrombosis. Further larger scale studies are needed. PMID:15496688

Neale, D; Tovey, C; Vali, A; Davies, S; Myers, K; Obiako, M; Ramkumar, V; Hafiz, A

2004-01-01

271

Relativistic description of finite nuclei based on realistic NN interactions  

SciTech Connect

A set of relativistic mean-field models is constructed, which includes the Hartree and Hartree-Fock (HF) approximations accounting for the exchange of isoscalar and isovector mesons as well as the pion. Density-dependent coupling functions are determined to reproduce the components of the nucleon self-energy at the Fermi surface, obtained within the Dirac-Brueckner-HF (DBHF) approach by using a realistic nucleon-nucleon interaction. It is investigated to which extent the various mean-field models can reproduce the DBHF results for the momentum dependence of the self-energies and the total energy of infinite matter. Also, the mean-field models are used to evaluate the bulk properties of spherical closed-shell nuclei. We find that the HF model, which allows for the exchange of {sigma}, {omega}, {rho}, and {delta} mesons and pions, yields the best reproduction of the DBHF results in infinite matter and also provides a good description of the properties of finite nuclei without any adjustment of parameters.

Dalen, E. N. E. van; Muether, H. [Institut fuer Theoretische Physik, Universitaet Tuebingen, Auf der Morgenstelle 14, D-72076 Tuebingen (Germany)

2011-08-15

272

Unsteady transonic algorithm improvements for realistic aircraft applications  

NASA Technical Reports Server (NTRS)

Improvements to a time-accurate approximate factorization (AF) algorithm were implemented for steady and unsteady transonic analysis of realistic aircraft configurations. These algorithm improvements were made to the CAP-TSD (Computational Aeroelasticity Program - Transonic Small Disturbance) code developed at the Langley Research Center. The code permits the aeroelastic analysis of complete aircraft in the flutter critical transonic speed range. The AF algorithm of the CAP-TSD code solves the unsteady transonic small-disturbance equation. The algorithm improvements include: an Engquist-Osher (E-O) type-dependent switch to more accurately and efficiently treat regions of supersonic flow; extension of the E-O switch for second-order spatial accuracy in these regions; nonreflecting far field boundary conditions for more accurate unsteady applications; and several modifications which accelerate convergence to steady-state. Calculations are presented for several configurations including the General Dynamics one-ninth scale F-16C aircraft model to evaluate the algorithm modifications. The modifications have significantly improved the stability of the AF algorithm and hence the reliability of the CAP-TSD code in general.

Batina, John T.

1987-01-01

273

Retained Intra-Abdominal Surgical Clamp Complicating Emergency Laparotomy: Incidental Finding on Hysterosalpingogram for Evaluation of Tubal Infertility  

PubMed Central

The finding of intraperitoneal foreign body complicating surgical intervention broadly remains as an issue of safety in the operative room, a source of emotive concern for the patient, and an upsetting but equally embarrassing situation to the surgeon and the team. However, in the media world, it is a source of sumptuous and captivating headline on the newspaper and to the legal profession, an attractive case to prosecute. A middle age teacher presented with secondary infertility. She had emergency laparotomy fifteen years ago for ruptured tubal ectopic pregnancy in a private hospital and postoperative period was uneventful. Amongst other investigations to find out the cause of infertility, she had hysterosalpingography and a radio-opaque clamp was visualized on the films. She was counselled and had laparotomy. A pair of surgical Kocher clamps was retrieved buried in the mesentery.

Adesiyun, Adebiyi Gbadebo; Ameh, Nkeiruka; Umar-Sullayman, Hajaratu; Avidime, Solomon; Aliyu, Rabia't

2014-01-01

274

Evaluation of the Recognition of Stroke in the Emergency Room (ROSIER) Scale in Chinese Patients in Hong Kong  

PubMed Central

Background and Purpose The objective of this study was to determine the performance of the Recognition Of Stroke In the Emergency Room (ROSIER) scale in risk-stratifying Chinese patients with suspected stroke in Hong Kong. Methods This was a prospective cohort study in an urban academic emergency department (ED) over a 7-month period. Patients over 18 years of age with suspected stroke were recruited between June 2011 and December 2011. ROSIER scale assessment was performed in the ED triage area. Logistic regression analysis was used to estimate the impacts of diagnostic variables, including ROSIER scale, past history and ED characteristics. Findings 715 suspected stroke patients were recruited for assessment, of whom 371 (52%) had acute cerebrovascular disease (302 ischaemic strokes, 24 transient ischaemic attacks (TIA), 45 intracerebral haemorrhages), and 344 (48%) had other illnesses i.e. stroke mimics. Common stroke mimics were spinal neuropathy, dementia, labyrinthitis and sepsis. The suggested cut-off score of>0 for the ROSIER scale for stroke diagnosis gave a sensitivity of 87% (95%CI 83–90), a specificity of 41% (95%CI 36–47), a positive predictive value of 62% (95%CI 57–66), and a negative predictive value of 75% (95%CI 68–81), and the AUC was 0.723. The overall accuracy at cut off>0 was 65% i.e. (323+141)/715. Interpretation The ROSIER scale was not as effective at differentiating acute stroke from stroke mimics in Chinese patients in Hong Kong as it was in the original studies, primarily due to a much lower specificity. If the ROSIER scale is to be clinically useful in Chinese suspected stroke patients, it requires further refinement. PMID:25343496

Jiang, Hui-lin; Chan, Cangel Pui-yee; Leung, Yuk-ki; Li, Yun-mei; Graham, Colin A.; Rainer, Timothy H.

2014-01-01

275

The implementation and evaluation of the Emergency Response Dose Assessment System (ERDAS) at Cape Canaveral Air Station/Kennedy Space Center  

SciTech Connect

NASA and the Air Force at Kennedy Space Center/Cape Canaveral Air Station (KSC/CCAS) are attempting to upgrade and improve their capabilities for emergency response dispersion modeling and mesoscale meteorological forecasting. Their goal is to improve short range forecasts (up to 24 hours) for phenomena such as thunderstorms and sea breezes and to more accurately predict toxic diffusion concentrations in case of hazardous spills. To assist NASA and the Air Force in achieving this goal, the Applied Meteorology Unit (AMU) has been evaluating the Emergency Response Dose Assessment System (ERDAS). ERDAS is a prototype software and hardware system configured to produce routine mesoscale meteorological forecasts and enhanced dispersion estimates on an operational basis for the KSC/CCAS region. ERDAS includes two major software systems which is run and accessed through a graphical user interface. The first software system is the Regional Atmospheric Modeling System (RAMS), a three-dimensional, multiple nested grid prognostic mesoscale model. The second software system is the Hybrid Particle and Concentration Transport (HYPACT) model, a pollutant trajectory and concentration model. ERDAS also runs the Rocket Exhaust Effluent Diffusion Model (REEDM). This paper describes the system, the model evaluation, the process of transitioning ERDAS from a research project to an operational system, and also presents the results of the launch case studies.

Evans, R.J. [ENSCO, Inc., Melbourne, FL (United States). Applied Meteorology Unit; Tremback, C.J.; Lyons, W.A. [MRC/ASTER, Ft. Collins, CO (United States)

1996-12-31

276

Entrepreneurial Education: A Realistic Alternative for Women and Minorities.  

ERIC Educational Resources Information Center

Entrepreneurial education is a valid, realistic occupational training alternative for minorities and women in business. Entrepreneurship requires that one become involved with those educational programs that contribute significantly to one's success. (Author)

Steward, James F.; Boyd, Daniel R.

1989-01-01

277

Student Work Experience: A Realistic Approach to Merchandising Education.  

ERIC Educational Resources Information Center

Relevant and realistic experiences are needed to prepare the student for a future career. Addresses the results of a survey of colleges and universities in the United States in regard to their student work experience (SWE) in fashion merchandising. (Author)

Horridge, Patricia; And Others

1980-01-01

278

Comparative Evaluation of Stroke Triage Algorithms for Emergency Medical Dispatchers (MeDS): Prospective Cohort Study Protocol  

PubMed Central

Background Stroke is a major cause of death and leading cause of disability in the United States. To maximize a stroke patient's chances of receiving thrombolytic treatment for acute ischemic stroke, it is important to improve prehospital recognition of stroke. However, it is known from published reports that emergency medical dispatchers (EMDs) using Card 28 of the Medical Priority Dispatch System protocols recognize stroke poorly. Therefore, to improve EMD's recognition of stroke, the National Association of Emergency Medical Dispatchers recently designed a new diagnostic stroke tool (Cincinnati Stroke Scale -CSS) to be used with Card 28. The objective of this study is to determine whether the addition of CSS improves diagnostic accuracy of stroke triage. Methods/Design This prospective experimental study will be conducted during a one-year period in the 911 call center of Santa Clara County, CA. We will include callers aged ? 18 years with a chief complaint suggestive of stroke and second party callers (by-stander or family who are in close proximity to the patient and can administer the tool) ? 18 years of age. Life threatening calls will be excluded from the study. Card 28 questions will be administered to subjects who meet study criteria. After completion of Card 28, CSS tool will be administered to all calls. EMDs will record their initial assessment of a cerebro-vascular accident (stroke) after completion of Card 28 and their final assessment after completion of CSS. These assessments will be compared with the hospital discharge diagnosis (ICD-9 codes) recorded in the Office of Statewide Health Planning and Development (OSHPD) database after linking the EMD database and OSHPD database using probabilistic linkage. The primary analysis will compare the sensitivity of the two stroke protocols using logistic regression and generalizing estimating equations to account for clustering by EMDs. To detect a 15% difference in sensitivity between the two groups with 80% power, we will enroll a total of 370 subjects in this trial. Discussion A three week pilot study was performed which demonstrated the feasibility of implementation of the study protocol. PMID:21272365

2011-01-01

279

OCCLUSION-FREE IMAGE GENERATION FOR REALISTIC TEXTURE MAPPING  

Microsoft Academic Search

ABSTRACT: Photo-realistic 3D models are nowadays,required in many applications. The 3D modelling pipeline can be imageor range-based and often ends up with ,a visualization ,of a ,virtual textured model. One of the ,main ,problems ,encountered ,in texture mapping ,is the disturbance in the images by occlusions, which do not allow the generation of photo-realistic textured 3D models. Occlusions can be

Diego Ortin; Fabio Remondino

280

A left realist approach to antifeminist fathers’ rights groups  

Microsoft Academic Search

Despite earlier critiques of left realists’ failure to adequately address feminist concerns, recent left realist theorizing\\u000a and empirical research have made valuable contributions to the understanding of woman abuse and other forms of gendered violence.\\u000a Left realism has further potential to contribute to the criminological understanding of woman abuse and its contributing socioeconomic\\u000a and cultural contexts. This article describes left

Molly Dragiewicz

2010-01-01

281

Emergency Contraception  

MedlinePLUS

... expected period after taking it. Continue Protection Against STDs Emergency contraception does not protect against sexually transmitted diseases (STDs) . Couples having sex must always use condoms ...

282

Evaluation of pulse oximetry in sickle cell anemia patients presenting to the emergency department in acute vasoocclusive crisis  

Microsoft Academic Search

This prospective study was done to evaluate the accuracy of pulse oximetry as an indicator of hypoxemia in sickle cell anemia patients presenting to the ED in acute vasoocculsive crisis. Thirteen patients (age older than 18 years) presenting in crisis, with pulse oximetry readings less than 95% had arterial blood gas (ABG) analysis performed. The mean pulse oximetry reading was

John T Comber; Bernard L Lopez

1996-01-01

283

Climate change impacts on irrigated maize in Mediterranean climates: Evaluation of double cropping as an emerging adaptation alternative  

Microsoft Academic Search

Because its relevance for the sustenance and livelihood of human systems, the assessment of the impacts that future climatic conditions may have on agricultural productivity becomes a key piece of information for agricultural scientists and policy makers.Several authors have performed assessments of the impacts of climate change on agricultural productivity evaluating alternatives for adaptation that are closely related to current

Francisco J. Meza; Daniel Silva; Hernán Vigil

2008-01-01

284

Southern Schools: An Evaluation of the Effects of the Emergency School Assistance Program and of School Desegregation. Volume I.  

ERIC Educational Resources Information Center

This evaluation sampled 150 pairs of schools (50 pairs of high schools and 100 pairs of elementary schools) eligible for ESAP funds, randomly designating one school from each pair as a control school to receive no ESAP funds and using a flip of the coin to so designate. The first volume of the report comprises four chapters and seven appendices.…

Crain, Robert L., Ed.

285

An analysis of Chemical Stockpile Emergency Preparedness Program exercise results. Volume 2: Preliminary evaluation and analysis of CSEPP exercise database  

SciTech Connect

This study investigated the quality and usefulness of the information in the Chemical Stockpile Emergency Preparedness Program (CSEPP) exercise database. It incorporates the results of two separate analytical efforts. The first effort investigated the process of assigning standardized codes to issues identified in CSEPP exercise reports. A small group of issues was coded independently by each of several individuals, and the results of the individual codings were compared. Considerable differences were found among the individuals` codings. The second effort consisted of a statistical multivariate analysis, to investigate whether exercise issues are evenly distributed among exercise tabs, sites, and objectives. It was found that certain tabs, sites, and objectives were disproportionately associated with problem areas in exercises. In some cases, these problem areas have persisted over time, but in other cases they have undergone significant shifts over the time span of the investigation. The study concludes that the database can be a useful resource for analyzing problem areas and setting priorities for CSEPP program resources. However, some further analyses should be performed in order to more fully explore the data and increase confidence in the results.

Wernette, D.; Lerner, K.

1998-06-01

286

OpenAirInterface Traffic Generator (OTG): A Realistic Traffic Generation Tool for Emerging  

E-print Network

of new application scenarios such as online gaming and machine-type communication. To highlight the capability and new features of the tool, the one-way delay of OpenArena online gaming application, with new access technologies, new client devices and with more and more services and ap- plications. High

Gesbert, David

287

Emergence of Joint Attention through Bootstrap Learning based on the Mechanisms of Visual Attention and Learning with Self-evaluation  

NASA Astrophysics Data System (ADS)

This study argues how human infants acquire the ability of joint attention through interactions with their caregivers from a viewpoint of cognitive developmental robotics. In this paper, a mechanism by which a robot acquires sensorimotor coordination for joint attention through bootstrap learning is described. Bootstrap learning is a process by which a learner acquires higher capabilities through interactions with its environment based on embedded lower capabilities even if the learner does not receive any external evaluation nor the environment is controlled. The proposed mechanism for bootstrap learning of joint attention consists of the robot's embedded mechanisms: visual attention and learning with self-evaluation. The former is to find and attend to a salient object in the field of the robot's view, and the latter is to evaluate the success of visual attention, not joint attention, and then to learn the sensorimotor coordination. Since the object which the robot looks at based on visual attention does not always correspond to the object which the caregiver is looking at in an environment including multiple objects, the robot may have incorrect learning situations for joint attention as well as correct ones. However, the robot is expected to statistically lose the learning data of the incorrect ones as outliers because of its weaker correlation between the sensor input and the motor output than that of the correct ones, and consequently to acquire appropriate sensorimotor coordination for joint attention even if the caregiver does not provide any task evaluation to the robot. The experimental results show the validity of the proposed mechanism. It is suggested that the proposed mechanism could explain the developmental mechanism of infants' joint attention because the learning process of the robot's joint attention can be regarded as equivalent to the developmental process of infants' one.

Nagai, Yukie; Hosoda, Koh; Morita, Akio; Asada, Minoru

288

Out-of-hours emergency dental services – evaluation of the first year of a pilot project in Fife  

Microsoft Academic Search

The Scottish Executive Health Department approved funding in 2001 for Fife NHS Board to pilot an integrated model of out-of-hours dental services based upon a dental nurse-led triage system during the evenings, weekends and some public holidays. After one year of the pilot project the activity was evaluated by analysing the triage database. Nearly 4,000 calls were received – Fridays

G V A Topping

2005-01-01

289

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital  

PubMed Central

Background Blood products and derivatives are indispensable resources in medical therapies. However, it is important to note that the number of donations is far from ideal. Despite constant campaign efforts, a deficit of 1 million units is expected by 2030. Objectives To determine the adequacy of the indications for red blood cell transfusion in an emergency hospital in Alagoas. Methods This was a cross-sectional observational study conducted at the Alagoas Blood Center. Of a total of 2936 red blood cell transfusion requests in 2009, 334 were randomized and compared with transfusion parameters described in the literature (primary variable). After analysis, the transfusion requests were categorized as adequate, inadequate or inconclusive. This last group included all red blood cell transfusion requests with insufficient clinical information, rendering their classification as adequate or inadequate impossible. The secondary variable involved the reasons for red blood cell transfusion. A 95% confidence interval was used in the statistical analysis. Results Forty-seven (14.07%) requests were adequate and 30 (8.98%) were inadequate. Most of the requests were classified as inconclusive (76.94%). The main indications for transfusion were upper gastrointestinal bleeding (26.95%), anemia (46.71%), hypovolemia/hypovolemic shock (10.78%) and sepsis/septic shock (3.29%). Conclusion It was not possible to reach a conclusion on the adequacy of the indication for transfusion in most of the cases. Therefore, it is important to adopt a transfusion protocol, rigorously analyze blood bank requests, to provide awareness campaigns on the rational use of blood and to implement strategies to use blood products more effectively. PMID:24106444

de Souza, Diego Agra; Silva, Felipe Gama e; Costa, Paulo José Medeiros de Souza

2013-01-01

290

Retrospective Evaluation of a Computerized Physician Order Entry Adaptation to Prevent Prescribing Errors in a Pediatric Emergency Department  

PubMed Central

Objective The goal was to determine the impact on medication prescribing errors of adding a pediatric medication list (quicklist) to a computerized physician order entry system in a pediatric emergency department. Methods The quicklist is a drug dosing support tool that targets the most common medications in our clinical setting. We performed a retrospective comparison of orders from 420 randomly selected visits before and after quicklist introduction. Error rates were analyzed with respect to urgency level, physician training level, and patient age. The quicklist was examined for frequency of use and error rates. Results The 840 patient visits (420 before intervention and 420 after intervention) generated 724 medication orders, which contained 156 medication prescribing errors (21%). The groups did not differ with respect to urgency level, physician training level, or patient age. There were significant decreases in the rate of errors per 100 visits, from 24 to 13 errors per 100 visits, and in the rate of errors per 100 orders, from 31 to 14 errors per 100 orders. The decrease in the error rates did not vary according to urgency score, age group, or physician training level. The quicklist was used in 30% of the orders in the postintervention group. In this group, the error rate was 1.9 errors per 100 orders when the quicklist was used, compared with 18.3 errors per 100 orders when the list was not used. Errors of wrong formulation, allergy, drug-drug interaction, and rule violations were eliminated. Conclusion The introduction of the quicklist was followed by a significant reduction in medication prescribing errors. A list with dosing support for commonly used pediatric medications may help adapt computerized physician order entry systems designed for adults to serve pediatric populations more effectively. PMID:18829802

Sard, Brian E.; Walsh, Kathleen E.; Doros, Gheorghe; Hannon, Megan; Moschetti, Wayne; Bauchner, Howard

2014-01-01

291

Psychiatric Emergencies  

PubMed Central

Dr. Bayrakal believes that the time has come for the family physician to deal with minor psychiatric disturbances in his office as well as psychiatric emergencies in the emergency department. The newly emerging medico-social philosophy of both the federal and provincial governments, he says, is giving greater responsibility and authority to the family physician in every area of medicine, including psychiatry. The author discusses major psychiatric emergencies (suicide, suicidal attempt, homicide, social scandal, as well as other psychiatric emergencies) on the ward including adolescent psychiatry. (The descriptions and treatment procedures are given on a concrete clinical level without theoretical overload.) In the family physician's work, psychological understanding is of profound importance. Giving him the added scope of psychiatric consideration to see the patient in bio-psycho-social totality will enable him to practice a more humanized form of medicine. PMID:20468779

Bayrakal, Sadi

1972-01-01

292

Emergent Patterns of Mate Choice in Human Populations  

Microsoft Academic Search

Abstract: We present a model of human mate choice that shows how realisticpopulation-level patterns of assortative mating can self-organizeand emerge from the behavior of individuals using simple mate searchrules. In particular, we model plausible psychological mechanisms formate search and choice in a realistic social ecology. Through individualinteractions, patterns emerge that match those observed in typical humansocieties, particularly in terms of

Jorge Simão; Peter M. Todd

2003-01-01

293

The Implementation and Evaluation of the Emergency Response Dose Assessment System (ERDAS) at Cape Canaveral Air Station/Kennedy Space Center  

NASA Technical Reports Server (NTRS)

The Emergency Response Dose Assessment System (ERDAS) is a system which combines the mesoscale meteorological prediction model RAMS with the diffusion models REEDM and HYPACT. Operators use a graphical user interface to run the models for emergency response and toxic hazard planning at CCAS/KCS. The Applied Meteorology Unit has been evaluating the ERDAS meteorological and diffusion models and obtained the following results: (1) RAMS adequately predicts the occurrence of the daily sea breeze during non-cloudy conditions for several cases. (2) RAMS shows a tendency to predict the sea breeze to occur slightly earlier and to move it further inland than observed. The sea breeze predictions could most likely be improved by better parameterizing the soil moisture and/or sea surface temperatures. (3) The HYPACT/REEDM/RAMS models accurately predict launch plume locations when RAMS winds are accurate and when the correct plume layer is modeled. (4) HYPACT does not adequately handle plume buoyancy for heated plumes since all plumes are presently treated as passive tracers. Enhancements should be incorporated into the ERDAS as it moves toward being a fully operational system and as computer workstations continue to increase in power and decrease in cost. These enhancements include the following: activate RAMS moisture physics; use finer RAMS grid resolution; add RAMS input parameters (e.g. soil moisture, radar, and/or satellite data); automate data quality control; implement four-dimensional data assimilation; modify HYPACT plume rise and deposition physics; and add cumulative dosage calculations in HYPACT.

Evans, Randolph J.; Tremback, Craig J.; Lyons, Walter A.

1996-01-01

294

Description and validation of realistic and structured endourology training model  

PubMed Central

Purpose: The aim of the present study was to validate a model of training, which combines the use of non-biological and ex vivo biological bench models, as well as the modelling of urological injuries for endourological treatment in a porcine animal model. Material and Methods: A total of 40 participants took part in this study. The duration of the activity was 16 hours. The model of training was divided into 3 levels: level I, concerning the acquisition of basic theoretical knowledge; level II, involving practice with the bench models and level III, concerning practice in the porcine animal model. First, trainees practiced with animals without using a model of injured (ureteroscopy, management of guide wires and catheters under fluoroscopic control) and later practiced in lithiasic animal model. During the activity, an evaluation of the face and content validity was conducted, as well as constructive validation provided by the trainees versus experts. Evolution of the variables during the course within each group was analysed using the Student’s t test for paired samples, while comparisons between groups, were performed using the Student’s t test for unpaired samples. Results: The assessments of face and content validity were satisfactory. The constructive validation, “within one trainee” shows that were statistical significant differences between the first time the trainees performed the tasks in the animal model and the last time, mainly in the knowledge of procedure and Holmium laser lithotripsy cathegories. At the beginning of level III, there are also statistical significant differences between trainee’s scores and the expert’s scores.Conclusions: This realistic Endourology training model allows the acquisition of knowledge and technical and non-technical skills as evidenced by the face, content and constructive validity. Structured use of bench models (biological and non biological) and animal model simulators increase the endourological basic skills. PMID:25374928

Soria, Federico; Morcillo, Esther; Sanz, Juan Luis; Budia, Alberto; Serrano, Alvaro; Sanchez-Margallo, Francisco M

2014-01-01

295

Evaluation of the impact of implementing the emergency medical services traumatic brain injury guidelines in Arizona: the Excellence in Prehospital Injury Care (EPIC) study methodology.  

PubMed

Traumatic brain injury (TBI) exacts a great toll on society. Fortunately, there is growing evidence that the management of TBI in the early minutes after injury may significantly reduce morbidity and mortality. In response, evidence-based prehospital and in-hospital TBI treatment guidelines have been established by authoritative bodies. However, no large studies have yet evaluated the effectiveness of implementing these guidelines in the prehospital setting. This article describes the background, design, implementation, emergency medical services (EMS) treatment protocols, and statistical analysis of a prospective, controlled (before/after), statewide study designed to evaluate the effect of implementing the EMS TBI guidelines-the Excellence in Prehospital Injury Care (EPIC) study (NIH/NINDS R01NS071049, "EPIC"; and 3R01NS071049-S1, "EPIC4Kids"). The specific aim of the study is to test the hypothesis that statewide implementation of the international adult and pediatric EMS TBI guidelines will significantly reduce mortality and improve nonmortality outcomes in patients with moderate or severe TBI. Furthermore, it will specifically evaluate the effect of guideline implementation on outcomes in the subgroup of patients who are intubated in the field. Over the course of the entire study (~9 years), it is estimated that approximately 25,000 patients will be enrolled. PMID:25112451

Spaite, Daniel W; Bobrow, Bentley J; Stolz, Uwe; Sherrill, Duane; Chikani, Vatsal; Barnhart, Bruce; Sotelo, Michael; Gaither, Joshua B; Viscusi, Chad; Adelson, P David; Denninghoff, Kurt R

2014-07-01

296

Realistic real-time outdoor rendering in augmented reality.  

PubMed

Realistic rendering techniques of outdoor Augmented Reality (AR) has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps). Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems. PMID:25268480

Kolivand, Hoshang; Sunar, Mohd Shahrizal

2014-01-01

297

Realistic Real-Time Outdoor Rendering in Augmented Reality  

PubMed Central

Realistic rendering techniques of outdoor Augmented Reality (AR) has been an attractive topic since the last two decades considering the sizeable amount of publications in computer graphics. Realistic virtual objects in outdoor rendering AR systems require sophisticated effects such as: shadows, daylight and interactions between sky colours and virtual as well as real objects. A few realistic rendering techniques have been designed to overcome this obstacle, most of which are related to non real-time rendering. However, the problem still remains, especially in outdoor rendering. This paper proposed a much newer, unique technique to achieve realistic real-time outdoor rendering, while taking into account the interaction between sky colours and objects in AR systems with respect to shadows in any specific location, date and time. This approach involves three main phases, which cover different outdoor AR rendering requirements. Firstly, sky colour was generated with respect to the position of the sun. Second step involves the shadow generation algorithm, Z-Partitioning: Gaussian and Fog Shadow Maps (Z-GaF Shadow Maps). Lastly, a technique to integrate sky colours and shadows through its effects on virtual objects in the AR system, is introduced. The experimental results reveal that the proposed technique has significantly improved the realism of real-time outdoor AR rendering, thus solving the problem of realistic AR systems. PMID:25268480

Kolivand, Hoshang; Sunar, Mohd Shahrizal

2014-01-01

298

A generic framework to simulate realistic lung, liver and renal pathologies in CT imaging.  

PubMed

Realistic three-dimensional (3D) mathematical models of subtle lesions are essential for many computed tomography (CT) studies focused on performance evaluation and optimization. In this paper, we develop a generic mathematical framework that describes the 3D size, shape, contrast, and contrast-profile characteristics of a lesion, as well as a method to create lesion models based on CT data of real lesions. Further, we implemented a technique to insert the lesion models into CT images in order to create hybrid CT datasets. This framework was used to create a library of realistic lesion models and corresponding hybrid CT images. The goodness of fit of the models was assessed using the coefficient of determination (R(2)) and the visual appearance of the hybrid images was assessed with an observer study using images of both real and simulated lesions and receiver operator characteristic (ROC) analysis. The average R(2) of the lesion models was 0.80, implying that the models provide a good fit to real lesion data. The area under the ROC curve was 0.55, implying that the observers could not readily distinguish between real and simulated lesions. Therefore, we conclude that the lesion-modeling framework presented in this paper can be used to create realistic lesion models and hybrid CT images. These models could be instrumental in performance evaluation and optimization of novel CT systems. PMID:25325156

Solomon, Justin; Samei, Ehsan

2014-11-01

299

A generic framework to simulate realistic lung, liver and renal pathologies in CT imaging  

NASA Astrophysics Data System (ADS)

Realistic three-dimensional (3D) mathematical models of subtle lesions are essential for many computed tomography (CT) studies focused on performance evaluation and optimization. In this paper, we develop a generic mathematical framework that describes the 3D size, shape, contrast, and contrast-profile characteristics of a lesion, as well as a method to create lesion models based on CT data of real lesions. Further, we implemented a technique to insert the lesion models into CT images in order to create hybrid CT datasets. This framework was used to create a library of realistic lesion models and corresponding hybrid CT images. The goodness of fit of the models was assessed using the coefficient of determination (R2) and the visual appearance of the hybrid images was assessed with an observer study using images of both real and simulated lesions and receiver operator characteristic (ROC) analysis. The average R2 of the lesion models was 0.80, implying that the models provide a good fit to real lesion data. The area under the ROC curve was 0.55, implying that the observers could not readily distinguish between real and simulated lesions. Therefore, we conclude that the lesion-modeling framework presented in this paper can be used to create realistic lesion models and hybrid CT images. These models could be instrumental in performance evaluation and optimization of novel CT systems.

Solomon, Justin; Samei, Ehsan

2014-11-01

300

Speaker Verification in Realistic Noisy Environment in Forensic Science  

NASA Astrophysics Data System (ADS)

In forensic voice telephony speaker verification, we may be requested to identify a speaker in a very noisy environment, unlike the conditions in general research. In a noisy environment, we process speech first by clarifying it. However, the previous study of speaker verification from clarified speech did not yield satisfactory results. In this study, we experimented on speaker verification with clarification of speech in a noisy environment, and we examined the relationship between improving acoustic quality and speaker verification results. Moreover, experiments with realistic noise such as a crime prevention alarm and power supply noise was conducted, and speaker verification accuracy in a realistic environment was examined. We confirmed the validity of speaker verification with clarification of speech in a realistic noisy environment.

Kamada, Toshiaki; Minematsu, Nobuaki; Osanai, Takashi; Makinae, Hisanori; Tanimoto, Masumi

301

NEUROLOGY/CLINICAL POLICY Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department with Syncope From the American College of Emergency Physicians Clinical Policies Subcommittee (Writing Com  

E-print Network

Policy statements and clinical policies are the official policies of the American College of Emergency Physicians and, as such, are not subject to the same peer review process as articles appearing in the print journal. Policy statements and clinical policies of ACEP do not necessarily reflect the policies and beliefs of Annals of Emergency Medicine and its editors. 0196-0644/$-see front matter Copyright © 2007 by the American College of Emergency Physicians. doi:10.1016/j.annemergmed.2007.02.001

J. Stephen Huff; Md (subcommittee Chair; Wyatt W. Decker; James V. Quinn; Andrew D. Perron; Anthony M. Napoli; Md (emra Representative; Wyatt W. Decker; Deborah B. Diercks; Jonathan A. Edlow; Francis M. Fesmire; Steven A. Godwin; Sigrid A. Hahn; John M. Howell; J. Stephen Huff; Thomas W. Lukens; Scott M. Silvers; Stephen J. Wolf

2007-01-01

302

Images of Poverty in Contemporary Realistic Fiction for Youth: Preliminary Results of a Content Analysis Using a Social Psychological Conceptual Framework.  

ERIC Educational Resources Information Center

This preliminary study of 20 contemporary realistic fiction books for youth, in middle school and above, analyzed images of poverty using a framework adapted from the work of Robert Leahy. Findings are related to demographics, images of poverty and emerging themes. Results indicate that, as a whole, the sample of books rely on concrete images of…

Fitzgibbons, Shirley A.; Tilley, Carol L.

303

Evaluation of Meropenem Regimens Suppressing Emergence of Resistance in Acinetobacter baumannii with Human Simulated Exposure in an In Vitro Intravenous-Infusion Hollow-Fiber Infection Model.  

PubMed

The emergence of resistance to carbapenems in Pseudomonas aeruginosa can be suppressed by optimizing the administration of meropenem. However, whether the same is true for Acinetobacter baumannii is not fully understood. We assessed the bactericidal activity of meropenem and its potency to suppress the emergence of resistance in A. baumannii with human simulated exposure in an in vitro intravenous-infusion hollow-fiber infection model (HFIM). Two clinical strains of carbapenem-susceptible multidrug-resistant A. baumannii (CS-MDRAB), CSRA24 and CSRA91, were used, and their MICs and mutant prevention concentrations (MPCs) were determined. Six meropenem dosage regimens (0.5, 1.0, or 2.0 g given every 8 h [q8h] with a 0.5-h or 3-h infusion for seven consecutive days) were simulated and then evaluated in the HFIM. Both the total population and resistant subpopulations of the two strains were quantified. Drug concentrations were measured by high-performance liquid chromatography. All dosage regimens, except for the lowest dosage (0.5 g for both the 0.5-h and 3-h infusions), showed 3-log CFU/ml bacterial killing. Dosage regimens of 2.0 g with 0.5-h and 3-h infusions exhibited an obvious bactericidal effect and suppressed resistance. Selective amplification of subpopulations with reduced susceptibility to meropenem was suppressed with a percentage of the dosage interval in which meropenem concentrations exceeded the MPC (T>MPC) of ?20% or with a ratio of T>MPC to the percentage of the dosage interval in which drug concentrations are within the mutant selection window of ?0.25. Our in vitro data support the use of a high dosage of meropenem (2.0 g q8h) for the treatment of severe infection caused by CS-MDRAB. PMID:25182633

Li, Xin; Wang, Lin; Zhang, Xian-Jia; Yang, Yang; Gong, Wei-Tao; Xu, Bin; Zhu, Ying-Qun; Liu, Wei

2014-11-01

304

Evaluation of the DAVROS (Development And Validation of Risk-adjusted Outcomes for Systems of emergency care) risk-adjustment model as a quality indicator for healthcare  

PubMed Central

Background and objective Risk-adjusted mortality rates can be used as a quality indicator if it is assumed that the discrepancy between predicted and actual mortality can be attributed to the quality of healthcare (ie, the model has attributional validity). The Development And Validation of Risk-adjusted Outcomes for Systems of emergency care (DAVROS) model predicts 7-day mortality in emergency medical admissions. We aimed to test this assumption by evaluating the attributional validity of the DAVROS risk-adjustment model. Methods We selected cases that had the greatest discrepancy between observed mortality and predicted probability of mortality from seven hospitals involved in validation of the DAVROS risk-adjustment model. Reviewers at each hospital assessed hospital records to determine whether the discrepancy between predicted and actual mortality could be explained by the healthcare provided. Results We received 232/280 (83%) completed review forms relating to 179 unexpected deaths and 53 unexpected survivors. The healthcare system was judged to have potentially contributed to 10/179 (8%) of the unexpected deaths and 26/53 (49%) of the unexpected survivors. Failure of the model to appropriately predict risk was judged to be responsible for 135/179 (75%) of the unexpected deaths and 2/53 (4%) of the unexpected survivors. Some 10/53 (19%) of the unexpected survivors died within a few months of the 7-day period of model prediction. Conclusions We found little evidence that deaths occurring in patients with a low predicted mortality from risk-adjustment could be attributed to the quality of healthcare provided. PMID:23605036

Wilson, Richard; Goodacre, Steve W; Klingbajl, Marcin; Kelly, Anne-Maree; Rainer, Tim; Coats, Tim; Holloway, Vikki; Townend, Will; Crane, Steve

2014-01-01

305

Emerging Viruses  

NSDL National Science Digital Library

Emerging viruses are those "whose incidence in humans has increased in the past 2 decades or threatens to increase in the near future." This week's Topic in Depth focuses on sites related to viruses, particularly those that are considered "emerging."The first site (1) is an essay by Alison Jacobson of the University of Capetown that discusses some emerging and potentially emerging viruses, along with factors that contribute to the threat. From a US government interagency working group, the second report (2) focuses on the responses to infectious disease outbreaks, including drugs, vaccines, and government response. A World Health Organization site (3) highlights recent reports of infectious disease, archived by date and by disease. This ThinkQuest site (4) gives a basic introduction to viruses and how they cause infections. An online virology tutorial (5) by Ed Rybicki of the University of Cape Town serves as a lesson on the basics of virology for a more advanced student. The next two sites focus on the specifics of selected viruses. From the Institute for Molecular Virology (6) comes a resource on Marburg and Ebola viruses, and from the National Biological Information Infrastructure (7) is a site on West Nile Virus. The last resource (8) is a scholarly journal from the Centers for Disease Control that presents some of the latest scientific research on emerging diseases.

Lee, Amy.

2002-01-01

306

Simulating Conservative Tracers in Fractured Till under Realistic Timescales  

E-print Network

Simulating Conservative Tracers in Fractured Till under Realistic Timescales by M.F. Helmke1, W solute transport through fractured till. Model results were compared to breakthrough curves (BTCs,4-piperazinediethanesulfonic acid (PIPES) in a large-diameter column of fractured till. Input parameters were determined from

Simpkins, William W.

307

Methods of communication and mediating processes in realistic job previews  

Microsoft Academic Search

Assigned 164 bank teller applicants (mean age 22 yrs) who were offered jobs to 1 of 3 experimental groups to investigate the effectiveness of presenting realistic job previews. Ss in Group 1 received a job preview from an incumbent teller; Ss in Group 2 received a job preview brochure; Ss in Group 3 served as controls. Substantially fewer Ss in

Stephen M. Colarelli

1984-01-01

308

Inquiring into the Real: A Realist Phenomenological Approach  

ERIC Educational Resources Information Center

The need for postpositivist or antipositivist methods in the social sciences, including library and information science, is well documented. A promising alternative synthesizes critical realism and phenomenology. This method embraces ontological reality in all things, including human and social action. The ontology underlying the realist

Budd, John M.; Hill, Heather; Shannon, Brooke

2010-01-01

309

UAV Based Distributed ATR under Realistic Simulated Environmental Effects  

E-print Network

UAV Based Distributed ATR under Realistic Simulated Environmental Effects Xiaohan Chen, Shanshan has grown increasingly reliant upon the use of unattended aerial vehicles (UAVs) for surveillance missions. There is an increasing trend towards fielding swarms of UAVs operating as large-scale sensor

Valenti, Matthew C.

310

A Realistic Technology and Engineering Assessment of Algae Biofuel Production  

E-print Network

A Realistic Technology and Engineering Assessment of Algae Biofuel Production T of microalgae biofuels production through an analysis of five production scenarios. These scenarios, or cases microalgae biofuel technologies for both oil and biogas production, provides an initial assessment of the US

Quinn, Nigel

311

Analysis of a Realistic Fault Model Large Distributed Systems  

E-print Network

will be transformed into a singular set of relations and tables so that their convergence rate and fault tolerance canAnalysis of a Realistic Fault Model for Large Distributed Systems M.H. Azadmanesh 1 A.W. Krings 2 for the convergence rate and fault tolerance of a broad family of convergent voting algorithms called Mean

Krings, Axel W.

312

Diagnosis of Realistic Bridging Faults with Single Stuckat Information  

E-print Network

Diagnosis of Realistic Bridging Faults with Single Stuck­at Information Brian Chess David B. Lavo F Precise failure analysis requires accurate fault diag­ nosis. A previously proposed method for diagnosing bridging faults using single stuck­at dictionaries was applied only to small circuits, produced large

Larrabee, Tracy

313

Toward Realistic and Artifact-Free Insider-Threat Data  

Microsoft Academic Search

Progress in insider-threat detection is currently limited by a lack of realistic, publicly available, real-world data. For reasons of privacy and confidentiality, no one wants to expose their sensitive data to the research community. Data can be sanitized to mitigate privacy and confidentialitycon- cerns, but the mere act of sanitizing the data may introduce artifacts that compromise its utility for

Kevin S. Killourhy; Roy A. Maxion

2007-01-01

314

Toward Realistic and Artifact-Free Insider-Threat Data  

Microsoft Academic Search

Progress in insider-threat detection is currently limited by a lack of realistic, publicly available, real-world data. For reasons of privacy and confidentiality, no one wants to expose their sensitive data to the research community. Data can be sanitized to mitigate privacy and confidentiality concerns, but the mere act of sanitizing the data may introduce artifacts that compromise its utility for

Kevin S. Killourhy; Roy A. Maxion

2007-01-01

315

Engendering Anthropocentrism: Lessons from Children's Realistic Animal Stories.  

ERIC Educational Resources Information Center

In children's realistic stories about animals a number of wholly and unambiguously anthropocentric assumptions are at work. For instance, in a study most of the books (81%) in one sampling of 50 stories involve a pet or the process of domesticating a wild animal. In most cases the primary animal character is a dog or horse. The predominance of…

Johnson, Kathleen R.

316

Thesis Proposal: Creating Realistic Physical Simulations From Video  

Microsoft Academic Search

Physical simulation techniques are widely used in computer graphics to produce realistic animations of complex natural phenomenon. The behavior of a physical simulator is governed by a set of parameters, typically specified by the animator. Tuning complex simulations, like rigid bodies and cloth is extremely laborious because of the large number of parameters that must be adjusted to achieve the

Kiran Bhat

317

Non-Realist Writing Co-ordinator: Dr Edwina Keown  

E-print Network

, Ghost Stories Week 7: Study Week Week 8: Aldous Huxley, Brave New World Week 9: George Orwell, 1984 Week) Aldous Huxley, Brave New World Revisited (London: Harper Collins, 1994) Sven Lindqvist, A History will be given to the potential of non-realist fictional forms to imagine other worlds, or other versions

O'Mahony, Donal E.

318

Toward realistic soft-tissue modeling in medical simulation  

Microsoft Academic Search

Most of today's medical simulation systems are based on geometric representations of anatomical structures that take no account of their physical nature. Representing physical phenomena and, more specifically, the realistic modeling of soft tissue will not only improve current medical simulation systems but will considerably enlarge the set of applications and the credibility of medical simulation, from neurosurgery planning to

H. Delingette

1998-01-01

319

Realistic Simulation of Jet Engine Noise using Petaflop Computing  

E-print Network

Realistic Simulation of Jet Engine Noise using Petaflop Computing Sponsor: National Science and supersonic jet noise prediction for modern-day turbofan aircraft engines using petascale computing. Jet noise that a 50% decrease in jet noise power output can be achieved by certain chevron and lobe mixer designs

Ginzel, Matthew

320

Intuitive Generation of Realistic Motions for Articulated Human Characters  

E-print Network

A long-standing goal in computer graphics is to create and control realistic motion for virtual human characters. Despite the progress made over the last decade, it remains challenging to design a system that allows a random user to intuitively...

Min, Jianyuan

2013-01-15

321

Face Tracking and Realistic Animations for Telecommunicant Clones  

Microsoft Academic Search

We present recent developments in the context of face cloning using view based techniques, permitted by the cooperation between analysis and synthesis algorithms. We detail efficient 3D face modelling techniques that are capable of reproducing convincing facial expressions, and we show how such realistic face models are suitable for a view based analysis framework, to recover both the global pose

Stéphane Valente; Jean-luc Dugelay

1999-01-01

322

Three-body monopole corrections to realistic interactions.  

PubMed

It is shown that a very simple three-body monopole term can solve practically all the spectroscopic problems-in the p, sd, and pf shells-that were hitherto assumed to need drastic revisions of the realistic potentials. PMID:12570413

Zuker, A P

2003-01-31

323

Parameter Optimisation Techniques for Robot Identification and Realistic Dynamic Simulation  

Microsoft Academic Search

Robotised laser welding is an application, which requires high tracking precision at high speed motions. For prediction of the weldability of a seam, a closed-loop dynamic simulation of the robot is essential. In order to accurately predict the path tracking errors of the robot along a laser welding seam, realistic dynamic robot models with accurate model parameters are crucial. An

R. R. Waiboer; R. G. K. M. Aarts; J. B. Jonker

2003-01-01

324

Firefly-Inspired Sensor Network Synchronicity with Realistic Radio Effects  

E-print Network

of individual nodes' firing phases. In this paper we present the Reachback Firefly Algorithm (RFAFirefly-Inspired Sensor Network Synchronicity with Realistic Radio Effects Geoffrey Werner), a decentralized syn- chronicity algorithm implemented on TinyOS-based motes. Our algorithm is based

Maróti, Miklós

325

Towards realistic file-system benchmarks with CodeMRI  

Microsoft Academic Search

Benchmarks are crucial to understanding software systems and assessing their performance. In file-system research, synthetic benchmarks are accepted and widely used as substitutes for more realistic and complex workloads. However, synthetic benchmarks are largely based on the benchmark writer's interpretation of the real workload, and how it exercises the system API. This is insufficient since even a simple operation through

Nitin Agrawal; Andrea C. Arpaci-Dusseau; Remzi H. Arpaci-Dusseau

2008-01-01

326

Two-Capacitor Problem: A More Realistic View.  

ERIC Educational Resources Information Center

Discusses the two-capacitor problem by considering the self-inductance of the circuit used and by determining how well the usual series RC circuit approximates the two-capacitor problem when realistic values of L, C, and R are chosen. (GA)

Powell, R. A.

1979-01-01

327

International Management: Creating a More Realistic Global Planning Environment.  

ERIC Educational Resources Information Center

Discusses the need for realistic global planning environments in international business education, introducing a strategic planning model that has teams interacting with teams to strategically analyze a selected multinational company. This dynamic process must result in a single integrated written analysis that specifies an optimal strategy for…

Waldron, Darryl G.

2000-01-01

328

Towards Synthesizing Realistic Workload Traces for Studying the Hadoop Ecosystem  

E-print Network

; and (ii) Quantifying the impact of shared storage on Hadoop system performance. Keywords-Cloud computing and storage capacity, choice of file system, layout and partitioning of data, and selection of networkTowards Synthesizing Realistic Workload Traces for Studying the Hadoop Ecosystem Guanying Wang, Ali

Butt, Ali R.

329

Realistic Animation of Liquids Nick Foster and Dimitri Metaxas  

E-print Network

are used to drive a height field equation representing the liquid surface. The nature of the coupling and Miller use a fast approximation to the two-dimensional shallow water equations to simulate surface wavesRealistic Animation of Liquids Nick Foster and Dimitri Metaxas Center for Human Modeling

330

Is Trust a Realistic Goal of Environmental Risk Communication?  

Microsoft Academic Search

Environmental risk communication often fails in its efforts to overcome prevalent public distrust of government and industrial agencies. But, is achieving trust a realistic goal? The authors begin by reexamining definitions of the terms trust and credibility and summarizing recent assessments of the role trust plays in risk communication. On the basis of research conducted among people living near major

Lillian Trettin; Catherine Musham

2000-01-01

331

Automated Finger Spelling by Highly Realistic 3D Animation  

ERIC Educational Resources Information Center

We present the design of a new 3D animation tool for self-teaching (signing and reading) finger spelling the first basic component in learning any sign language. We have designed a highly realistic hand with natural animation of the finger motions. Smoothness of motion (in real time) is achieved via programmable blending of animation segments. The…

Adamo-Villani, Nicoletta; Beni, Gerardo

2004-01-01

332

Realistic, RealTime Rendering of Ocean Waves Microsoft Research  

E-print Network

includes reflection, refraction, and Fresnel effects which are critical for producing the look and feel realistic wave geometry and sophisticated lighting effects such as reflection, refraction and Fresnel is a technique for efficiently rendering per-pixel Fresnel reflection and refraction on a dynamic bump map using

Rajamani, Sriram K.

333

Novel Micropatterned Cardiac Cell Cultures with Realistic Ventricular Microstructure  

PubMed Central

Systematic studies of cardiac structure-function relationships to date have been hindered by the intrinsic complexity and variability of in vivo and ex vivo model systems. Thus, we set out to develop a reproducible cell culture system that can accurately replicate the realistic microstructure of native cardiac tissues. Using cell micropatterning techniques, we aligned cultured cardiomyocytes at micro- and macroscopic spatial scales to follow local directions of cardiac fibers in murine ventricular cross sections, as measured by high-resolution diffusion tensor magnetic resonance imaging. To elucidate the roles of ventricular tissue microstructure in macroscopic impulse conduction, we optically mapped membrane potentials in micropatterned cardiac cultures with realistic tissue boundaries and natural cell orientation, cardiac cultures with realistic tissue boundaries but random cell orientation, and standard isotropic monolayers. At 2 Hz pacing, both microscopic changes in cell orientation and ventricular tissue boundaries independently and synergistically increased the spatial dispersion of conduction velocity, but not the action potential duration. The realistic variations in intramural microstructure created unique spatial signatures in micro- and macroscopic impulse propagation within ventricular cross-section cultures. This novel in vitro model system is expected to help bridge the existing gap between experimental structure-function studies in standard cardiac monolayers and intact heart tissues. PMID:19413993

Badie, Nima; Bursac, Nenad

2009-01-01

334

A possible definition of a {\\it Realistic} Physics Theory  

E-print Network

A definition of a {\\it Realistic} Physics Theory is proposed based on the idea that, at all time, the set of physical properties possessed (at that time) by a system should unequivocally determine the probabilities of outcomes of all possible measurements.

Nicolas Gisin

2014-01-02

335

Behavioral Game Theory: Towards a Realistic Representation of Strategic Behavior?  

E-print Network

Behavioral Game Theory: Towards a Realistic Representation of Strategic Behavior? Giovanna Devetag have been traditionally modelled using the formal language of game theory, first introduced by von Neumann and Morgenstern's 1944 seminal book Theory of Games and Economic Behavior. Game theory

Qian, Ning

336

A Realistic Video Avatar System for Networked Virtual Environments  

Microsoft Academic Search

With the advancements in collaborative virtual reality applications there is a need for representing users with a higher degree of realism for better immersion. Represent- ing users with facial animation in an interactive collabo- rative virtual environment is a daunting task. This paper proposes an avatar system for a realistic representation of users. In working towards this goal, this paper

Vivek Rajan; Satheesh Subramanian; Damin Keenan Andrew Johnson; Daniel Sandin; Thomas DeFanti

2002-01-01

337

A Three-dimensionalPhysiologically Realistic Model of the Retina  

E-print Network

A Three-dimensionalPhysiologically Realistic Model of the Retina Michael Tadross, Cameron of the retina by providing a flexible, real-valued three-dimensional architecture. This model exhibits of individual cells in the different layers of the retina. The network performs both fimctions in a consistent

Whitehouse, Kamin

338

Realist synthesis: illustrating the method for implementation research  

PubMed Central

Background Realist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question ‘what interventions and strategies are effective in enabling evidence-informed healthcare?’ The strengths and challenges of conducting realist review are also considered. Methods The realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses. Results Based on key terms and concepts related to various interventions to promote evidence-informed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area. Conclusions Realist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review. PMID:22515663

2012-01-01

339

Emerging phleboviruses?  

PubMed Central

The Bunyavidae family is the largest grouping of RNA viruses and arguably the most diverse. Bunyaviruses have a truly global distribution and can infect vertebrates, invertebrates and plants. The majority of bunyaviruses are vectored by arthropods and thus have the remarkable capability to replicate in hosts of disparate phylogeny. The family has provided many examples of emerging viruses including Sin Nombre and related viruses responsible for hantavirus cardiopulmonary syndrome in the Americas, first identified in 1993, and Schmallenberg virus which emerged in Europe in 2011, causing foetal malformations in ruminants. In addition, some well-known bunyaviruses like Rift Valley fever and Crimean-Congo haemorrhagic fever viruses continue to emerge in new geographical locations. In this short review we focus on newly identified viruses associated with severe haemorrhagic disease in humans in China and the US. PMID:24607799

Elliott, Richard M; Brennan, Benjamin

2014-01-01

340

Emerging equity market volatility  

Microsoft Academic Search

Understanding volatility in emerging capital markets is important for determining the cost of capital and for evaluating direct investment and asset allocation decisions. We provide an approach that allows the relative importance of world and local information to change through time in both the expected returns and conditional variance processes. Our time-series and cross-sectional models analyze the reasons that volatility

Geert Bekaert; Campbell R. Harvey

1997-01-01

341

Emergency department triage revisited  

Microsoft Academic Search

Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure

Gerard FitzGerald; George A Jelinek; Deborah Scott; Marie Frances Gerdtz

2010-01-01

342

Emergent Curriculum.  

ERIC Educational Resources Information Center

Emergent curriculum in early childhood education refers to the process of using the spontaneity generated in the daily life of the children and adults in the program, along with teacher planning, to develop the curriculum. This book presents a story about a year in the life of a fictional child care center as a context for the discussion of…

Jones, Elizabeth; Nimmo, John

343

[Outpatient emergencies].  

PubMed

The outpatient monitoring of patients sometimes involves emergency situations. In their practice, the nurses who visit the patient's home are confronted with the limits of their intervention. Faced with these delicate situations team coordination is a strength and the reactivity of the caregivers often contributes to a satisfactory outcome for the patient. PMID:24979919

Rivallan, Armel; Le Nagard, Philippe

2014-01-01

344

Emerging Scholars  

ERIC Educational Resources Information Center

This year's group of "emerging scholars" is a force to be reckoned with. This diverse group of young (under-40) crusaders is pushing the boundaries of research, technology and public policy in ways never imagined and reaching new heights of accomplishments. The Class of 2009 includes a physiologist who devised an artificial pancreas to produce the…

Anyaso, Hilary Hurd; Rolo, Mark Anthony; Roach, Ronald; Delos, Robin Chen; Branch-Brioso, Karen; Miranda, Maria Eugenia; Seymour, Add, Jr.; Grossman, Wendy; Nealy, Michelle J.; Lum, Lydia

2009-01-01

345

Emergency Response  

Microsoft Academic Search

Too many times the emergency responder either doesn't have the proper equipment, or doesn't know what to use or how to use gas detection in a hazardous atmospheric incident. Firefighters, EMS providers and law enforcement personnel should be aware of the need for gas detection to protect themselves and those they serve to protect. You have heard about the BIG

Mike Platek

2008-01-01

346

Radiation Emergencies  

MedlinePLUS

Radiation is a type of energy. People are exposed to small amounts of radiation every day from sources such as sunlight. A radiation emergency would involve larger amounts of radiation and could be caused by Dirty bombs - a mix of explosives with ...

347

Evidence of Multistability in a Realistic Computer Simulation of Hippocampus Subfield CA1  

PubMed Central

The manner in which hippocampus processes neural signals is thought to be central to the memory encoding process. A theoretically-oriented literature has suggested that this is carried out via “attractors” or distinctive spatio-temporal patterns of activity. However, these ideas have not been thoroughly investigated using computational models featuring both realistic single-cell physiology and detailed cell-to-cell connectivity. Here we present a 452 cell simulation based on Traub et al’s pyramidal cell [81] and interneuron [83] models, incorporating patterns of synaptic connectivity based on an extensive review of the neuroanatomic literature. When stimulated with a one second physiologically realistic input, our simulated tissue shows the ability to hold activity on-line for several seconds; furthermore, its spiking activity, as measured by frequency and interspike interval (ISI) distributions, resembles that of in vivo hippocampus. An interesting emergent property of the system is its tendency to transition from stable state to stable state, a behavior consistent with recent experimental findings [73]. Inspection of spike trains and simulated blockade of KAHP channels suggest that this is mediated by spike frequency adaptation. This finding, in conjunction with studies showing that apamin, a KAHP channel blocker, enhances the memory consolidation process in laboratory animals, suggests the formation of stable attractor states is central to the process by which memories are encoded. Ways that this methodology could shed light on the etiology of mental illness, such as schizophrenia, are discussed. PMID:19378385

Siekmeier, Peter J.

2009-01-01

348

The role of myeloperoxidase (MPO) for prognostic evaluation in sensitive cardiac troponin I negative chest pain patients in the emergency department  

PubMed Central

Background: The diagnostic work-up of patients with acute chest pain in the emergency department (ED) is a challenging task. Serial troponin testing is required to rule-out acute myocardial infarction. Objective: To evaluate the value of myeloperoxidase (MPO) testing in sensitive cardiac troponin I (cTnI) negative patients with suspected acute coronary syndromes (ACS) in the routine setting of an ED. Methods: MPO was assessed in 432 consecutive patients presenting to the ED with ACS. In 266 patients, serial blood samples were available. After 6 weeks, major adverse cardiac events (MACE) were assessed. MPO and cTnI were measured in all available samples. For cTnI, a sensitive assay was used. Cut-off values were derived from an independent sample of 300 healthy volunteers. Results: Incidence of MACE in our population was 13%. MPO levels revealed sensitivity (Sens) of 82.1% and specificity (Spec) of 37.2% for MACE compared with 60.7% Sens and 61.4% Spec for sensitive cTnI. In serial sensitive cTnI negative patients (n=218), MACE incidence was 6.4%. MPO continued to demonstrate significant discriminatory power for the prognosis of MACE. Multivariate analyses confirmed these findings. Conclusion: MPO has an independent prognostic value overall and most notably in patients tested negative with a higher sensitive cardiac troponin I assay. MPO could be a promising biomarker for the initial evaluation of patients in chest pain units and is worth further investigation. PMID:24222831

Shih, Jessie; Muller, Reinhold; Vollert, Jorn O; Muller, Christian; Danne, Oliver; Datwyler, Saul; Mockel, Martin

2013-01-01

349

Chernobyl nuclear accident hydrologic analysis and emergency evaluation of radionuclide distributions in the Dnieper River, Ukraine, during the 1993 summer flood  

SciTech Connect

This report describes joint activities of Program 7.1.F, ``Radionuclide Transport in Water and Soil Systems,`` of the USA/Commonwealth of Independent States (CIS) Joint Coordinating Committee of Civilian Nuclear Reactor Safety to study the hydrogeochemical behavior of radionuclides released to the Pripyat and Dnieper rivers from the Chernobyl Nuclear Power Plant in Ukraine. These joint activities included rapid evaluation of radionuclide distributions in the Pripyat and Dnieper river system and field data evaluation and modeling for the 1993 summer flood to assist the Ukrainian government in their emergency response during the flood. In July-August 1993, heavy rainfall over the Pripyat River Catchment in Belarus and Ukraine caused severe flooding, significantly raising {sup 90}Sr concentrations in the river. Near the Chernobyl area, the maximum {sup 90}Sr concentration in the Pripyat River reached 20--25 PCi/L in early August; near the Pripyat River mouth, the concentration rose to 35 pCi/L. The peak {sup 90}Sr concentration in the Kiev Reservoir (a major source of drinking water for Kiev) was 12 pCi/L. Based on these measured radionuclide levels, additional modeling results and the assumption of water purification in a water treatment station, {sup 90}Sr concentrations in Kiev`s drinking water were estimated to be less than 8 pCi/L. Unlike {sup 90}Sr, {sup 137}Cs concentrations in the Pripyat River during the flood did not rise significantly to the pre-flood levels. Estimated {sup 137}Cs concentrations for the Kiev drinking water were two orders of magnitude lower than the drinking water standard of 500 pCi/L for {sup 137}Cs.

Voitsekhovitch, O.V. [Ukrainian Hydrometeorological Inst., Kiev (Ukraine); Zheleznyak, M.J. [Ukrainian Academy of Sciences, Kiev (Ukraine). Cybernetics Center; Onishi, Y. [Pacific Northwest Lab., Richland, WA (United States)

1994-06-01

350

Biophysically Realistic Filament Bending Dynamics in Agent-Based Biological Simulation  

PubMed Central

An appealing tool for study of the complex biological behaviors that can emerge from networks of simple molecular interactions is an agent-based, computational simulation that explicitly tracks small-scale local interactions – following thousands to millions of states through time. For many critical cell processes (e.g. cytokinetic furrow specification, nuclear centration, cytokinesis), the flexible nature of cytoskeletal filaments is likely to be critical. Any computer model that hopes to explain the complex emergent behaviors in these processes therefore needs to encode filament flexibility in a realistic manner. Here I present a numerically convenient and biophysically realistic method for modeling cytoskeletal filament flexibility in silico. Each cytoskeletal filament is represented by a series of rigid segments linked end-to-end in series with a variable attachment point for the translational elastic element. This connection scheme allows an empirically tuning, for a wide range of segment sizes, viscosities, and time-steps, that endows any filament species with the experimentally observed (or theoretically expected) static force deflection, relaxation time-constant, and thermal writhing motions. I additionally employ a unique pair of elastic elements – one representing the axial and the other the bending rigidity– that formulate the restoring force in terms of single time-step constraint resolution. This method is highly local –adjacent rigid segments of a filament only interact with one another through constraint forces—and is thus well-suited to simulations in which arbitrary additional forces (e.g. those representing interactions of a filament with other bodies or cross-links / entanglements between filaments) may be present. Implementation in code is straightforward; Java source code is available at www.celldynamics.org. PMID:19283085

Alberts, Jonathan B.

2009-01-01

351

Neurobiologically Realistic Determinants of Self-Organized Criticality in Networks of Spiking Neurons  

PubMed Central

Self-organized criticality refers to the spontaneous emergence of self-similar dynamics in complex systems poised between order and randomness. The presence of self-organized critical dynamics in the brain is theoretically appealing and is supported by recent neurophysiological studies. Despite this, the neurobiological determinants of these dynamics have not been previously sought. Here, we systematically examined the influence of such determinants in hierarchically modular networks of leaky integrate-and-fire neurons with spike-timing-dependent synaptic plasticity and axonal conduction delays. We characterized emergent dynamics in our networks by distributions of active neuronal ensemble modules (neuronal avalanches) and rigorously assessed these distributions for power-law scaling. We found that spike-timing-dependent synaptic plasticity enabled a rapid phase transition from random subcritical dynamics to ordered supercritical dynamics. Importantly, modular connectivity and low wiring cost broadened this transition, and enabled a regime indicative of self-organized criticality. The regime only occurred when modular connectivity, low wiring cost and synaptic plasticity were simultaneously present, and the regime was most evident when between-module connection density scaled as a power-law. The regime was robust to variations in other neurobiologically relevant parameters and favored systems with low external drive and strong internal interactions. Increases in system size and connectivity facilitated internal interactions, permitting reductions in external drive and facilitating convergence of postsynaptic-response magnitude and synaptic-plasticity learning rate parameter values towards neurobiologically realistic levels. We hence infer a novel association between self-organized critical neuronal dynamics and several neurobiologically realistic features of structural connectivity. The central role of these features in our model may reflect their importance for neuronal information processing. PMID:21673863

Rubinov, Mikail; Sporns, Olaf; Thivierge, Jean-Philippe; Breakspear, Michael

2011-01-01

352

Realistic fetus skin color processing for ultrasound volume rendering  

NASA Astrophysics Data System (ADS)

This paper proposes realistic fetus skin color processing using a 2D color map and a tone mapping function (TMF) for ultrasound volume rendering. The contributions of this paper are a 2D color map generated through a gamut model of skin color and a TMF that depends on the lighting position. First, the gamut model of fetus skin color is calculated by color distribution of baby images. The 2D color map is created using a gamut model for tone mapping of ray casting. For the translucent effect, a 2D color map in which lightness is inverted is generated. Second, to enhance the contrast of rendered images, the luminance, color, and tone curve TMF parameters are changed using 2D Gaussian function that depends on the lighting position. The experimental results demonstrate that the proposed method achieves better realistic skin color reproduction than the conventional method.

Kim, Yun-Tae; Kim, Kyuhong; Park, Sung-Chan; Kang, Jooyoung; Kim, Jung-Ho

2014-01-01

353

Lean thinking in healthcare: a realist review of the literature  

Microsoft Academic Search

ObjectiveTo understand how lean thinking has been put into practice in healthcare and how it has worked.DesignA realist literature review.Data sourcesThe authors systematically searched for articles in PubMed, Web of Science and Business Source Premier (January 1998 to February 2008) and then added articles through a snowball approach.Review methodsThe authors included empirical studies of lean thinking applications in healthcare and

Pamela Mazzocato; Carl Savage; Mats Brommels; Håkan Aronsson; Johan Thor

2010-01-01

354

Speech-driven facial animation with realistic dynamics  

Microsoft Academic Search

This paper presents an integral system capable of generating animations with realistic dynamics, including the in- dividualized nuances, of three-dimensional (3-D) human faces driven by speech acoustics. The system is capable of capturing short phenomena in the orofacial dynamics of a given speaker by tracking the 3-D location of various MPEG-4 facial points through stereovi- sion. A perceptual transformation of

Ricardo Gutierrez-osuna; Praveen K. Kakumanu; Anna Esposito; Oscar N. Garcia; Adriana Bojórquez; José Luis Castillo; Isaac Rudomín

2005-01-01

355

Realistic 3-D Scene Modeling from Uncalibrated Image Sequences  

Microsoft Academic Search

This contribution addresses the problem of obtaining photo- realistic 3D models of a scene from images alone with a structure-from-motion approach. The 3D scene is observed from multiple viewpoints by freely moving a camera around the object. No restrictions on camera movement and inter- nal camera parameters like zoom are imposed, as the cam- era pose and intrinsic parameters are

Reinhard Koch; Marc Pollefeys; Luc J. Van Gool

1999-01-01

356

Developments in realistic design for aperiodic Mo/Si multilayermirrors  

SciTech Connect

Aperiodic multilayers have been designed for various applications, using numeric algorithms and analytical solutions, for many years with varying levels of success. This work developed a more realistic model for simulating aperiodic Mo/Si multilayers to be used in these algorithms by including the formation of MoSi{sub 2}. Using a genetic computer code we were able to optimize a 45{sup o} multilayer for a large bandpass reflection multilayer that gave good agreement with the model.

Aquila, A.L.; Salmassi, F.; Dollar, F.; Liu, Y.; Gullikson, E.M.

2006-04-05

357

Magical realist pathways into and under the psychotherapeutic imaginary  

Microsoft Academic Search

My experience of people's life stories from my work as a narrative therapist consistently destabilised distinctions between imagined\\/magical and real experiences. I came to realise that the day-to-day magical realist juxtapositions I came upon were encounters with people's daily lives, as lived, that have remained unacknowledged within the literatures of counselling. In this paper I speculate about the possible reasons

Jane Speedy

2011-01-01

358

Photoabsorption on He4 with a Realistic Nuclear Force  

Microsoft Academic Search

The He4 total photoabsorption cross section is calculated with the realistic nucleon-nucleon potential Argonne V18 and the three-nucleon force (3NF) Urbana IX. Final state interaction is included rigorously via the Lorentz integral transform method. A rather pronounced giant resonance with peak cross sections of 3.0 (3.2) mb is obtained with (without) the 3NF. Above 50 MeV strong 3NF effects, up

Doron Gazit; Sonia Bacca; Nir Barnea; Winfried Leidemann; Giuseppina Orlandini

2006-01-01

359

Simulation of human ischemic stroke in realistic 3D geometry  

NASA Astrophysics Data System (ADS)

In silico research in medicine is thought to reduce the need for expensive clinical trials under the condition of reliable mathematical models and accurate and efficient numerical methods. In the present work, we tackle the numerical simulation of reaction-diffusion equations modeling human ischemic stroke. This problem induces peculiar difficulties like potentially large stiffness which stems from the broad spectrum of temporal scales in the nonlinear chemical source term as well as from the presence of steep spatial gradients in the reaction fronts, spatially very localized. Furthermore, simulations on realistic 3D geometries are mandatory in order to describe correctly this type of phenomenon. The main goal of this article is to obtain, for the first time, 3D simulations on realistic geometries and to show that the simulation results are consistent with those obtain in experimental studies or observed on MRI images in stroke patients. For this purpose, we introduce a new resolution strategy based mainly on time operator splitting that takes into account complex geometry coupled with a well-conceived parallelization strategy for shared memory architectures. We consider then a high order implicit time integration for the reaction and an explicit one for the diffusion term in order to build a time operator splitting scheme that exploits efficiently the special features of each problem. Thus, we aim at solving complete and realistic models including all time and space scales with conventional computing resources, that is on a reasonably powerful workstation. Consequently and as expected, 2D and also fully 3D numerical simulations of ischemic strokes for a realistic brain geometry, are conducted for the first time and shown to reproduce the dynamics observed on MRI images in stroke patients. Beyond this major step, in order to improve accuracy and computational efficiency of the simulations, we indicate how the present numerical strategy can be coupled with spatial adaptive multiresolution schemes. Preliminary results in the framework of simple geometries allow to assess the proposed strategy for further developments.

Dumont, Thierry; Duarte, Max; Descombes, Stéphane; Dronne, Marie-Aimée; Massot, Marc; Louvet, Violaine

2013-06-01

360

Making sense of complex data: a mapping process for analyzing findings of a realist review on guideline implementability  

PubMed Central

Background Realist reviews offer a rigorous method to analyze heterogeneous data emerging from multiple disciplines as a means to develop new concepts, understand the relationships between them, and identify the evidentiary base underpinning them. However, emerging synthesis methods such as the Realist Review are not well operationalized and may be difficult for the novice researcher to grasp. The objective of this paper is to describe the development of an analytic process to organize and synthesize data from a realist review. Methods Clinical practice guidelines have had an inconsistent and modest impact on clinical practice, which may in part be due to limitations in their design. This study illustrates the development of a transparent method for organizing and analyzing a complex data set informed by a Realist Review on guideline implementability to better understand the characteristics of guidelines that affect their uptake in practice (e.g., clarity, format). The data organization method consisted of 4 levels of refinement: 1) extraction and 2) organization of data; 3) creation of a conceptual map of guideline implementability; and 4) the development of a codebook of definitions. Results This new method is comprised of four steps: data extraction, data organization, development of a conceptual map, and operationalization vis-a-vis a codebook. Applying this method, we extracted 1736 guideline attributes from 278 articles into a consensus-based set of categories, and collapsed them into 5 core conceptual domains for our guideline implementability map: Language, Format, Rigor of development, Feasibility, Decision-making. Conclusions This study advances analysis methods by offering a systematic approach to analyzing complex data sets where the goals are to condense, organize and identify relationships. PMID:24028286

2013-01-01

361

Exposure Render: An Interactive Photo-Realistic Volume Rendering Framework  

PubMed Central

The field of volume visualization has undergone rapid development during the past years, both due to advances in suitable computing hardware and due to the increasing availability of large volume datasets. Recent work has focused on increasing the visual realism in Direct Volume Rendering (DVR) by integrating a number of visually plausible but often effect-specific rendering techniques, for instance modeling of light occlusion and depth of field. Besides yielding more attractive renderings, especially the more realistic lighting has a positive effect on perceptual tasks. Although these new rendering techniques yield impressive results, they exhibit limitations in terms of their exibility and their performance. Monte Carlo ray tracing (MCRT), coupled with physically based light transport, is the de-facto standard for synthesizing highly realistic images in the graphics domain, although usually not from volumetric data. Due to the stochastic sampling of MCRT algorithms, numerous effects can be achieved in a relatively straight-forward fashion. For this reason, we have developed a practical framework that applies MCRT techniques also to direct volume rendering (DVR). With this work, we demonstrate that a host of realistic effects, including physically based lighting, can be simulated in a generic and flexible fashion, leading to interactive DVR with improved realism. In the hope that this improved approach to DVR will see more use in practice, we have made available our framework under a permissive open source license. PMID:22768292

Kroes, Thomas; Post, Frits H.; Botha, Charl P.

2012-01-01

362

Relating realist metatheory to issues of gender and mental health.  

PubMed

This paper seeks to advance the debate that considers critical realism as an alternative approach for understanding gender and mental health and its relatedness to mental health research and practice. The knowledge base of how 'sex' and 'gender' affect mental health and illness is expanding. However, the way we conceptualize gender is significant and challenging as quite often our ability to think about 'gender' as independent of 'sex' is not common. The influences and interplay of how sex (biological) and gender (social) affect mental health and illness requires consideration. Critical realism suggests a shared ontology and epistemology for the natural and social sciences. While much of the debate surrounding gender is guided within a constructivist discourse, an exploration of the concept 'gender' is reflected on and some key realist propositions are considered for mental health research and practice. This is achieved through the works of some key realist theorists. Critical realism offers potential for research and practice in relation to gender and mental health because it facilitates changes in our understanding, while simultaneously, not discarding that which is already known. In so doing, it allows the biological (sex) and social (gender) domains of knowledge for mental health and illness to coexist, without either being reduced to or defined by the other. Arguably, greater depth and explanations for gender and mental health issues are presented within a realist metatheory. PMID:20584241

Bergin, M; Wells, John S G; Owen, Sara

2010-06-01

363

ENERGY EMERGENCY RESPONSE PLAN  

E-print Network

Standardized Emergency Management System (SEMS) ........................4 National Incident Management System.................................................................11 Energy Emergency Management Center .

364

Evaluating the Relationship among Parents' Oral and Written Language Skills, the Home Literacy Environment, and Their Preschool Children's Emergent Literacy Skills  

ERIC Educational Resources Information Center

Studies have examined the impact of parents' educational level on their child's emergent literacy skills and have found positive associations (Korat, 2009). However, a review of the literature indicates that previous studies have not investigated whether parents' oral and written language skills relate to their child's emergent oral and written…

Taylor, Nicole A.

2011-01-01

365

Development and Evaluation of Educational Materials for Pre-Hospital and Emergency Department Personnel on the Care of Patients with Autism Spectrum Disorder  

ERIC Educational Resources Information Center

With the rising prevalence of patients with autism spectrum disorder (ASD), there has been an increase in the acute presentation of these individuals to the general health care system. Emergency medical services and emergency department personnel commonly address the health care needs of patients with ASD at times of crisis. Unfortunately, there…

McGonigle, John J.; Migyanka, Joann M.; Glor-Scheib, Susan J.; Cramer, Ryan; Fratangeli, Jeffrey J.; Hegde, Gajanan G.; Shang, Jennifer; Venkat, Arvind

2014-01-01

366

Use of an agent-based simulation model to evaluate a mobile-based system for supporting emergency evacuation decision making.  

PubMed

Recently, mass casualty incidents (MCIs) have been occurring frequently and have gained international attention. There is an urgent need for scientifically proven and effective emergency responses to MCIs, particularly as the severity of incidents is continuously increasing. The emergency response to MCIs is a multi-dimensional and multi-participant dynamic process that changes in real-time. The evacuation decisions that assign casualties to different hospitals in a region are very important and impact both the results of emergency treatment and the efficiency of medical resource utilization. Previously, decisions related to casualty evacuation were made by an incident commander with emergency experience and in accordance with macro emergency guidelines. There are few decision-supporting tools available to reduce the difficulty and psychological pressure associated with the evacuation decisions an incident commander must make. In this study, we have designed a mobile-based system to collect medical and temporal data produced during an emergency response to an MCI. Using this information, our system's decision-making model can provide personal evacuation suggestions that improve the overall outcome of an emergency response. The effectiveness of our system in reducing overall mortality has been validated by an agent-based simulation model established to simulate an emergency response to an MCI. PMID:25354665

Tian, Yu; Zhou, Tian-Shu; Yao, Qin; Zhang, Mao; Li, Jing-Song

2014-12-01

367

Can near real-time monitoring of emergency department diagnoses facilitate early response to sporadic meningococcal infection? - prospective and retrospective evaluations  

PubMed Central

Background Meningococcal infection causes severe, rapidly progressing illness and reporting of cases is mandatory in New South Wales (NSW), Australia. The NSW Department of Health operates near real-time Emergency Department (ED) surveillance that includes capture and statistical analysis of clinical preliminary diagnoses. The system can provide alerts in response to specific diagnoses entered in the ED computer system. This study assessed whether once daily reporting of clinical diagnoses of meningococcal infection using the ED surveillance system provides an opportunity for timelier public health response for this disease. Methods The study involved a prospective and retrospective component. First, reporting of ED diagnoses of meningococcal infection from the ED surveillance system prospectively operated in parallel with conventional surveillance which requires direct telephone reporting of this scheduled medical condition to local public health authorities by hospitals and laboratories when a meningococcal infection diagnosis is made. Follow-up of the ED diagnoses determined whether meningococcal infection was confirmed, and the time difference between ED surveillance report and notification by conventional means. Second, cases of meningococcal infection reported by conventional surveillance during 2004 were retrospectively matched to ED visits to determine the sensitivity and positive predictive value (PPV) of ED surveillance. Results During the prospective evaluation, 31 patients were diagnosed with meningococcal infection in participating EDs. Of these, 12 had confirmed meningococcal disease, resulting in a PPV of 38.7%. All confirmed cases were notified earlier to public health authorities by conventional reporting. Of 149 cases of notified meningococcal disease identified retrospectively, 130 were linked to an ED visit. The sensitivity and PPV of the ED diagnosis for meningococcal infection was 36.2% and 36.7%, respectively. Conclusions Based on prospective evaluation, it is reassuring that existing mechanisms for reporting meningococcal infection perform well and are timely. The retrospective evaluation found low sensitivity and PPV of ED diagnoses for meningococcal disease. Even if more rapid forwarding of ED meningococcal diagnoses to public health authorities were possible, the low sensitivity and PPV do not justify this. In this study, use of an ED surveillance system to augment conventional surveillance of this scheduled medical condition did not demonstrate a benefit. PMID:20979656

2010-01-01

368

76 FR 71991 - Agency Information Collection Activities: Proposed Collection; Comment Request, Emergency...  

Federal Register 2010, 2011, 2012, 2013

...HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2011-0038...Collection; Comment Request, Emergency Management Institute Course Evaluation Form AGENCY: Federal Emergency Management Agency, DHS. ACTION:...

2011-11-21

369

77 FR 9952 - Agency Information Collection Activities: Proposed Collection; Comment Request, Emergency...  

Federal Register 2010, 2011, 2012, 2013

...HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2011-0038...Collection; Comment Request, Emergency Management Institute Course Evaluation Form AGENCY: Federal Emergency Management Agency, DHS. ACTION:...

2012-02-21

370

Emergency Medical Services Program Standards.  

ERIC Educational Resources Information Center

This guide contains 45 program standards for the emergency medical services program conducted in technical institutes in Georgia. The standards are divided into 12 categories: foundations (philosophy, purpose, goals, program objectives, availability, evaluation); admissions (admission requirements, provisional admission requirements, recruitment,…

Georgia Univ., Athens. Dept. of Vocational Education.

371

Cost and Resource Utilization Associated with Use of Computed Tomography to Evaluate Chest Pain in the Emergency Department: The ROMICAT Study  

PubMed Central

Background Coronary computed tomography angiography (cCTA) allows for rapid non-invasive exclusion of obstructive coronary artery disease (CAD). However, concern exists whether implementation of cCTA in the assessment of patients presenting to the emergency room with acute chest pain will lead to increased downstream testing and costs compared to alternative strategies. Our aim was to compare observed actual costs of usual care (UC) with projected costs of a strategy including early cCTA in the evaluation of patients with acute chest pain in the Rule Out Myocardial Infarction Using Computed Tomography (ROMICAT I) study. Methods and Results We compared cost and hospital length of stay of UC observed among 368 patients enrolled in the ROMICAT I trial with projected costs of management based on cCTA. Costs of UC were determined by an electronic cost accounting system. Notably, UC was not influenced by cCTA results, as patients and caregivers were blinded to the cCTA results. Costs after early implementation cCTA were estimated assuming changes in management based on cCTA findings of presence and severity of CAD. Sensitivity analysis was used to test influence of key variables on both outcomes and costs. We determined that in comparison to UC, cCTA-guided triage whereby patients with no CAD are discharged, could reduce total hospital costs by 23%, p < 0.001. However, when the prevalence of obstructive CAD increases, index hospitalization cost increases such that when the prevalence of ?50% stenosis is greater than 28–33%, the use of cCTA becomes more costly than UC. Conclusion cCTA may be a cost saving tool in acute chest pain populations that have a prevalence of potentially obstructive CAD lower than 30%. However, increased cost would be anticipated in populations with higher prevalence of disease. PMID:24021693

Hulten, Edward; Goehler, Alexander; Bittencourt, Marcio; Bamberg, Fabian; Schlett, Christopher L.; Truong, Quynh A.; Nichols, John; Nasir, Khurram; Rogers, Ian S.; Gazelle, Scott G.; Nagurney, John T.; Hoffmann, Udo; Blankstein, Ron

2013-01-01

372

Comparative evaluation of different medication safety measures for the emergency department: physicians' usage and acceptance of training, poster, checklist and computerized decision support  

PubMed Central

Background Although usage and acceptance are important factors for a successful implementation of clinical decision support systems for medication, most studies only concentrate on their design and outcome. Our objective was to comparatively investigate a set of traditional medication safety measures such as medication safety training for physicians, paper-based posters and checklists concerning potential medication problems versus the additional benefit of a computer-assisted medication check. We concentrated on usage, acceptance and suitability of such interventions in a busy emergency department (ED) of a 749 bed acute tertiary care hospital. Methods A retrospective, qualitative evaluation study was conducted using a field observation and a questionnaire-based survey. Six physicians were observed while treating 20 patient cases; the questionnaire, based on the Technology Acceptance Model 2 (TAM2), has been answered by nine ED physicians. Results During field observations, we did not observe direct use of any of the implemented interventions for medication safety (paper-based and electronic). Questionnaire results indicated that the electronic medication safety check was the most frequently used intervention, followed by checklist and posters. However, despite their positive attitude, physicians most often stated that they use the interventions in only up to ten percent for subjectively “critical” orders. Main reasons behind the low usage were deficits in ease-of-use and fit to the workflow. The intention to use the interventions was rather high after overcoming these barriers. Conclusions Methodologically, the study contributes to Technology Acceptance Model (TAM) research in an ED setting and confirms TAM2 as a helpful diagnostic tool in identifying barriers for a successful implementation of medication safety interventions. In our case, identified barriers explaining the low utilization of the implemented medication safety interventions - despite their positive reception - include deficits in accessibility, briefing for the physicians about the interventions, ease-of-use and compatibility to the working environment. PMID:23890121

2013-01-01

373

Toward realistic effective models of quantum-Hall edges  

NASA Astrophysics Data System (ADS)

We have investigated the dynamical properties of edge excitations in the (fractional) quantum-Hall regime for a sharp confining potential, emphasizing the effects resulting from the presence of long-range interaction. Our study uses chiral-Luttinger-liquid models that are motivated by the close analogy between the physics of edge excitations and that of plasmons in quasi-one-dimensional electron systems. We find that incorporating realistic long-range interaction is especially important for multi-branch edges. Results are presented for the tunneling-IV-curve power-law exponent and the two-terminal conductance.

Zülicke, U.; MacDonald, A. H.

1998-01-01

374

ROC Analysis and a Realistic Model of Heart Rate Variability  

E-print Network

We have carried out a pilot study on a standard collection of electrocardiograms from patients who suffer from congestive heart failure, and subjects without cardiac pathology, using receiver-operating-characteristic (ROC) analysis. The scale-dependent wavelet-coefficient standard deviation \\sigma_{wav}(m), a multiresolution-based analysis measure, is found to be superior to two commonly used measures of cardiac dysfunction when the two classes of patients cannot be completely separated. A jittered integrate-and-fire model with a fractal Gaussian-noise kernel provides a realistic simulation of heartbeat sequences for both heart-failure patients and normal subjects.

Stefan Thurner; Markus C. Feurstein; Malvin C. Teich

1998-06-19

375

Sphaleron-Like Processes in a Realistic Heat Bath  

E-print Network

We measure the diffusion rate of Chern-Simons number in the (1+1)-dimensional Abelian Higgs model interacting with a realistic heat bath for temperatures between 1/13 and 2/3 times the sphaleron energy. It is found that the measured rate is close to that predicted by the sphaleron approximation at the lower end of the temperature range considered but falls at least an order of magnitude short of the sphaleron estimate at the upper end of that range. We show numerically that the sphaleron approximation breaks down as soon as the gauge-invariant two-point function yields correlation length close to the sphaleron size.

A. Krasnitz; R. Potting

1993-12-16

376

alpha-particle photoabsorption with a realistic nuclear force  

E-print Network

The 4He total photoabsorption cross section is calculated with the realistic nucleon-nucleon potential Argonne V18 and the three-nucleon force (3NF) Urbana IX. Final state interaction is included rigorously via the Lorentz Integral Transform method. A rather pronounced giant resonance with peak cross sections of 3 (3.2) mb is obtained with (without) 3NF. Above 50 MeV strong 3NF effects, up to 35%, are present. Good agreement with experiment is found close to threshold. A comparison in the giant resonance region is inconclusive, since present data do not show a unique picture.

Gazit, D; Barnea, N; Leidemann, W; Orlandini, G

2005-01-01

377

alpha-particle photoabsorption with a realistic nuclear force  

E-print Network

The 4He total photoabsorption cross section is calculated with the realistic nucleon-nucleon potential Argonne V18 and the three-nucleon force (3NF) Urbana IX. Final state interaction is included rigorously via the Lorentz Integral Transform method. A rather pronounced giant resonance with peak cross sections of 3 (3.2) mb is obtained with (without) 3NF. Above 50 MeV strong 3NF effects, up to 35%, are present. Good agreement with experiment is found close to threshold. A comparison in the giant resonance region is inconclusive, since present data do not show a unique picture.

D. Gazit; S. Bacca; N. Barnea; W. Leidemann; G. Orlandini

2005-12-12

378

Photoabsorption on {sup 4}He with a Realistic Nuclear Force  

SciTech Connect

The {sup 4}He total photoabsorption cross section is calculated with the realistic nucleon-nucleon potential Argonne V18 and the three-nucleon force (3NF) Urbana IX. Final state interaction is included rigorously via the Lorentz integral transform method. A rather pronounced giant resonance with peak cross sections of 3.0 (3.2) mb is obtained with (without) the 3NF. Above 50 MeV strong 3NF effects, up to 35%, are present. Good agreement with experiment is found close to threshold. A comparison in the giant resonance region is inconclusive, since data do not show a unique picture.

Gazit, Doron; Barnea, Nir [The Racah Institute of Physics, The Hebrew University, 91904 Jerusalem (Israel); Bacca, Sonia [Gesellschaft fuer Schwerionenforschung, Planckstrasse 1, 64291 Darmstadt (Germany); Leidemann, Winfried; Orlandini, Giuseppina [Dipartimento di Fisica, Universita di Trento and Istituto Nazionale di Fisica Nucleare, Gruppo Collegato di Trento, I-38050 Povo (Italy)

2006-03-24

379

Supersymmetry and light quark masses in a realistic superstring model  

NASA Astrophysics Data System (ADS)

We examine the light quark masses in a standard-like superstring model in the four-dimensional free fermionic formulation. We find that the supersymmetry constraints in the observable and hidden sectors eliminate all large contributions to mu and mu and force them to be much smaller than the other quark masses. The requirement for an acceptable Higgs doublet spectrum results in mu? md. In these models a realistic md can alway be obtained whereas mu is at most 10 -5 MeV. For particular choices of flat directions or vacua mu can be as small as 10 -7 MeV but cannot vanish.

Halyo, Edi

1994-08-01

380

Cathodic disbonding of pipeline coatings under realistic conditions  

NASA Astrophysics Data System (ADS)

Cathodic disbonding is one undesirable aspect of the combination of the corrosion control technology commonly used for the exterior of buried pipelines. This technology consists of the combined use of protective coatings and cathodic protection. While standard cathodic disbonding tests performed in the laboratory provide a relative ranking of coatings, due to the simplicity of the test environments and accelerated nature of the tests, the results may not necessarily be directly related to service performance. Therefore, the objective of this work was to determine the cathodic disbonding behavior of three commonly used pipeline coating materials (i.e., fusion bonded epoxy, coal tar enamel, and tape coatings) under more realistic conditions. The research plan allowed the comparison of cathodic disbonding tests results between standard and realistic conditions by utilizing laboratory tests with controlled environments and cathodic protection levels. Several areas of focus were the effects of a moderate level of polarization, high level of polarization, and elevated temperatures. Additional factors examined included electrolyte composition (soil extract versus NaCl solutions), wet/dry cycling, and simulated soil conditions (i.e., sand moistened with soil extract). These tests delineated the effects of test parameters on cathodic disbonding and coating performance was related to these parameters. The processes considered to be important to the cathodic disbonding behavior of coatings are discussed as well as the implications of the realistic test results on laboratory cathodic disbonding test procedures. It was confirmed that greater disbonding occurred at more negative (i.e., cathodic) potentials, with higher alkalinity, and at elevated temperatures. This study also showed that disbonding increased greatly when sand moistened with soil extract solution was utilized in place of bulk electrolyte. The addition of such a barrier to convection may present a viable method to accelerate cathodic disbonding tests and is more representative of conditions in soils along pipelines. Wet/dry cycling showed no measurable effect on the extent of disbonding. Temperature, however, was determined to be a significant factor. The effect of initial electrolyte composition was not certain when comparing between NaCl and different soil extract solutions. Tests under realistic conditions generally exhibited larger scatter than standard tests, probably due to the added complexity caused by calcareous deposit formations and concurrent alteration of the electrolyte with the use of soil extract solutions.

Trautman, Brenda Lee

1998-09-01

381

Emerging holography  

SciTech Connect

We rederive AdS/CFT predictions for infrared two-point functions by an entirely four-dimensional approach, without reference to holography. This approach, originally due to Migdal in the context of QCD, utilizes an extrapolation from the ultraviolet to the infrared using a Pade approximation of the two-point function. We show that the Pade approximation and AdS/CFT give the same leading order predictions, and we discuss including power corrections such as those due to condensates of gluons and quarks in QCD. At finite order the Pade approximation provides a gauge invariant regularization of a higher dimensional gauge theory in the spirit of deconstructed extra dimensions. The radial direction of anti-de Sitter space emerges naturally in this approach.

Erlich, Joshua [Department of Physics, College of William and Mary, Williamsburg, Virginia 23187 (United States); Kribs, Graham D. [Department of Physics and Institute of Theoretical Science, University of Oregon, Eugene, Oregon 97403 (United States); Low, Ian [School of Natural Sciences, Institute for Advanced Study, Princeton, New Jersey 08540 (United States)

2006-05-01

382

Realistic simulated lung nodule dataset for testing CAD detection and sizing  

NASA Astrophysics Data System (ADS)

The development of computer-aided diagnosis (CAD) methods for the processing of CT lung scans continues to become increasingly popular due to the potential of these algorithms to reduce image reading time, errors caused by user fatigue, and user subjectivity when screening for the presence of malignant lesions. This study seeks to address the critical need for a realistic simulated lung nodule CT image dataset based on real tumor morphologies that can be used for the quantitative evaluation and comparison of these CAD algorithms. The manual contouring of 17 different lung metastases was performed and reconstruction of the full 3-D surface of each tumor was achieved through the utilization of an analytical equation comprised of a spherical harmonics series. 2-D nodule slice representations were then computed based on these analytical equations to produce realistic simulated nodules that can be inserted into CT datasets with well-circumscribed, vascularized, or juxtapleural borders and also be scaled to represent nodule growth. The 3-D shape and intensity profile of each simulated nodule created from the spherical harmonics reconstruction was compared to the real patient CT lung metastasis from which its contour points were derived through the calculation of a 3-D correlation coefficient, producing an average value of 0.8897 (+/-0.0609). This database of realistic simulated nodules can fulfill the need for a reproducible and reliable gold standard for CAD algorithms with regards to nodule detection and sizing, especially given its virtually unlimited capacity for expansion to other nodule shape variants, organ systems, and imaging modalities.

Ambrosini, Robert D.; O'Dell, Walter G.

2010-03-01

383

Toward the classification of the realistic free fermionic models  

SciTech Connect

The realistic free fermionic models have had remarkable success in providing plausible explanations for various properties of the Standard Model which include the natural appearance of three generations, the explanation of the heavy top quark mass and the qualitative structure of the fermion mass spectrum in general, the stability of the proton and more. These intriguing achievements makes evident the need to understand the general space of these models. While the number of possibilities is large, general patterns can be extracted. In this paper the author presents a detailed discussion on the construction of the realistic free fermionic models with the aim of providing some insight into the basic structures and building blocks that enter the construction. The role of free phases in the determination of the phenomenology of the models is discussed in detail. The author discusses the connection between the free phases and mirror symmetry in (2,2) models and the corresponding symmetries in the case of (2,0) models. The importance of the free phases in determining the effective low energy phenomenology is illustrated in several examples. The classification of the models in terms of boundary condition selection rules, real world-sheet fermion pairings, exotic matter states and the hidden sector is discussed.

Faraggi, A.E.

1997-08-01

384

CHARMM-GUI Membrane Builder toward realistic biological membrane simulations.  

PubMed

CHARMM-GUI Membrane Builder, http://www.charmm-gui.org/input/membrane, is a web-based user interface designed to interactively build all-atom protein/membrane or membrane-only systems for molecular dynamics simulations through an automated optimized process. In this work, we describe the new features and major improvements in Membrane Builder that allow users to robustly build realistic biological membrane systems, including (1) addition of new lipid types, such as phosphoinositides, cardiolipin (CL), sphingolipids, bacterial lipids, and ergosterol, yielding more than 180 lipid types, (2) enhanced building procedure for lipid packing around protein, (3) reliable algorithm to detect lipid tail penetration to ring structures and protein surface, (4) distance-based algorithm for faster initial ion displacement, (5) CHARMM inputs for P21 image transformation, and (6) NAMD equilibration and production inputs. The robustness of these new features is illustrated by building and simulating a membrane model of the polar and septal regions of E. coli membrane, which contains five lipid types: CL lipids with two types of acyl chains and phosphatidylethanolamine lipids with three types of acyl chains. It is our hope that CHARMM-GUI Membrane Builder becomes a useful tool for simulation studies to better understand the structure and dynamics of proteins and lipids in realistic biological membrane environments. © 2014 Wiley Periodicals, Inc. PMID:25130509

Wu, Emilia L; Cheng, Xi; Jo, Sunhwan; Rui, Huan; Song, Kevin C; Dávila-Contreras, Eder M; Qi, Yifei; Lee, Jumin; Monje-Galvan, Viviana; Venable, Richard M; Klauda, Jeffery B; Im, Wonpil

2014-10-15

385

Simulation of Combustion Systems with Realistic g-jitter  

NASA Technical Reports Server (NTRS)

In this project a transient, fully three-dimensional computer simulation code was developed to simulate the effects of realistic g-jitter on a number of combustion systems. The simulation code is capable of simulating flame spread on a solid and nonpremixed or premixed gaseous combustion in nonturbulent flow with simple combustion models. Simple combustion models were used to preserve computational efficiency since this is meant to be an engineering code. Also, the use of sophisticated turbulence models was not pursued (a simple Smagorinsky type model can be implemented if deemed appropriate) because if flow velocities are large enough for turbulence to develop in a reduced gravity combustion scenario it is unlikely that g-jitter disturbances (in NASA's reduced gravity facilities) will play an important role in the flame dynamics. Acceleration disturbances of realistic orientation, magnitude, and time dependence can be easily included in the simulation. The simulation algorithm was based on techniques used in an existing large eddy simulation code which has successfully simulated fire dynamics in complex domains. A series of simulations with measured and predicted acceleration disturbances on the International Space Station (ISS) are presented. The results of this series of simulations suggested a passive isolation system and appropriate scheduling of crew activity would provide a sufficiently "quiet" acceleration environment for spherical diffusion flames.

Mell, William E.; McGrattan, Kevin B.; Baum, Howard R.

2003-01-01

386

Unsteady transonic flow calculations for realistic aircraft configurations  

NASA Technical Reports Server (NTRS)

A transonic unsteady aerodynamic and aeroelasticity code has been developed for application to realistic aircraft configurations. The new code is called CAP-TSD which is an acronym for Computational Aeroelasticity Program - Transonic Small Disturbance. The CAP-TSD code uses a time-accurate approximate factorization (AF) algorithm for solution of the unsteady transonic small-disturbance equation. The AF algorithm is very efficient for solution of steady and unsteady transonic flow problems. It can provide accurate solutions in only several hundred time steps yielding a significant computational cost savings when compared to alternative methods. The new code can treat complete aircraft geometries with multiple lifting surfaces and bodies including canard, wing, tail, control surfaces, launchers, pylons, fuselage, stores, and nacelles. Applications are presented for a series of five configurations of increasing complexity to demonstrate the wide range of geometrical applicability of CAP-TSD. These results are in good agreement with available experimental steady and unsteady pressure data. Calculations for the General Dynamics one-ninth scale F-16C aircraft model are presented to demonstrate application to a realistic configuration. Unsteady results for the entire F-16C aircraft undergoing a rigid pitching motion illustrated the capability required to perform transonic unsteady aerodynamic and aeroelastic analyses for such configurations.

Batina, John T.; Seidel, David A.; Bland, Samuel R.; Bennett, Robert M.

1987-01-01

387

Neuronize: a tool for building realistic neuronal cell morphologies  

PubMed Central

This study presents a tool, Neuronize, for building realistic three-dimensional models of neuronal cells from the morphological information extracted through computer-aided tracing applications. Neuronize consists of a set of methods designed to build 3D neural meshes that approximate the cell membrane at different resolution levels, allowing a balance to be reached between the complexity and the quality of the final model. The main contribution of the present study is the proposal of a novel approach to build a realistic and accurate 3D shape of the soma from the incomplete information stored in the digitally traced neuron, which usually consists of a 2D cell body contour. This technique is based on the deformation of an initial shape driven by the position and thickness of the first order dendrites. The addition of a set of spines along the dendrites completes the model, building a final 3D neuronal cell suitable for its visualization in a wide range of 3D environments. PMID:23761740

Brito, Juan P.; Mata, Susana; Bayona, Sofia; Pastor, Luis; DeFelipe, Javier; Benavides-Piccione, Ruth

2013-01-01

388

Realistic implementation of chiral magnetic wave in heavy ion collisions  

NASA Astrophysics Data System (ADS)

A chiral magnetic wave (CMW) is a gapless collective excitation of chiral charges along the direction of magnetic field in the quark-gluon plasma that arises from the triangle anomaly of QCD. We perform a reliable study of the CMW in a realistic simulation of heavy ion collisions, and find that the CMW contributions to the charge-dependent elliptic flow of pions, ?v2?v2 (?-)-v2(?+), linearly depending on the net charge asymmetry A±?(N+-N-)/(N++N-) with a positive slope r, is comparable to the recent experimental results from the Relativistic Heavy Ion Collider (RHIC). We identify a "freeze-out hole effect," which is a direct consequence of the propagation of the CMW during the realistic evolution of the fireball, as the dominant physics effect responsible for a sizable contribution from the CMW to the slope parameter r, and emphasize that a proper treatment of the freeze-out condition is crucial in any reliable computation of the CMW contribution to the slope parameter r. We also implement a chiral phase transition effect in our study, which illustrates the sensitivity of the results to chiral phase transition temperature, and suggest that the CMW can be an important probe of the QCD chiral phase transition. Our results on the impact parameter dependence compare well with the RHIC experiments. We also give predictions for the Large Hadron Collider (LHC) energy.

Yee, Ho-Ung; Yin, Yi

2014-04-01

389

Hemodynamic Changes Caused by Flow Diverters in Rabbit Aneurysm Models: Comparison of Virtual and Realistic FD Deployments Based on Micro-CT Reconstruction  

PubMed Central

Adjusting hemodynamics via flow diverter (FD) implantation is emerging as a novel method of treating cerebral aneurysms. However, most previous FD-related hemodynamic studies were based on virtual FD deployment, which may produce different hemodynamic outcomes than realistic (in vivo) FD deployment. We compared hemodynamics between virtual FD and realistic FD deployments in rabbit aneurysm models using computational fluid dynamics (CFD) simulations. FDs were implanted for aneurysms in 14 rabbits. Vascular models based on rabbit-specific angiograms were reconstructed for CFD studies. Real FD configurations were reconstructed based on micro-CT scans after sacrifice, while virtual FD configurations were constructed with SolidWorks software. Hemodynamic parameters before and after FD deployment were analyzed. According to the metal coverage (MC) of implanted FDs calculated based on micro-CT reconstruction, 14 rabbits were divided into two groups (A, MC >35%; B, MC <35%). Normalized mean wall shear stress (WSS), relative residence time (RRT), inflow velocity, and inflow volume in Group A were significantly different (P<0.05) from virtual FD deployment, but pressure was not (P>0.05). The normalized mean WSS in Group A after realistic FD implantation was significantly lower than that of Group B. All parameters in Group B exhibited no significant difference between realistic and virtual FDs. This study confirmed MC-correlated differences in hemodynamic parameters between realistic and virtual FD deployment. PMID:23823503

Fang, Yibin; Yu, Ying; Cheng, Jiyong; Wang, Shengzhang; Wang, Kuizhong; Liu, Jian-Min; Huang, Qinghai

2013-01-01

390

Detecting Emerging Trends from Scientific Corpora  

Microsoft Academic Search

Emerging trend detection is a new challenge and an attractive topic in text mining. Our research goal was to construct a model to detect emerging trends in a set of scientific articles; the resulting model is richer in topic representation and more appropriate for evaluating emerging trends than existing models. To achieve this end, we associated each topic with many

Minh-Hoang Le; Tu-Bao Ho; Yoshiteru Nakamori

391

Vision-realistic Rendering: Simulation of the Scanned Foveal Image with Elimination of Artifacts due to  

E-print Network

Vision-realistic Rendering: Simulation of the Scanned Foveal Image with Elimination of Artifacts, and finally compositing to form a vision-realistic rendered image. Although processing in image space allows-realistic rendered image simulating vision based on actual wavefront data from a patient with keratoconus. To embark

Barsky, Brian A.

392

A realistic coupled nonlinear artificial ECG, BP and respiratory signal generator for assessing noise performance  

E-print Network

A realistic coupled nonlinear artificial ECG, BP and respiratory signal generator for assessing differential equations is capable of generating realistic synthetic electrocardiograms (ECGs). Open source code with realistic inter-signal coupling between the respiration, BP and ECG time series. The time-varying surface

McSharry, Patrick E.

393

Is ASEAN powerful? Neo-realist versus constructivist approaches to power in Southeast Asia  

Microsoft Academic Search

This paper asks: ‘is ASEAN powerful?’ The argument is made that there is a divide over this question between two broad groups of scholars who are referred to as ‘neo-realists’ (including realists) and ‘constructivists’. Focusing attention on this question is useful because it helps to bring into view three, not always explicit, points of argument between constructivists and neo-realists in

Sarah Eaton; Richard Stubbs

2006-01-01

394

Evaluation of thermal discomfort in Athens territory and its effect on the daily number of recorded patients at hospitals' emergency rooms  

NASA Astrophysics Data System (ADS)

Previous research has shown that temperature and humidity affect human health. However, only a few studies have examined the association of a biometeorological index, which combines several meteorological parameters and human physiology, with health outcomes. The aim of the present study is to assess the thermal discomfort in Athens city by using the Predicted Mean Vote (PMV) as well as to examine its association with the number of patients recorded at the emergency rooms of four main hospitals. Patients were selected based on their diagnosis during the summer season (June August) from 1998 to 2004. Data included hourly values of meteorological parameters and daily numbers of patients who visited the emergency units of cardiology departments. Poisson regression models were applied using generalized estimating equations. A strong negative correlation between mean and maximum daily values of PMV and the number of emergency department visits was identified. More studies are needed to explore the association of this biometeorological index with health outcomes in other regions.

Pantavou, Katerina; Theoharatos, Georgios; Nikolopoulos, Georgios; Katavoutas, Georgios; Asimakopoulos, Dimosthenis

2008-11-01

395

Normal and Pathological NCAT Image and PhantomData Based onPhysiologically Realistic Left Ventricle Finite-Element Models  

SciTech Connect

The 4D NURBS-based Cardiac-Torso (NCAT) phantom, whichprovides a realistic model of the normal human anatomy and cardiac andrespiratory motions, is used in medical imaging research to evaluate andimprove imaging devices and techniques, especially dynamic cardiacapplications. One limitation of the phantom is that it lacks the abilityto accurately simulate altered functions of the heart that result fromcardiac pathologies such as coronary artery disease (CAD). The goal ofthis work was to enhance the 4D NCAT phantom by incorporating aphysiologically based, finite-element (FE) mechanical model of the leftventricle (LV) to simulate both normal and abnormal cardiac motions. Thegeometry of the FE mechanical model was based on gated high-resolutionx-ray multi-slice computed tomography (MSCT) data of a healthy malesubject. The myocardial wall was represented as transversely isotropichyperelastic material, with the fiber angle varying from -90 degrees atthe epicardial surface, through 0 degreesat the mid-wall, to 90 degreesat the endocardial surface. A time varying elastance model was used tosimulate fiber contraction, and physiological intraventricular systolicpressure-time curves were applied to simulate the cardiac motion over theentire cardiac cycle. To demonstrate the ability of the FE mechanicalmodel to accurately simulate the normal cardiac motion as well abnormalmotions indicative of CAD, a normal case and two pathologic cases weresimulated and analyzed. In the first pathologic model, a subendocardialanterior ischemic region was defined. A second model was created with atransmural ischemic region defined in the same location. The FE baseddeformations were incorporated into the 4D NCAT cardiac model through thecontrol points that define the cardiac structures in the phantom whichwere set to move according to the predictions of the mechanical model. Asimulation study was performed using the FE-NCAT combination toinvestigate how the differences in contractile function between thesubendocardial and transmural infarcts manifest themselves in myocardialSPECT images. The normal FE model produced strain distributions that wereconsistent with those reported in the literature and a motion consistentwith that defined in the normal 4D NCAT beating heart model based ontagged MRI data. The addition of a subendocardial ischemic region changedthe average transmural circumferential strain from a contractile value of0.19 to a tensile value of 0.03. The addition of a transmural ischemicregion changed average circumferential strain to a value of 0.16, whichis consistent with data reported in the literature. Model resultsdemonstrated differences in contractile function between subendocardialand transmural infarcts and how these differences in function aredocumented in simulated myocardial SPECT images produced using the 4DNCAT phantom. In comparison to the original NCAT beating heart model, theFE mechanical model produced a more accurate simulation for the cardiacmotion abnormalities. Such a model, when incorporated into the 4D NCATphantom, has great potential for use in cardiac imaging research. Withits enhanced physiologically-based cardiac model, the 4D NCAT phantom canbe used to simulate realistic, predictive imaging data of a patientpopulation with varying whole-body anatomy and with varying healthy anddiseased states of the heart that will provide a known truth from whichto evaluate and improve existing and emerging 4D imaging techniques usedin the diagnosis of cardiac disease.

Veress, Alexander I.; Segars, W. Paul; Weiss, Jeffrey A.; Tsui,Benjamin M.W.; Gullberg, Grant T.

2006-08-02

396

MEDICAL EMERGENCIES What is a medical emergency?  

E-print Network

MEDICAL EMERGENCIES What is a medical emergency? Serious injury or illness. What do I do if there is a medical emergency occurring or one has occurred? CALL 911. Paramedics and ambulance service or visitor. What information do I need to have readily available when reporting a medical emergency

Fernandez, Eduardo

397

MEDICAL EMERGENCIES What is a medical emergency?  

E-print Network

MEDICAL EMERGENCIES What is a medical emergency? Serious injury or illness. What do I do if there is a medical emergency occurring or one has occurred? NOTIFY 911 or University Police. Paramedics and ambulance, the employee to the nearest medical facility or CALL 911 for emergency assistance CALL OptaComp at 877

Fernandez, Eduardo

398

MEDICAL EMERGENCIES What is a medical emergency?  

E-print Network

MEDICAL EMERGENCIES What is a medical emergency? Serious injury or illness. What do I do if there is a medical emergency occurring or one has occurred? CALL 911. Paramedics and ambulance service or visitor. What information do I need to have readily available when reporting a medical emergency? Building

Fernandez, Eduardo

399

Emerging memories  

NASA Astrophysics Data System (ADS)

Memory is a key component of any data processing system. Following the classical Turing machine approach, memories hold both the data to be processed and the rules for processing them. In the history of microelectronics, the distinction has been rather between working memory, which is exemplified by DRAM, and storage memory, exemplified by NAND. These two types of memory devices now represent 90% of all memory market and 25% of the total semiconductor market, and have been the technology drivers in the last decades. Even if radically different in characteristics, they are however based on the same storage mechanism: charge storage, and this mechanism seems to be near to reaching its physical limits. The search for new alternative memory approaches, based on more scalable mechanisms, has therefore gained new momentum. The status of incumbent memory technologies and their scaling limitations will be discussed. Emerging memory technologies will be analyzed, starting from the ones that are already present for niche applications, and which are getting new attention, thanks to recent technology breakthroughs. Maturity level, physical limitations and potential for scaling will be compared to existing memories. At the end the possible future composition of memory systems will be discussed.

Baldi, Livio; Bez, Roberto; Sandhu, Gurtej

2014-12-01

400

Diagnostic imaging in pediatric emergencies  

SciTech Connect

Evaluation of pediatric emergencies by diagnostic imaging technics can involve both invasive and noninvasive procedures. Nuclear medicine, conventional radiography, ultrasound, computerized axial tomography, and xeroradiography are the major nonangiographic diagnostic technics available for patient evaluation. We will emphasize the use of computerized axial tomography, nuclear medicine, xeroradiography, and ultrasound in the evaluation of emergencies in the pediatric age group. Since the radiologist is the primary consultant with regard to diagnostic imaging, his knowledge of these modulities can greatly influence patient care and clinical results.

Heller, R.M.; Coulam, C.M.; Allen, J.H.; Fleischer, A.; Lee, G.S.; Kirchner, S.G.; James A.E. Jr.

1980-07-01

401

Fluidic Emergency Thruster for Aircraft  

NASA Technical Reports Server (NTRS)

The design, development, fabrication and test evaluation of two prototype fluidic emergency thrusters (FET) for aircraft stabilization are discussed. The fluidic control units were designed to provide, between two diametrically opposed nozzles, a thrust differential proportional to an input voltage signal. The emergency roll control requirements of the X-14 VTOL research aircraft were defined as typical design goals. Two control units, one on each wing tip, are intended to provide a maximum thrust of 224 pounds per unit. The units are designed to operate with 2500 psig, 2000 F gas from a solid propellant gas generator. The emergency system including the gas generator was designed to add less than 11 pounds per wing tip. The operating time under emergency conditions was specified as five seconds. The fluidic emergency thruster is similar in concept to a JATO system but has the added feature of controllable thrust.

Honda, T. S.

1972-01-01

402

Virtual reality for emergency training  

SciTech Connect

Virtual reality is a sequence of scenes generated by a computer as a response to the five different senses. These senses are sight, sound, taste, touch, smell. Other senses that can be used in virtual reality include balance, pheromonal, and immunological senses. Many application areas include: leisure and entertainment, medicine, architecture, engineering, manufacturing, and training. Virtual reality is especially important when it is used for emergency training and management of natural disasters including earthquakes, floods, tornados and other situations which are hard to emulate. Classical training methods for these extraordinary environments lack the realistic surroundings that virtual reality can provide. In order for virtual reality to be a successful training tool the design needs to include certain aspects; such as how real virtual reality should be and how much fixed cost is entailed in setting up the virtual reality trainer. There are also pricing questions regarding the price per training session on virtual reality trainer, and the appropriate training time length(s).

Altinkemer, K. [Purdue Univ., West Lafayette, IN (United States). Krannert Graduate School of Management

1995-12-31

403

Realistic facial animation generation based on facial expression mapping  

NASA Astrophysics Data System (ADS)

Facial expressions reflect internal emotional states of a character or in response to social communications. Though much effort has been taken to generate realistic facial expressions, it still remains a challenging topic due to human being's sensitivity to subtle facial movements. In this paper, we present a method for facial animation generation, which reflects true facial muscle movements with high fidelity. An intermediate model space is introduced to transfer captured static AU peak frames based on FACS to the conformed target face. And then dynamic parameters derived using a psychophysics method is integrated to generate facial animation, which is assumed to represent natural correlation of multiple AUs. Finally, the animation sequence in the intermediate model space is mapped to the target face to produce final animation.

Yu, Hui; Garrod, Oliver; Jack, Rachael; Schyns, Philippe

2014-01-01

404

Hiding a Realistic Object Using a Broadband Terahertz Invisibility Cloak  

E-print Network

The invisibility cloak has been a long-standing dream for many researchers over the decades. The introduction of transformational optics has revitalized this field by providing a general method to design material distributions to hide the subject from detection. By transforming space and light propagation, a three-dimensional (3D) object is perceived as having a reduced number of dimensions, in the form of points, lines, and thin sheets, making it "undetectable" judging from the scattered field. Although a variety of cloaking devices have been reported at microwave and optical frequencies, the spectroscopically important Terahertz (THz) domain remains unexplored. Moreover, due to the difficulties in fabricating cloaking devices that are optically large in all three dimensions, hiding realistic 3D objects has yet to be demonstrated. Here, we report the first experimental demonstration of a 3D THz cloaking device fabricated using a scalable Projection Microstereolithography process. The cloak operates at a broa...

Zhou, Fan; Cao, Wei; Stuart, Colin T; Gu, Jianqiang; Zhang, Weili; Sun, Cheng

2011-01-01

405

Ring Current Modeling in a Realistic Magnetic Field Configuration  

NASA Technical Reports Server (NTRS)

A 3-dimensional kinetic model has been developed to study the dynamics of the storm time ring current in a dipole magnetic field. In this paper, the ring current model is extended to include a realistic, time-varying magnetic field model. The magnetic field is expressed as the cross product of the gradients of two Euler potentials and the bounce-averaged particle drifts are calculated in the Euler potential coordinates. A dipolarization event is modeled by collapsing a tail-like magnetosphere to a dipole-like configuration. Our model is able to simulate the sudden enhancements in the ring current ion fluxes and the corresponding ionospheric precipitation during the substorm expansion.

Fok, M.-C.; Moore, T. E.

1997-01-01

406

Tool for Generating Realistic Residential Hot Water Event Schedules: Preprint  

SciTech Connect

The installed energy savings for advanced residential hot water systems can depend greatly on detailed occupant use patterns. Quantifying these patterns is essential for analyzing measures such as tankless water heaters, solar hot water systems with demand-side heat exchangers, distribution system improvements, and recirculation loops. This paper describes the development of an advanced spreadsheet tool that can generate a series of year-long hot water event schedules consistent with realistic probability distributions of start time, duration and flow rate variability, clustering, fixture assignment, vacation periods, and seasonality. This paper also presents the application of the hot water event schedules in the context of an integral-collector-storage solar water heating system in a moderate climate.

Hendron, B.; Burch, J.; Barker, G.

2010-08-01

407

Generalized seniority with realistic interactions in open-shell nuclei  

E-print Network

Generalized seniority provides a truncation scheme for the nuclear shell model, based on pairing correlations, which offers the possibility of dramatically reducing the dimensionality of the nuclear shell-model problem. Systematic comparisons against results obtained in the full shell-model space are required to assess the viability of this scheme. Here, we extend recent generalized seniority calculations for semimagic nuclei, the Ca isotopes, to open-shell nuclei, with both valence protons and valence neutrons. The even-mass Ti and Cr isotopes are treated in a full major shell and with realistic interactions, in the generalized seniority scheme with one broken proton pair and one broken neutron pair. Results for level energies, orbital occupations, and electromagnetic observables are compared with those obtained in the full shell-model space. We demonstrate that, even for the Ti isotopes, significant benefit would be obtained in going beyond the approximation of one broken pair of each type, while the Cr iso...

Caprio, M A; Cai, K; Constantinou, Ch; Hellemans, V

2014-01-01

408

New wavelet functions for realistic flexible robots modeling  

NASA Astrophysics Data System (ADS)

In this paper new wavelet functions, to build suitable basis functions to model a flexible robot, are proposed. These functions, continuous with second derivatives, allow to derive a very precise model, above all at low frequencies, numerically stable and efficient from a computational point of view, also under the hypothesis of links having varying cross-section and gravitational loads. Moreover the deformation Lagrangian variables are displacements, rotations and curvatures in suitable points of the links; this is very useful if inclinometers, piezoelectrics and stay rods, to monitor and/or control the robot, are used. The proposed method has been validated with several simulations of almost realistic robots, especially by modeling, controlling and simulating a mobile base robot with two flexible links carrying a variable mass body.

Celentano, Laura

2013-10-01

409

Identifying a steganographer in realistic and heterogeneous data sets  

NASA Astrophysics Data System (ADS)

We consider the problem of universal pooled steganalysis, in which we aim to identify a steganographer who sends many images (some of them innocent) in a network of many other innocent users. The detector must deal with multiple users and multiple images per user, and particularly the differences between cover sources used by different users. Despite being posed for five years, this problem has only previously been addressed by our 2011 paper. We extend our prior work in two ways. First, we present experiments in a new, highly realistic, domain: up to 4000 actors each transmitting up to 200 images, real-world data downloaded from a social networking site. Second, we replace hierarchical clustering by the method called local outlier factor (LOF), giving greater accuracy of detection, and allowing a guilty actor sending moderate payloads to be detected, even amongst thousands of other actors sending hundreds of thousands of images.

Ker, Andrew D.; Pevný, Tomás

2012-03-01

410

Performance of Airborne Precision Spacing Under Realistic Wind Conditions  

NASA Technical Reports Server (NTRS)

With the expected worldwide increase of air traffic during the coming decade, both the Federal Aviation Administration s (FAA s) Next Generation Air Transportation System (NextGen), as well as Eurocontrol s Single European Sky ATM Research (SESAR) program have, as part of their plans, air traffic management solutions that can increase performance without requiring time-consuming and expensive infrastructure changes. One such solution involves the ability of both controllers and flight crews to deliver aircraft to the runway with greater accuracy than is possible today. Previous research has shown that time-based spacing techniques, wherein the controller assigns a time spacing to each pair of arriving aircraft, is one way to achieve this goal by providing greater runway delivery accuracy that produces a concomitant increase in system-wide performance. The research described herein focuses on a specific application of time-based spacing, called Airborne Precision Spacing (APS), which has evolved over the past ten years. This research furthers APS understanding by studying its performance with realistic wind conditions obtained from atmospheric sounding data and with realistic wind forecasts obtained from the Rapid Update Cycle (RUC) short-range weather forecast. In addition, this study investigates APS performance with limited surveillance range, as provided by the Automatic Dependent Surveillance-Broadcast (ADS-B) system, and with an algorithm designed to improve APS performance when an ADS-B signal is unavailable. The results presented herein quantify the runway threshold delivery accuracy of APS un-der these conditions, and also quantify resulting workload metrics such as the number of speed changes required to maintain spacing.

Wieland, Frederick; Santos, Michel; Krueger, William; Houston, Vincent E.

2011-01-01

411

Computer simulations of realistic three-dimensional microstructures  

NASA Astrophysics Data System (ADS)

A novel and efficient methodology is developed for computer simulations of realistic two-dimensional (2D) and three-dimensional (3D) microstructures. The simulations incorporate realistic 2D and 3D complex morphologies/shapes, spatial patterns, anisotropy, volume fractions, and size distributions of the microstructural features statistically similar to those in the corresponding real microstructures. The methodology permits simulations of sufficiently large 2D as well as 3D microstructural windows that incorporate short-range (on the order of particle/feature size) as well as long-range (hundred times the particle/feature size) microstructural heterogeneities and spatial patterns at high resolution. The utility of the technique has been successfully demonstrated through its application to the 2D microstructures of the constituent particles in wrought Al-alloys, the 3D microstructure of discontinuously reinforced Al-alloy (DRA) composites containing SiC particles that have complex 3D shapes/morphologies and spatial clustering, and 3D microstructure of boron modified Ti-6Al-4V composites containing fine TiB whiskers and coarse primary TiB particles. The simulation parameters are correlated with the materials processing parameters (such as composition, particle size ratio, extrusion ratio, extrusion temperature, etc.), which enables the simulations of rational virtual 3D microstructures for the parametric studies on microstructure-properties relationships. The simulated microstructures have been implemented in the 3D finite-elements (FE)-based framework for simulations of micro-mechanical response and stress-strain curves. Finally, a new unbiased and assumption free dual-scale virtual cycloids probe for estimating surface area of 3D objects constructed by 2D serial section images is also presented.

Mao, Yuxiong

412

Fast realistic modeling in bioelectromagnetism using lead-field interpolation.  

PubMed

The practical use of realistic models in bioelectromagnetism is limited by the time-consuming amount of numerical calculations. We propose a method leading to much higher speed than currently available, and compatible with any kind of numerical methods (boundary elements (BEM), finite elements, finite differences). Illustrated with the BEM for EEG and MEG, it applies to ECG and MCG as well. The principle is two-fold. First, a Lead-Field matrix is calculated (once for all) for a grid of dipoles covering the brain volume. Second, any forward solution is interpolated from the pre-calculated Lead-Fields corresponding to grid dipoles near the source. Extrapolation is used for shallow sources falling outside the grid. Three interpolation techniques were tested: trilinear, second-order Bézier (Bernstein polynomials), and 3D spline. The trilinear interpolation yielded the highest speed gain, with factors better than x10,000 for a 9,000-triangle BEM model. More accurate results could be obtained with the Bézier interpolation (speed gain approximately 1,000), which, combined with a 8-mm step grid, lead to intrinsic localization and orientation errors of only 0.2 mm and 0.2 degrees. Further improvements in MEG could be obtained by interpolating only the contribution of secondary currents. Cropping grids by removing shallow points lead to a much better estimation of the dipole orientation in EEG than when solving the forward problem classically, providing an efficient alternative to locally refined models. This method would show special usefulness when combining realistic models with stochastic inverse procedures (simulated annealing, genetic algorithms) requiring many forward calculations. PMID:11500990

Yvert, B; Crouzeix-Cheylus, A; Pernier, J

2001-09-01

413

Towards a realistic population of simulated galaxy groups and clusters  

NASA Astrophysics Data System (ADS)

We present a new suite of large-volume cosmological hydrodynamical simulations called cosmo-OWLS. They form an extension to the OverWhelmingly Large Simulations (OWLS) project, and have been designed to help improve our understanding of cluster astrophysics and non-linear structure formation, which are now the limiting systematic errors when using clusters as cosmological probes. Starting from identical initial conditions in either the Planck or WMAP7 cosmologies, we systematically vary the most important `sub-grid' physics, including feedback from supernovae and active galactic nuclei (AGN). We compare the properties of the simulated galaxy groups and clusters to a wide range of observational data, such as X-ray luminosity and temperature, gas mass fractions, entropy and density profiles, Sunyaev-Zel'dovich flux, I-band mass-to-light ratio, dominance of the brightest cluster galaxy and central massive black hole (BH) masses, by producing synthetic observations and mimicking observational analysis techniques. These comparisons demonstrate that some AGN feedback models can produce a realistic population of galaxy groups and clusters, broadly reproducing both the median trend and, for the first time, the scatter in physical properties over approximately two decades in mass (1013 M? ? M500 ? 1015 M?) and 1.5 decades in radius (0.05 ? r/r500 ? 1.5). However, in other models, the AGN feedback is too violent (even though they reproduce the observed BH scaling relations), implying that calibration of the models is required. The production of realistic populations of simulated groups and clusters, as well as models that bracket the observations, opens the door to the creation of synthetic surveys for assisting the astrophysical and cosmological interpretation of cluster surveys, as well as quantifying the impact of selection effects.

Le Brun, Amandine M. C.; McCarthy, Ian G.; Schaye, Joop; Ponman, Trevor J.

2014-06-01

414

Toward modeling of regional myocardial ischemia and infarction: generation of realistic coronary arterial tree for the heart model of the XCAT phantom  

NASA Astrophysics Data System (ADS)

A realistic 3D coronary arterial tree (CAT) has been developed for the heart model of the computer generated 3D XCAT phantom. The CAT allows generation of a realistic model of the location, size and shape of the associated regional ischemia or infarction for a given coronary arterial stenosis or occlusion. This in turn can be used in medical imaging applications. An iterative rule-based generation method that systematically utilized anatomic, morphometric and physiologic knowledge was used to construct a detailed realistic 3D model of the CAT in the XCAT phantom. The anatomic details of the myocardial surfaces and large coronary arterial vessel segments were first extracted from cardiac CT images of a normal patient with right coronary dominance. Morphometric information derived from porcine data from the literature, after being adjusted by scaling laws, provided statistically nominal diameters, lengths, and connectivity probabilities of the generated coronary arterial segments in modeling the CAT of an average human. The largest six orders of the CAT were generated based on the physiologic constraints defined in the coronary generation algorithms. When combined with the heart model of the XCAT phantom, the realistic CAT provides a unique simulation tool for the generation of realistic regional myocardial ischemia and infraction. Together with the existing heart model, the new CAT provides an important improvement over the current 3D XCAT phantom in providing a more realistic model of the normal heart and the potential to simulate myocardial diseases in evaluation of medical imaging instrumentation, image reconstruction, and data processing methods.

Fung, George S. K.; Segars, W. Paul; Veress, Alexander I.; Gullberg, Grant T.; Tsui, Benjamin M. W.

2009-02-01

415

Evaluating the Continuity of Offending from Adolescence to Emerging Adulthood and its Effect on Academic Failure among College Student Arrestees: A Research Note  

Microsoft Academic Search

Life-course\\/developmental criminology has generated a significant amount of research in recent years, yet some questions remained unanswered. The current study seeks to fill the gap in the literature by exploring two related research questions: (1) Are there identifiable factors that distinguish offenders who demonstrate continuity in their offending in adolescence and emerging adulthood? (2) Does offending continuity increase the likelihood

Wesley G. Jennings; David N. Khey; Margaret Mahoney; Jennifer Reingle

2011-01-01

416

Visualizing context through theory deconstruction: a content analysis of three bodies of evaluation theory literature.  

PubMed

While the evaluation field collectively agrees that contextual factors bear on evaluation practice and related scholarly endeavors, the discipline does not yet have an explicit framework for understanding evaluation context. To address this gap in the knowledge base, this paper explores the ways in which evaluation context has been addressed in the practical-participatory, values-engaged, and emergent realist evaluation literatures. Five primary dimensions that constitute evaluation context were identified for this purpose: (1) stakeholder; (2) program; (3) organization; (4) historical/political; and (5) evaluator. Journal articles, book chapters, and conference papers rooted in the selected evaluation approaches were compared along these dimensions in order to explore points of convergence and divergence in the theories. Study results suggest that the selected prescriptive theories most clearly explicate stakeholder and evaluator contexts. Programmatic, organizational, and historical/political contexts, on the other hand, require further clarification. PMID:22469338

Vo, Anne T

2013-06-01

417

Diversified Business Groups in Emerging Economies Emerging Economies Emerging Economies Emerging Economies Emerging Economies  

Microsoft Academic Search

Abstract Abstract Abstract Abstract Diversified business groups dominate the organizational landscape of many emerging and transition economies. Are these diversified groups good or bad for these economies? How can we explain their emergence and persistence? Why are they so visible and dominant in developing countries but not in devel- oped ones? How should regulatory authorities view them? In this paper

MAITREESH GHATAK; RAJA KALI

418

A realistic benchmark for visual indoor place recognition  

Microsoft Academic Search

An important competence for a mobile robot system is the ability to localize and perform context interpretation. This is required to perform basic navigation and to facilitate local specific services. Recent advances in vision have made this modality a viable alternative to the traditional range sensors and visual place recognition algorithms emerged as a useful and widely applied tool for

Andrzej Pronobis; Barbara Caputo; Patric Jensfelt; Henrik I. Christensen

2010-01-01

419

Corporate reputation versus corporate branding: the realist debate  

Microsoft Academic Search

Studies in the fields of marketing and corporate identity are at a crossroads. Changes in the structure of organisations and their operating environments have led to the emergence of the concept of corporate branding and possibly even the development of a new domain of management science. This paper traces the development of brand thinking from both a marketing (customer market)

David Bickerton

2000-01-01

420

A Realist Defense of the Alien Tort Statute  

Microsoft Academic Search

This Article offers a new justification for modern litigation under the Alien Tort Statute (ATS), a provision from the 1789 Judiciary Act that permits victims of human rights violations anywhere in the world to sue tortfeasors in U.S. courts. The ATS, moribund for nearly 200 years, has recently emerged as an important but controversial tool for the enforcement of human

Robert Knowles

2011-01-01

421

Prehospital Burn Care for Emergency Medical Technicians.  

ERIC Educational Resources Information Center

Describes the development, objectives, content, and evaluation of a unique, 60-minute, synchronized slide/tape program on prehospital burn care for emergency medical technicians; and presents a design for valid content-reference formative evaluation. (Author/VT)

Lindstrom, Robert A.; And Others

1978-01-01

422

A matched-pair cluster design study protocol to evaluate implementation of the Canadian C-spine rule in hospital emergency departments: Phase III  

Microsoft Academic Search

BACKGROUND: Physicians in Canadian emergency departments (EDs) annually treat 185,000 alert and stable trauma victims who are at risk for cervical spine (C-spine) injury. However, only 0.9% of these patients have suffered a cervical spine fracture. Current use of radiography is not efficient. The Canadian C-Spine Rule is designed to allow physicians to be more selective and accurate in ordering

Ian G Stiell; Jeremy Grimshaw; George A Wells; Doug Coyle; Howard J Lesiuk; Brian H Rowe; Robert J Brison; Michael John Schull; Jacques Lee; Catherine M Clement

2007-01-01

423

Out-of-hospital cardiac arrest. Evaluation of one year of activity in Saint-Etienne's emergency medical system using the Utstein style  

Microsoft Academic Search

Objective: to provide researchers with a description of the method of dealing with out-of-hospital cardiac arrests, and the results thereof, using the Utstein style. Design: a series of out-of-hospital cardiac arrests between 1 October 1991 and 31 September 1992. Setting: a French ‘département’ (administrative subdivision). Population: 570, 000 inhabitants; area: 2600 km2; emergency medical system consisting of two levels of

François Giraud; Claire Rascle; Michel Guignand

1996-01-01

424

Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis.  

PubMed

Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. PMID:23892207

Sheehan, Barbara; Nigrovic, Lise E; Dayan, Peter S; Kuppermann, Nathan; Ballard, Dustin W; Alessandrini, Evaline; Bajaj, Lalit; Goldberg, Howard; Hoffman, Jeffrey; Offerman, Steven R; Mark, Dustin G; Swietlik, Marguerite; Tham, Eric; Tzimenatos, Leah; Vinson, David R; Jones, Grant S; Bakken, Suzanne

2013-10-01

425

Coulomb frictional interfaces in modeling cemented total hip replacements: a more realistic model.  

PubMed

Loosening of cemented femoral hip stems could be initiated by failure of the cement mantle due to high cement stresses. The goals of this study were to determine if realistic stem-cement interface characteristics could result in high cement stresses when compared to a bonded stem-cement interface and to determine if stem design parameters could be chosen to reduce peak cement stresses. Three-dimensional finite-element models of cemented femoral hip components were studied with bonded or realistic Coulomb friction stem-cement interfaces. The results showed that the use of a non-bonded, non-linear Coulomb friction interface resulted in substantially different stress fields in the cement when compared to a bonded stem-cement interface. Tensile stresses in the proximal cement mantel for the Coulomb friction interface case (10.8 MPa) were greater than the fatigue strength of the cement. In contrast, the tensile stresses in the cement mantle were not greater than the fatigue strength for the bonded case (7.5 MPa). Failure of the cement mantle in the proximal femur could therefore be initiated by a lack of a bond at the stem-cement interface. The effect of different cross-sectional stem geometries (medial radii of 3.0, 4.9 and 5.5 mm and antero-posterior widths of 9.8 and 13.7 mm) and different elastic moduli (cobalt chromium alloy and titanium alloy) for the stem material were also evaluated for models with a Coulomb friction interface. Changes in the stem cross-section and elastic modulus had only limited effects on the stress distributions in the cement. Of the parameters evaluated in this study, the characteristics of the stem-cement interface had the largest effect on cement mantle stresses. PMID:7559676

Mann, K A; Bartel, D L; Wright, T M; Burstein, A H

1995-09-01

426

XCAT/DRASIM: a realistic CT/human-model simulation package  

NASA Astrophysics Data System (ADS)

The aim of this research is to develop a complete CT/human-model simulation package by integrating the 4D eXtended CArdiac-Torso (XCAT) phantom, a computer generated NURBS surface based phantom that provides a realistic model of human anatomy and respiratory and cardiac motions, and the DRASIM (Siemens Healthcare) CT-data simulation program. Unlike other CT simulation tools which are based on simple mathematical primitives or voxelized phantoms, this new simulation package has the advantages of utilizing a realistic model of human anatomy and physiological motions without voxelization and with accurate modeling of the characteristics of clinical Siemens CT systems. First, we incorporated the 4D XCAT anatomy and motion models into DRASIM by implementing a new library which consists of functions to read-in the NURBS surfaces of anatomical objects and their overlapping order and material properties in the XCAT phantom. Second, we incorporated an efficient ray-tracing algorithm for line integral calculation in DRASIM by computing the intersection points of the rays cast from the x-ray source to the detector elements through the NURBS surfaces of the multiple XCAT anatomical objects along the ray paths. Third, we evaluated the integrated simulation package by performing a number of sample simulations of multiple x-ray projections from different views followed by image reconstruction. The initial simulation results were found to be promising by qualitative evaluation. In conclusion, we have developed a unique CT/human-model simulation package which has great potential as a tool in the design and optimization of CT scanners, and the development of scanning protocols and image reconstruction methods for improving CT image quality and reducing radiation dose.

Fung, George S. K.; Stierstorfer, Karl; Segars, W. Paul; Taguchi, Katsuyuki; Flohr, Thomas G.; Tsui, Benjamin M. W.

2011-03-01

427

A novel CPU/GPU simulation environment for large-scale biologically realistic neural modeling  

PubMed Central

Computational Neuroscience is an emerging field that provides unique opportunities to study complex brain structures through realistic neural simulations. However, as biological details are added to models, the execution time for the simulation becomes longer. Graphics Processing Units (GPUs) are now being utilized to accelerate simulations due to their ability to perform computations in parallel. As such, they have shown significant improvement in execution time compared to Central Processing Units (CPUs). Most neural simulators utilize either multiple CPUs or a single GPU for better performance, but still show limitations in execution time when biological details are not sacrificed. Therefore, we present a novel CPU/GPU simulation environment for large-scale biological networks, the NeoCortical Simulator version 6 (NCS6). NCS6 is a free, open-source, parallelizable, and scalable simulator, designed to run on clusters of multiple machines, potentially with high performance computing devices in each of them. It has built-in leaky-integrate-and-fire (LIF) and Izhikevich (IZH) neuron models, but users also have the capability to design their own plug-in interface for different neuron types as desired. NCS6 is currently able to simulate one million cells and 100 million synapses in quasi real time by distributing data across eight machines with each having two video cards. PMID:24106475

Hoang, Roger V.; Tanna, Devyani; Jayet Bray, Laurence C.; Dascalu, Sergiu M.; Harris, Frederick C.

2013-01-01

428

IN CASE OF EMERGENCY EMERGENCY EVENT  

E-print Network

IN CASE OF EMERGENCY EMERGENCY EVENT CARDIAC ARREST FIRST ACTION 801-585-2677 24 hrs Pull local alarm Close doors, evacuate nearby Call University Police 801-585-2677 MEDICAL ASSIST 801 flames for lighting. EMERGENCY ASSEMBLY POINT (OUTSIDE) IDENTIFIED BY MY DEPARTMENT: Format courtesy

Tipple, Brett

429

Realistic quantum manipulation of two-level system fluctuators  

E-print Network

Two-level system fluctuators in superconducting devices have demonstrated coherent coupling with superconducting qubits. Here, we show that universal quantum logic gates can be realized in these two-level systems solely by tuning a superconducting resonator in which they are imbedded. Because of the large energy separation between the fluctuators, conventional gate schemes in the cavity QED approach that are widely used for solid-state qubits cannot be directly applied to the fluctuators. We study a scheme to perform the gate operations by exploiting the controllability of the superconducting resonator with realistic parameters. Numerical simulation that takes into account the decay of the resonator mode shows that the quantum logic gates can be realized with high fidelity at moderate resonator decay rate. The quantum logic gates can also be realized between fluctuators inside different Josephson junctions that are connected by a superconducting loop. Our scheme can be applied to explore the coupling between two-level system fluctuators and superconducting resonators as well as the coherent properties of the fluctuators.

L. Tian; K. Jacobs

2009-03-02

430

Knowing how to look predicts the ability to draw realistically.  

PubMed

Some young children are able to create stunningly realistic drawings resembling those of adult artists. What perceptual abilities underlie this talent? This study examined two candidate skills on which adult artists excel: the ability to segment a complex form mentally (measured by the Block Design Task) and the ability to see hidden forms (measured by the Group Embedded Figures Test). Sixty-seven 6- to 13-year-olds with a wide range of drawing abilities completed these tasks as well as an IQ test and an observational drawing task. While children who scored high on drawing realism outperformed those who scored low in drawing realism on both perceptual tasks, only detection of embedded figures predicted drawing realism. This occurred independently of age, gender, years of training, and verbal and non-verbal IQ. There are certainly many contributors to this complex ability, but one component appears to be the tendency to see things more as they really are and thereby recognize the continuous contour of an object despite interference from other overlapping objects. PMID:24863053

Drake, Jennifer E

2014-11-01