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

PubMed

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

2017-09-01

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

Design, characterization, and sensitivity of the supernova trigger system at Daya Bay

NASA Astrophysics Data System (ADS)

Wei, Hanyu; Lebanowski, Logan; Li, Fei; Wang, Zhe; Chen, Shaomin

2016-02-01

Providing an early warning of galactic supernova explosions from neutrino signals is important in studying supernova dynamics and neutrino physics. A dedicated supernova trigger system has been designed and installed in the data acquisition system at Daya Bay and integrated into the worldwide Supernova Early Warning System (SNEWS). Daya Bay's unique feature of eight identically-designed detectors deployed in three separate experimental halls makes the trigger system naturally robust against cosmogenic backgrounds, enabling a prompt analysis of online triggers and a tight control of the false-alert rate. The trigger system is estimated to be fully sensitive to 1987A-type supernova bursts throughout most of the Milky Way. The significant gain in sensitivity of the eight-detector configuration over a mass-equivalent single detector is also estimated. The experience of this online trigger system is applicable to future projects with spatially distributed detectors.

Evaluation of real-time clinical decision support systems for platelet and cryoprecipitate orders.

PubMed

Collins, Ryan A; Triulzi, Darrell J; Waters, Jonathan H; Reddy, Vivek; Yazer, Mark H

2014-01-01

To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines. There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders. CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.

Integration of physical abuse clinical decision support into the electronic health record at a Tertiary Care Children's Hospital.

PubMed

Suresh, Srinivasan; Saladino, Richard A; Fromkin, Janet; Heineman, Emily; McGinn, Tom; Richichi, Rudolph; Berger, Rachel P

2018-04-12

To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set. Preintervention subjects' providers had neither alerts nor access to the order set. Compliance with clinical guidelines was calculated. Ninety-nine preintervention subjects and 130 RCT subjects (73 RCT-experimental and 57 RCT-control) met criteria to undergo a physical abuse evaluation. Full compliance with clinical guidelines was 84% pre-intervention, 86% in RCT-control group, and 89% in RCT-experimental group. The physical abuse order set was used 43 times during the 7-month RCT. When the abuse order set was used, full compliance was 100%. The proportion of cases in which there was partial compliance decreased from 10% to 3% once the order set became available (P = .04). Male gender, having >10 years of experience and completion of a pediatric emergency medicine fellowship were associated with increased compliance. A child abuse clinical decision support system comprised of a trigger system, alerts and a physical abuse order set was quickly accepted into clinical practice. Use of the physical abuse order set always resulted in full compliance with clinical guidelines. Given the high baseline compliance at our site, evaluation of this alert system in hospitals with lower baseline compliance rates will be more valuable in assessing the efficacy in adherence to clinical guidelines for the evaluation of suspected child abuse.

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

NASA Astrophysics Data System (ADS)

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

2004-09-01

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

Wireless Sensor Node for Autonomous Monitoring and Alerts in Remote Environments

NASA Technical Reports Server (NTRS)

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

2015-01-01

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

The Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network.

PubMed

Benthin, Cody; Pannu, Sonal; Khan, Akram; Gong, Michelle

2016-10-01

The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsis-related syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. A majority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of one common electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.

PubMed

Austrian, Jonathan S; Jamin, Catherine T; Doty, Glenn R; Blecker, Saul

2018-05-01

The purpose of this study was to determine whether an electronic health record-based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Primary outcomes were length of stay (LOS) and in-hospital mortality; other outcomes included time to first lactate and blood cultures prior to antibiotics. We also assessed sensitivity, positive predictive value (PPV), and clinician response to the alerts. Mean LOS for patients with sepsis decreased from 10.1 to 8.6 days (P < .001) following alert introduction. In adjusted time series analysis, the intervention was associated with a decreased LOS of 16% (95% CI, 5%-25%; P = .007, with significance of α = 0.006) and no change thereafter (0%; 95% CI, -2%, 2%). The sepsis alert system had no effect on mortality or other clinical or process measures. The intervention had a sensitivity of 80.4% and a PPV of 14.6%. Alerting based on simple laboratory and vital sign criteria was insufficient to improve sepsis outcomes. Alert fatigue due to the low PPV is likely the primary contributor to these results. A more sophisticated algorithm for sepsis identification is needed to improve outcomes.

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

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

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

2004-01-01

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

Does Telehealth Monitoring Identify Exacerbations of Chronic Obstructive Pulmonary Disease and Reduce Hospitalisations? An Analysis of System Data

PubMed Central

Bentley, Claire L; Mountain, Gail A

2017-01-01

Background The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD. Objective The aim was to undertake the first analysis of system data to determine whether telehealth monitoring can identify an exacerbation of COPD, providing clinicians with an opportunity to intervene with timely treatment and prevent hospital readmission. Methods A total of 23 participants received a telehealth-supported intervention. This paper reports on the analysis of data from a telehealth monitoring system that captured data from two sources: (1) data uploaded both manually and using Bluetooth peripheral devices by the 23 participants and (2) clinical records entered as nursing notes by the clinicians. Rules embedded in the telehealth monitoring system triggered system alerts to be reviewed by remote clinicians who determined whether clinical intervention was required. We also analyzed data on the frequency and length (bed days) of hospital admissions, frequency of hospital Accident and Emergency visits that did not lead to hospital admission, and frequency and type of community health care service contacts—other than the COPD discharge service—for all participants for the duration of the intervention and 6 months postintervention. Results Patients generated 512 alerts, 451 of which occurred during the first 42 days that all participants used the equipment. Patients generated fewer alerts over time with typically seven alerts per day within the first 10 days and four alerts per day thereafter. They also had three times more days without alerts than with alerts. Alerts were most commonly triggered by reports of being more tired, having difficulty with self-care, and blood pressure being out of range. During the 8-week intervention, and for 6-month follow-up, eight of the 23 patients were hospitalized. Hospital readmission rates (2/23, 9%) in the first 28 days of service were lower than the 20% UK norm. Conclusions It seems that the clinical team can identify exacerbations based on both an increase in alerts and the types of system-generated alerts as evidenced by their efforts to provided treatment interventions. There was some indication that telehealth monitoring potentially delayed hospitalizations until after patients had been discharged from the service. We suggest that telehealth-supported care can fulfill an important role in enabling patients with COPD to better manage their condition and remain out of hospital, but adequate resourcing and timely response to alerts is a critical factor in supporting patients to remain at home. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 68856013; http://www.isrctn.com/ISRCTN68856013 (Archived by WebCite at http://www.webcitation.org/6ofApNB2e) PMID:28330829

Development of an Earthquake Impact Scale

NASA Astrophysics Data System (ADS)

Wald, D. J.; Marano, K. D.; Jaiswal, K. S.

2009-12-01

With the advent of the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) system, domestic (U.S.) and international earthquake responders are reconsidering their automatic alert and activation levels as well as their response procedures. To help facilitate rapid and proportionate earthquake response, we propose and describe an Earthquake Impact Scale (EIS) founded on two alerting criteria. One, based on the estimated cost of damage, is most suitable for domestic events; the other, based on estimated ranges of fatalities, is more appropriate for most global events. Simple thresholds, derived from the systematic analysis of past earthquake impact and response levels, turn out to be quite effective in communicating predicted impact and response level of an event, characterized by alerts of green (little or no impact), yellow (regional impact and response), orange (national-scale impact and response), and red (major disaster, necessitating international response). Corresponding fatality thresholds for yellow, orange, and red alert levels are 1, 100, and 1000, respectively. For damage impact, yellow, orange, and red thresholds are triggered by estimated losses exceeding 1M, 10M, and $1B, respectively. The rationale for a dual approach to earthquake alerting stems from the recognition that relatively high fatalities, injuries, and homelessness dominate in countries where vernacular building practices typically lend themselves to high collapse and casualty rates, and it is these impacts that set prioritization for international response. In contrast, it is often financial and overall societal impacts that trigger the level of response in regions or countries where prevalent earthquake resistant construction practices greatly reduce building collapse and associated fatalities. Any newly devised alert protocols, whether financial or casualty based, must be intuitive and consistent with established lexicons and procedures. In this analysis, we make an attempt at both simple and intuitive color-coded alerting criterion; yet, we preserve the necessary uncertainty measures by which one can gauge the likelihood for the alert to be over- or underestimated.

How Regrouping Alerts in Computerized Physician Order Entry Layout Influences Physicians' Prescription Behavior: Results of a Crossover Randomized Trial.

PubMed

Wipfli, Rolf; Ehrler, Frederic; Bediang, Georges; Bétrancourt, Mireille; Lovis, Christian

2016-06-02

As demonstrated in several publications, low positive predictive value alerts in computerized physician order entry (CPOE) induce fatigue and may interrupt physicians unnecessarily during prescription of medication. Although it is difficult to increase the consideration of medical alerts by physician through an improvement of their predictive value, another approach consists to act on the way they are presented. The interruption management model inspired us to propose an alternative alert display strategy of regrouping the alerts in the screen layout, as a possible solution for reducing the interruption in physicians' workflow. In this study, we compared 2 CPOE designs based on a particular alert presentation strategy: one design involved regrouping the alerts in a single place on the screen, and in the other, the alerts were located next to the triggering information. Our objective was to evaluate experimentally whether the new design led to fewer interruptions in workflow and if it affected alert handling. The 2 CPOE designs were compared in a controlled crossover randomized trial. All interactions with the system and eye movements were stored for quantitative analysis. The study involved a group of 22 users consisting of physicians and medical students who solved medical scenarios containing prescription tasks. Scenario completion time was shorter when the alerts were regrouped (mean 117.29 seconds, SD 36.68) than when disseminated on the screen (mean 145.58 seconds, SD 75.07; P=.045). Eye tracking revealed that physicians fixated longer on alerts in the classic design (mean 119.71 seconds, SD 76.77) than in the centralized alert design (mean 70.58 seconds, SD 33.53; P=.001). Visual switches between prescription and alert areas, indicating interruption, were reduced with centralized alerts (mean 41.29, SD 21.26) compared with the classic design (mean 57.81, SD 35.97; P=.04). Prescription behavior (ie, prescription changes after alerting), however, did not change significantly between the 2 strategies of display. The After-Scenario Questionnaire (ASQ) that was filled out after each scenario showed that overall satisfaction was significantly rated lower when alerts were regrouped (mean 4.37, SD 1.23) than when displayed next to the triggering information (mean 5.32, SD 0.94; P=.02). Centralization of alerts in a table might be a way to motivate physicians to manage alerts more actively, in a meaningful way, rather than just being interrupted by them. Our study could not provide clear recommendations yet, but provides objective data through a cognitive psychological approach. Future tests should work on standardized scenarios that would enable to not only measure physicians' behavior (visual fixations and handling of alerts) but also validate those actions using clinical criteria.

Successful ShakeAlert Performance for the Napa Quake

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

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

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

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

PubMed

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

2018-05-04

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

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

NASA Astrophysics Data System (ADS)

Kumar, Munesh; Siddique, Shoaib; Noor, Humera

2009-04-01

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

A New GRB follow-up Software at TUG

NASA Astrophysics Data System (ADS)

Dindar, M.; Parmaksizoglu, M.; Helhel, S.; Esenoglu, H.; Kirbiyik, H.

2016-12-01

A gamma-ray burst (GRB) optical photometric follow-up system at TUBITAK (Scientic and Technological Research Council of Turkey) National Observatory (TUG) has been planned. It uses the 0.6 m Telescope (T60) and can automatically respond to GRB Coordinates Network (GCN) alerts. The telescopes slew relatively fast, being able to point to a new target field within 30 s upon a request. Whenever available, the 1 m T100 and 2.5 m RTT150 telescopes will be used in the future. As an example in 2015, the GRB software system (will be server side) at T60-telescope responded to GRB alert and started the observation as early as 129 s after the GRB trigger autonomously.

Assessing the Minimum Number of Synchronization Triggers Necessary for Temporal Variance Compensation in Commercial Electroencephalography (EEG) Systems

DTIC Science & Technology

2012-09-01

by the ARL Translational Neuroscience Branch. It covers the Emotiv EPOC,6 Advanced Brain Monitoring (ABM) B-Alert X10,7 Quasar 8 DSI helmet-based...Systems; ARL-TR-5945; U.S. Army Research Laboratory: Aberdeen Proving Ground, MD, 2012 4 Ibid. 5 Ibid. 6 EPOC is a trademark of Emotiv . 7 B

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

PubMed

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

2011-01-01

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

Swift detection of MAXI J1820+070

NASA Astrophysics Data System (ADS)

Kennea, J. A.; Marshall, F. E.; Page, K. L.; Palmer, D. M.; Siegel, M. H.; Neil Gehrels Swift Observatory Team

2018-03-01

This is reposted from GCN #22471 as it is of interest to the transient community. At 00:11:39 UT, the Swift Burst Alert Telescope (BAT) triggered and located MAXI J1820+070 (Kawamuro et al, 2018; ATel #11399) (trigger=813771, retriggering as trigger=813772).

Effects of an air pollution personal alert system on health service usage in a high-risk general population: a quasi-experimental study using linked data.

PubMed

Lyons, R A; Rodgers, S E; Thomas, S; Bailey, R; Brunt, H; Thayer, D; Bidmead, J; Evans, B A; Harold, P; Hooper, M; Snooks, H

2016-05-23

There is no evidence to date on whether an intervention alerting people to high levels of pollution is effective in reducing health service utilisation. We evaluated alert accuracy and the effect of a targeted personal air pollution alert system, airAware, on emergency hospital admissions, emergency department attendances, general practitioner contacts and prescribed medications. Quasi-experimental study describing accuracy of alerts compared with pollution triggers; and comparing relative changes in healthcare utilisation in the intervention group to those who did not sign-up. Participants were people diagnosed with asthma, chronic obstructive pulmonary disease (COPD) or coronary heart disease, resident in an industrial area of south Wales and registered patients at 1 of 4 general practices. Longitudinal anonymised record linked data were modelled for participants and non-participants, adjusting for differences between groups. During the 2-year intervention period alerts were correctly issued on 208 of 248 occasions; sensitivity was 83.9% (95% CI 78.8% to 87.9%) and specificity 99.5% (95% CI 99.3% to 99.6%). The intervention was associated with a 4-fold increase in admissions for respiratory conditions (incidence rate ratio (IRR) 3.97; 95% CI 1.59 to 9.93) and a near doubling of emergency department attendance (IRR=1.89; 95% CI 1.34 to 2.68). The intervention was associated with increased emergency admissions for respiratory conditions. While findings may be context specific, evidence from this evaluation questions the benefits of implementing near real-time personal pollution alert systems for high-risk individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Characterization of computer network events through simultaneous feature selection and clustering of intrusion alerts

NASA Astrophysics Data System (ADS)

Chen, Siyue; Leung, Henry; Dondo, Maxwell

2014-05-01

As computer network security threats increase, many organizations implement multiple Network Intrusion Detection Systems (NIDS) to maximize the likelihood of intrusion detection and provide a comprehensive understanding of intrusion activities. However, NIDS trigger a massive number of alerts on a daily basis. This can be overwhelming for computer network security analysts since it is a slow and tedious process to manually analyse each alert produced. Thus, automated and intelligent clustering of alerts is important to reveal the structural correlation of events by grouping alerts with common features. As the nature of computer network attacks, and therefore alerts, is not known in advance, unsupervised alert clustering is a promising approach to achieve this goal. We propose a joint optimization technique for feature selection and clustering to aggregate similar alerts and to reduce the number of alerts that analysts have to handle individually. More precisely, each identified feature is assigned a binary value, which reflects the feature's saliency. This value is treated as a hidden variable and incorporated into a likelihood function for clustering. Since computing the optimal solution of the likelihood function directly is analytically intractable, we use the Expectation-Maximisation (EM) algorithm to iteratively update the hidden variable and use it to maximize the expected likelihood. Our empirical results, using a labelled Defense Advanced Research Projects Agency (DARPA) 2000 reference dataset, show that the proposed method gives better results than the EM clustering without feature selection in terms of the clustering accuracy.

Evaluation of Nursing Documentation Completion of Stroke Patients in the Emergency Department: A Pre-Post Analysis Using Flowsheet Templates and Clinical Decision Support.

PubMed

Richardson, Karen J; Sengstack, Patricia; Doucette, Jeffrey N; Hammond, William E; Schertz, Matthew; Thompson, Julie; Johnson, Constance

2016-02-01

The primary aim of this performance improvement project was to determine whether the electronic health record implementation of stroke-specific nursing documentation flowsheet templates and clinical decision support alerts improved the nursing documentation of eligible stroke patients in seven stroke-certified emergency departments. Two system enhancements were introduced into the electronic record in an effort to improve nursing documentation: disease-specific documentation flowsheets and clinical decision support alerts. Using a pre-post design, project measures included six stroke management goals as defined by the National Institute of Neurological Disorders and Stroke and three clinical decision support measures based on entry of orders used to trigger documentation reminders for nursing: (1) the National Institutes of Health's Stroke Scale, (2) neurological checks, and (3) dysphagia screening. Data were reviewed 6 months prior (n = 2293) and 6 months following the intervention (n = 2588). Fisher exact test was used for statistical analysis. Statistical significance was found for documentation of five of the six stroke management goals, although effect sizes were small. Customizing flowsheets to meet the needs of nursing workflow showed improvement in the completion of documentation. The effects of the decision support alerts on the completeness of nursing documentation were not statistically significant (likely due to lack of order entry). For example, an order for the National Institutes of Health Stroke Scale was entered only 10.7% of the time, which meant no alert would fire for nursing in the postintervention group. Future work should focus on decision support alerts that trigger reminders for clinicians to place relevant orders for this population.

Earthquake Early Warning: New Strategies for Seismic Hardware

NASA Astrophysics Data System (ADS)

Allardice, S.; Hill, P.

2017-12-01

Implementing Earthquake Early Warning System (EEWS) triggering algorithms into seismic networks has been a hot topic of discussion for some years now. With digitizer technology now available, such as the Güralp Minimus, with on average 40-60ms delay time (latency) from earthquake origin to issuing an alert the next step is to provide network operators with a simple interface for on board parameter calculations from a seismic station. A voting mechanism is implemented on board which mitigates the risk of false positives being communicated. Each Minimus can be configured to with a `score' from various sources i.e. Z channel on seismometer, N/S E/W channels on accelerometer and MEMS inside Minimus. If the score exceeds the set threshold then an alert is sent to the `Master Minimus'. The Master Minimus within the network will also be configured as to when the alert should be issued i.e. at least 3 stations must have triggered. Industry standard algorithms focus around the calculation of Peak Ground Acceleration (PGA), Peak Ground Velocity (PGV), Peak Ground Displacement (PGD) and C. Calculating these single station parameters on-board in order to stream only the results could help network operators with possible issues, such as restricted bandwidth. Developments on the Minimus allow these parameters to be calculated and distributed through Common Alert Protocol (CAP). CAP is the XML based data format used for exchanging and describing public warnings and emergencies. Whenever the trigger conditions are met the Minimus can send a signed UDP packet to the configured CAP receiver which can then send the alert via SMS, e-mail or CAP forwarding. Increasing network redundancy is also a consideration when developing these features, therefore the forwarding CAP message can be sent to multiple destinations. This allows for a hierarchical approach by which the single station (or network) parameters can be streamed to another Minimus, or data centre, or both, so that there is no one single point of failure. Developments on the Guralp Minimus to calculate these on board parameters which are capable of streaming single station parameters, accompanied with the ultra-low latency is the next generation of EEWS and Güralps contribution to the community.

Evaluation of prescriber responses to pharmacogenomics clinical decision support for thiopurine S-methyltransferase testing.

PubMed

Ubanyionwu, Samuel; Formea, Christine M; Anderson, Benjamin; Wix, Kelly; Dierkhising, Ross; Caraballo, Pedro J

2018-02-15

Results of a study of prescribers' responses to a pharmacogenomics-based clinical decision support (CDS) alert designed to prompt thiopurine S -methyltransferase (TPMT) status testing are reported. A single-center, retrospective, chart review-based study was conducted to evaluate prescriber compliance with a pretest CDS alert that warned of potential thiopurine drug toxicity resulting from deficient TPMT activity due to TPMT gene polymorphism. The CDS alert was triggered when prescribers ordered thiopurine drugs for patients whose records did not indicate TPMT status or when historical thiopurine use was documented in the electronic health record. The alert pop-up also provided a link to online educational resources to guide thiopurine dosing calculations. During the 9-month study period, 500 CDS alerts were generated: in 101 cases (20%), TPMT phenotyping or TPMT genotyping was ordered; in 399 cases (80%), testing was not ordered. Multivariable regression analysis indicated that documentation of historical thiopurine use was the only independent predictor of test ordering. Among the 99 patients tested subsequent to CDS alerts, 70 (71%) had normal TPMT activity, 29 (29%) had intermediate activity, and none had deficient activity. The online resources provided thiopurine dosing recommendations applicable to 24 patients, but only 3 were prescribed guideline-supported doses after CDS alerts. The pretest CDS rule resulted in a large proportion of neglected alerts due to poor alerting accuracy and consequent alert fatigue. Prescriber usage of online thiopurine dosing resources was low. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Vital signs and other observations used to detect deterioration in pregnant women: an analysis of vital sign charts in consultant-led UK maternity units.

PubMed

Smith, G B; Isaacs, R; Andrews, L; Wee, M Y K; van Teijlingen, E; Bick, D E; Hundley, V

2017-05-01

Obstetric early warning systems are recommended for monitoring hospitalised pregnant and postnatal women. We decided to compare: (i) vital sign values used to define physiological normality; (ii) symptoms and signs used to escalate care; (iii) type of chart used; and (iv) presence of explicit instructions for escalating care. One-hundred-and-twenty obstetric early warning charts and escalation protocols were obtained from consultant-led maternity units in the UK and Channel Islands. These data were extracted: values used to determine normality for each maternal vital sign; chart colour-coding; instructions following early warning system triggering; other criteria used as triggers. There was considerable variation in the charts, warning systems and escalation protocols. Of 120 charts, 89.2% used colour; 69.2% used colour-coded escalation systems. Forty-one (34.2%) systems required the calculation of weighted scores. Seventy-five discrete combinations of 'normal' vital sign ranges were found, the most common being: heart rate=50-99beats/min; respiratory rate=11-20breaths/min; blood pressure, systolic=100-149mmHg, diastolic ≤89mmHg; SpO 2 =95-100%; temperature=36.0-37.9°C; and Alert-Voice-Pain-Unresponsive assessment=Alert. Most charts (90.8%) provided instructions about who to contact following triggering, but only 41.7% gave instructions about subsequent observation frequency. The wide range of 'normal' vital sign values in different systems suggests a lack of equity in the processes for detecting deterioration and escalating care in hospitalised pregnant and postnatal women. Agreement regarding 'normal' vital sign ranges is urgently required and would assist the development of a standardised obstetric early warning system and chart. Copyright © 2017 Elsevier Ltd. All rights reserved.

Judging the urgency of non-verbal auditory alarms: a case study.

PubMed

Arrabito, G Robert; Mondor, Todd; Kent, Kimberley

2004-06-22

When designed correctly, non-verbal auditory alarms can convey different levels of urgency to the aircrew, and thereby permit the operator to establish the appropriate level of priority to address the alarmed condition. The conveyed level of urgency of five non-verbal auditory alarms presently used in the Canadian Forces CH-146 Griffon helicopter was investigated. Pilots of the CH-146 Griffon helicopter and non-pilots rated the perceived urgency of the signals using a rating scale. The pilots also ranked the urgency of the alarms in a post-experiment questionnaire to reflect their assessment of the actual situation that triggers the alarms. The results of this investigation revealed that participants' ratings of perceived urgency appear to be based on the acoustic properties of the alarms which are known to affect the listener's perceived level of urgency. Although for 28% of the pilots the mapping of perceived urgency to the urgency of their perception of the triggering situation was statistically significant for three of the five alarms, the overall data suggest that the triggering situations are not adequately conveyed by the acoustic parameters inherent in the alarms. The pilots' judgement of the triggering situation was intended as a means of evaluating the reliability of the alerting system. These data will subsequently be discussed with respect to proposed enhancements in alerting systems as it relates to addressing the problem of phase of flight. These results call for more serious consideration of incorporating situational awareness in the design and assignment of auditory alarms in aircraft.

Earthquake impact scale

USGS Publications Warehouse

Wald, D.J.; Jaiswal, K.S.; Marano, K.D.; Bausch, D.

2011-01-01

With the advent of the USGS prompt assessment of global earthquakes for response (PAGER) system, which rapidly assesses earthquake impacts, U.S. and international earthquake responders are reconsidering their automatic alert and activation levels and response procedures. To help facilitate rapid and appropriate earthquake response, an Earthquake Impact Scale (EIS) is proposed on the basis of two complementary criteria. On the basis of the estimated cost of damage, one is most suitable for domestic events; the other, on the basis of estimated ranges of fatalities, is generally more appropriate for global events, particularly in developing countries. Simple thresholds, derived from the systematic analysis of past earthquake impact and associated response levels, are quite effective in communicating predicted impact and response needed after an event through alerts of green (little or no impact), yellow (regional impact and response), orange (national-scale impact and response), and red (international response). Corresponding fatality thresholds for yellow, orange, and red alert levels are 1, 100, and 1,000, respectively. For damage impact, yellow, orange, and red thresholds are triggered by estimated losses reaching $1M, $100M, and $1B, respectively. The rationale for a dual approach to earthquake alerting stems from the recognition that relatively high fatalities, injuries, and homelessness predominate in countries in which local building practices typically lend themselves to high collapse and casualty rates, and these impacts lend to prioritization for international response. In contrast, financial and overall societal impacts often trigger the level of response in regions or countries in which prevalent earthquake resistant construction practices greatly reduce building collapse and resulting fatalities. Any newly devised alert, whether economic- or casualty-based, should be intuitive and consistent with established lexicons and procedures. Useful alerts should also be both specific (although allowably uncertain) and actionable. In this analysis, an attempt is made at both simple and intuitive color-coded alerting criteria; yet the necessary uncertainty measures by which one can gauge the likelihood for the alert to be over- or underestimated are preserved. The essence of the proposed impact scale and alerting is that actionable loss information is now available in the immediate aftermath of significant earthquakes worldwide on the basis of quantifiable loss estimates. Utilizing EIS, PAGER's rapid loss estimates can adequately recommend alert levels and suggest appropriate response protocols, despite the uncertainties; demanding or awaiting observations or loss estimates with a high level of accuracy may increase the losses. ?? 2011 American Society of Civil Engineers.

ECG Holter monitor with alert system and mobile application

NASA Astrophysics Data System (ADS)

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

2016-05-01

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

The 2014 Mw 6.0 Napa Earthquake, California: Observations from Real-time GPS-enhanced Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Johanson, I. A.; Grapenthin, R.; Allen, R. M.

2014-12-01

Recently, progress has been made to demonstrate feasibility and benefits of including real-time GPS (rtGPS) in earthquake early warning and rapid response systems. While most concepts have yet to be integrated into operational environments, the Berkeley Seismological Laboratory is currently running an rtGPS based finite fault inversion scheme in true real-time, which is triggered by the seismic-based ShakeAlert system and then sends updated earthquake alerts to a test receiver. The Geodetic Alarm System (G-larmS) was online and responded to the 2014 Mw6.0 South Napa earthquake in California. We review G-larmS' performance during this event and for 13 aftershocks, and we present rtGPS observations and real-time modeling results for the main shock. The first distributed slip model and a magnitude estimate of Mw5.5 were available 24 s after the event origin time, which could be reduced to 14 s after a bug fix (~8 s S-wave travel time, ~6 s data latency). The system continued to re-estimate the magnitude once every second: it increased to Mw5.9 3 s after the first alert and stabilized at Mw5.8 after 15 s. G-larmS' solutions for the subsequent small magnitude aftershocks demonstrate that Mw~6.0 is the current limit for alert updates to contribute back to the seismic-based early warning system.

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

PubMed

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

2017-12-01

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

Optical and X-ray early follow-up of ANTARES neutrino alerts

NASA Astrophysics Data System (ADS)

Adrián-Martínez, S.; Ageron, M.; Albert, A.; Samarai, I. Al; André, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bogazzi, C.; Bormuth, R.; Bou-Cabo, M.; Bouwhuis, M. C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Chiarusi, T.; Circella, M.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Dekeyser, I.; Deschamps, A.; De Bonis, G.; Distefano, C.; Donzaud, C.; Dornic, D.; Drouhin, D.; Dumas, A.; Eberl, T.; Elsässer, D.; Enzenhöfer, A.; Fehn, K.; Felis, I.; Fermani, P.; Folger, F.; Fusco, L. A.; Galatà, S.; Gay, P.; Geißelsöder, S.; Geyer, K.; Giordano, V.; Gleixner, A.; Gracia-Ruiz, R.; Graf, K.; van Haren, H.; Heijboer, A. J.; Hello, Y.; Hernández-Rey, J. J.; Herrero, A.; Hößl, J.; Hofestädt, J.; Hugon, C.; James, C. W.; de Jong, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kooijman, P.; Kouchner, A.; Kreykenbohm, I.; Kulikovskiy, V.; Lahmann, R.; Lambard, G.; Lattuada, D.; Lefèvre, D.; Leonora, E.; Loucatos, S.; Mangano, S.; Marcelin, M.; Margiotta, A.; Martínez-Mora, J. A.; Martini, S.; Mathieu, A.; Michael, T.; Migliozzi, P.; Moussa, A.; Mueller, C.; Neff, M.; Nezri, E.; Păvălaš, G. E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Racca, C.; Riccobene, G.; Richter, R.; Roensch, K.; Rostovtsev, A.; Saldaña, M.; Samtleben, D. F. E.; Sanguineti, M.; Sapienza, P.; Schmid, J.; Schnabel, J.; Schulte, S.; Schüssler, F.; Seitz, T.; Sieger, C.; Spurio, M.; Steijger, J. J. M.; Stolarczyk, Th.; Sánchez-Losa, A.; Taiuti, M.; Tamburini, C.; Trovato, A.; Tselengidou, M.; Tönnis, C.; Turpin, D.; Vallage, B.; Vallée, C.; Van Elewyck, V.; Vecchi, M.; Visser, E.; Vivolo, D.; Wagner, S.; Wilms, J.; Zornoza, J. D.; Zúñiga, J.; Klotz, A.; Boer, M.; Le Van Suu, A.; Akerlof, C.; Zheng, W.; Evans, P.; Gehrels, N.; Kennea, J.; Osborne, J. P.; Coward, D. M.

2016-02-01

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from a single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert.

Optical and X-ray early follow-up of ANTARES neutrino alerts

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

Adrián-Martínez, S.; Ardid, M.; Ageron, M.

High-energy neutrinos could be produced in the interaction of charged cosmic rays with matter or radiation surrounding astrophysical sources. Even with the recent detection of extraterrestrial high-energy neutrinos by the IceCube experiment, no astrophysical neutrino source has yet been discovered. Transient sources, such as gamma-ray bursts, core-collapse supernovae, or active galactic nuclei are promising candidates. Multi-messenger programs offer a unique opportunity to detect these transient sources. By combining the information provided by the ANTARES neutrino telescope with information coming from other observatories, the probability of detecting a source is enhanced, allowing the possibility of identifying a neutrino progenitor from amore » single detected event. A method based on optical and X-ray follow-ups of high-energy neutrino alerts has been developed within the ANTARES collaboration. This method does not require any assumptions on the relation between neutrino and photon spectra other than time-correlation. This program, denoted as TAToO, triggers a network of robotic optical telescopes (TAROT and ROTSE) and the Swift-XRT with a delay of only a few seconds after a neutrino detection, and is therefore well-suited to search for fast transient sources. To identify an optical or X-ray counterpart to a neutrino signal, the images provided by the follow-up observations are analysed with dedicated pipelines. A total of 42 alerts with optical and 7 alerts with X-ray images taken with a maximum delay of 24 hours after the neutrino trigger have been analysed. No optical or X-ray counterparts associated to the neutrino triggers have been found, and upper limits on transient source magnitudes have been derived. The probability to reject the gamma-ray burst origin hypothesis has been computed for each alert.« less

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

PubMed

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

2009-09-01

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

Concomitant prescribing and dispensing errors at a Brazilian hospital: a descriptive study

PubMed Central

Silva, Maria das Dores Graciano; Rosa, Mário Borges; Franklin, Bryony Dean; Reis, Adriano Max Moreira; Anchieta, Lêni Márcia; Mota, Joaquim Antônio César

2011-01-01

OBJECTIVE: To analyze the prevalence and types of prescribing and dispensing errors occurring with high-alert medications and to propose preventive measures to avoid errors with these medications. INTRODUCTION: The prevalence of adverse events in health care has increased, and medication errors are probably the most common cause of these events. Pediatric patients are known to be a high-risk group and are an important target in medication error prevention. METHODS: Observers collected data on prescribing and dispensing errors occurring with high-alert medications for pediatric inpatients in a university hospital. In addition to classifying the types of error that occurred, we identified cases of concomitant prescribing and dispensing errors. RESULTS: One or more prescribing errors, totaling 1,632 errors, were found in 632 (89.6%) of the 705 high-alert medications that were prescribed and dispensed. We also identified at least one dispensing error in each high-alert medication dispensed, totaling 1,707 errors. Among these dispensing errors, 723 (42.4%) content errors occurred concomitantly with the prescribing errors. A subset of dispensing errors may have occurred because of poor prescription quality. The observed concomitancy should be examined carefully because improvements in the prescribing process could potentially prevent these problems. CONCLUSION: The system of drug prescribing and dispensing at the hospital investigated in this study should be improved by incorporating the best practices of medication safety and preventing medication errors. High-alert medications may be used as triggers for improving the safety of the drug-utilization system. PMID:22012039

DO THE FERMI GAMMA-RAY BURST MONITOR AND SWIFT BURST ALERT TELESCOPE SEE THE SAME SHORT GAMMA-RAY BURSTS?

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

Burns, Eric; Briggs, Michael S.; Connaughton, Valerie

2016-02-20

Compact binary system mergers are expected to generate gravitational radiation detectable by ground-based interferometers. A subset of these, the merger of a neutron star with another neutron star or a black hole, are also the most popular model for the production of short gamma-ray bursts (GRBs). The Swift Burst Alert Telescope (BAT) and the Fermi Gamma-ray Burst Monitor (GBM) trigger on short GRBs (SGRBs) at rates that reflect their relative sky exposures, with the BAT detecting 10 per year compared to about 45 for GBM. We examine the SGRB populations detected by Swift BAT and Fermi GBM. We find thatmore » the Swift BAT triggers on weaker SGRBs than Fermi GBM, providing they occur close to the center of the BAT field of view, and that the Fermi GBM SGRB detection threshold remains flatter across its field of view. Overall, these effects combine to give the instruments the same average sensitivity, and account for the SGRBs that trigger one instrument but not the other. We do not find any evidence that the BAT and GBM are detecting significantly different populations of SGRBs. Both instruments can detect untriggered SGRBs using ground searches seeded with time and position. The detection of SGRBs below the on-board triggering sensitivities of Swift BAT and Fermi GBM increases the possibility of detecting and localizing the electromagnetic counterparts of gravitational wave (GW) events seen by the new generation of GW detectors.« less

Automated inhaled nitric oxide alerts for adult extracorporeal membrane oxygenation patient identification.

PubMed

Belenkiy, Slava M; Batchinsky, Andriy I; Park, Timothy S; Luellen, David E; Serio-Melvin, Maria L; Cancio, Leopoldo C; Pamplin, Jeremy C; Chung, Kevin K; Salinas, Josè; Cannon, Jeremy W

2014-09-01

Recently, automated alerts have been used to identify patients with respiratory failure based on set criteria, which can be gleaned from the electronic medical record (EMR). Such an approach may also be useful for identifying patients with severe adult respiratory distress syndrome (ARDS) who may benefit from extracorporeal membrane oxygenation (ECMO). Inhaled nitric oxide (iNO) is a common rescue therapy for severe ARDS which can be easily tracked in the EMR, and some patients started on iNO may have indications for initiating ECMO. This case series summarizes our experience with using automated electronic alerts for ECMO team activation focused particularly on an alert triggered by the initiation of iNO. After a brief trial evaluation, our Smart Alert system generated an automated page and e-mail alert to ECMO team members whenever a nonzero value for iNO appeared in the respiratory care section of our EMR. If iNO was initiated for severe respiratory failure, a detailed evaluation by the ECMO team determined if ECMO was indicated. For those patients managed with ECMO, we tabulated baseline characteristics, indication for ECMO, and outcomes. From September 2012 to July 2013, 45 iNO alerts were generated on 42 unique patients. Six patients (14%) met criteria for ECMO. Of these, four were identified exclusively by the iNO alert. At the time of the alert, the median PaO₂-to-FIO₂ ratio was 64 mm Hg (range, 55-107 mm Hg), the median age-adjusted oxygenation index was 73 (range, 51-96), and the median Murray score was 3.4 (range, 3-3.75), indicating severe respiratory failure. Median time from iNO alert to ECMO initiation was 81 hours (range, -2-292 hours). Survival to hospital discharge was 83% in those managed with ECMO. Automated alerts may be useful for identifying patients with severe ARDS who may be ECMO candidates. Diagnostic test, level V.

A trial of retrofitted advisory collision avoidance technology in government fleet vehicles.

PubMed

Thompson, James P; Mackenzie, Jamie R R; Dutschke, Jeffrey K; Baldock, Matthew R J; Raftery, Simon J; Wall, John

2018-06-01

In-vehicle collision avoidance technology (CAT) has the potential to prevent crash involvement. In 2015, Transport for New South Wales undertook a trial of a Mobileye 560 CAT system that was installed in 34 government fleet vehicles for a period of seven months. The system provided headway monitoring, lane departure, forward collision and pedestrian collision warnings, using audio and visual alerts. The purpose of the trial was to determine whether the technology could change the driving behaviour of fleet vehicle drivers and improve their safety. The evaluation consisted of three components: (1) analysis of objective data to examine effects of the technology on driving behaviour, (2) analysis of video footage taken from a sample of the vehicles to examine driving circumstances that trigger headway monitoring and forward collision warnings, and (3) a survey completed by 122 of the 199 individuals who drove the trial vehicles to examine experiences with, and attitudes to, the technology. Analysis of the objective data found that the system resulted in changes in behaviour with increased headway and improved lane keeping, but that these improvements dissipated once the warning alerts were switched off. Therefore, the system is capable of altering behaviour but only when it is actively providing alerts. In-vehicle video footage revealed that over a quarter of forward collision warnings were false alarms, in which a warning event was triggered despite there being no vehicle travelling ahead. The surveyed drivers recognised that the system could improve safety but most did not wish to use it themselves as they found it to be distracting and felt that it would not prevent them from having a crash. The results demonstrate that collision avoidance technology can improve driving behaviour but drivers may need to be educated about the potential benefits for their driving in order to accept the technology. Copyright © 2018 Elsevier Ltd. All rights reserved.

Integration of Grid and Sensor Web for Flood Monitoring and Risk Assessment from Heterogeneous Data

NASA Astrophysics Data System (ADS)

Kussul, Nataliia; Skakun, Sergii; Shelestov, Andrii

2013-04-01

Over last decades we have witnessed the upward global trend in natural disaster occurrence. Hydrological and meteorological disasters such as floods are the main contributors to this pattern. In recent years flood management has shifted from protection against floods to managing the risks of floods (the European Flood risk directive). In order to enable operational flood monitoring and assessment of flood risk, it is required to provide an infrastructure with standardized interfaces and services. Grid and Sensor Web can meet these requirements. In this paper we present a general approach to flood monitoring and risk assessment based on heterogeneous geospatial data acquired from multiple sources. To enable operational flood risk assessment integration of Grid and Sensor Web approaches is proposed [1]. Grid represents a distributed environment that integrates heterogeneous computing and storage resources administrated by multiple organizations. SensorWeb is an emerging paradigm for integrating heterogeneous satellite and in situ sensors and data systems into a common informational infrastructure that produces products on demand. The basic Sensor Web functionality includes sensor discovery, triggering events by observed or predicted conditions, remote data access and processing capabilities to generate and deliver data products. Sensor Web is governed by the set of standards, called Sensor Web Enablement (SWE), developed by the Open Geospatial Consortium (OGC). Different practical issues regarding integration of Sensor Web with Grids are discussed in the study. We show how the Sensor Web can benefit from using Grids and vice versa. For example, Sensor Web services such as SOS, SPS and SAS can benefit from the integration with the Grid platform like Globus Toolkit. The proposed approach is implemented within the Sensor Web framework for flood monitoring and risk assessment, and a case-study of exploiting this framework, namely the Namibia SensorWeb Pilot Project, is described. The project was created as a testbed for evaluating and prototyping key technologies for rapid acquisition and distribution of data products for decision support systems to monitor floods and enable flood risk assessment. The system provides access to real-time products on rainfall estimates and flood potential forecast derived from the Tropical Rainfall Measuring Mission (TRMM) mission with lag time of 6 h, alerts from the Global Disaster Alert and Coordination System (GDACS) with lag time of 4 h, and the Coupled Routing and Excess STorage (CREST) model to generate alerts. These are alerts are used to trigger satellite observations. With deployed SPS service for NASA's EO-1 satellite it is possible to automatically task sensor with re-image capability of less 8 h. Therefore, with enabled computational and storage services provided by Grid and cloud infrastructure it was possible to generate flood maps within 24-48 h after trigger was alerted. To enable interoperability between system components and services OGC-compliant standards are utilized. [1] Hluchy L., Kussul N., Shelestov A., Skakun S., Kravchenko O., Gripich Y., Kopp P., Lupian E., "The Data Fusion Grid Infrastructure: Project Objectives and Achievements," Computing and Informatics, 2010, vol. 29, no. 2, pp. 319-334.

Centile-based early warning scores derived from statistical distributions of vital signs.

PubMed

Tarassenko, Lionel; Clifton, David A; Pinsky, Michael R; Hravnak, Marilyn T; Woods, John R; Watkinson, Peter J

2011-08-01

To develop an early warning score (EWS) system based on the statistical properties of the vital signs in at-risk hospitalised patients. A large dataset comprising 64,622 h of vital-sign data, acquired from 863 acutely ill in-hospital patients using bedside monitors, was used to investigate the statistical properties of the four main vital signs. Normalised histograms and cumulative distribution functions were plotted for each of the four variables. A centile-based alerting system was modelled using the aggregated database. The means and standard deviations of our population's vital signs are very similar to those published in previous studies. When compared with EWS systems based on a future outcome, the cut-off values in our system are most different for respiratory rate and systolic blood pressure. With four-hourly observations in a 12-h shift, about 1 in 8 at-risk patients would trigger our alerting system during the shift. A centile-based EWS system will identify patients with abnormal vital signs regardless of their eventual outcome and might therefore be more likely to generate an alert when presented with patients with redeemable morbidity or avoidable mortality. We are about to start a stepped-wedge clinical trial gradually introducing an electronic version of our EWS system on the trauma wards in a teaching hospital. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

Baker, J.; Modlin, C.W.; Frerking, C.J.

HIPROTECT (pronounced High-protect) is a system designed to protect national archaeological and natural treasures from destruction by vandals or looters. The system is being developed jointly by the Lawrence Livermore National Laboratory and the University of California at Riverside under the DOD Legacy Resource Management Program. Thousands of archaeological sites are located on military bases and national park lands. Treasure hunters or vandals are pillaging and destroying these sites at will, since the sites are generally located in remote areas, unattended and unprotected. The HIPROTECT system is designed to detect trespassers at the protected sites and to alert park officialsmore » or military officials of intrusions. An array of sensors is used to detect trespassers. The sensors are triggered when a person or vehicle approaches the site. Alarm messages are transmitted to alert park officials or law enforcement officials by way of a cellular telephone link. A video and audio system is included to assist the officials in verifying that an intrusion has occurred and to allow two-way communication with the intruders.« less

Very high-energy gamma-ray follow-up program using neutrino triggers from IceCube

NASA Astrophysics Data System (ADS)

IceCube Collaboration; Aartsen, M. G.; Abraham, K.; Ackermann, M.; Adams, J.; Aguilar, J. A.; Ahlers, M.; Ahrens, M.; Altmann, D.; Andeen, K.; Anderson, T.; Ansseau, I.; Anton, G.; Archinger, M.; Argüelles, C.; Auffenberg, J.; Axani, S.; Bai, X.; Barwick, S. W.; Baum, V.; Bay, R.; Beatty, J. J.; Becker Tjus, J.; Becker, K.-H.; BenZvi, S.; Berley, D.; Bernardini, E.; Bernhard, A.; Besson, D. Z.; Binder, G.; Bindig, D.; Bissok, M.; Blaufuss, E.; Blot, S.; Bohm, C.; Börner, M.; Bos, F.; Bose, D.; Böser, S.; Botner, O.; Braun, J.; Brayeur, L.; Bretz, H.-P.; Bron, S.; Burgman, A.; Carver, T.; Casier, M.; Cheung, E.; Chirkin, D.; Christov, A.; Clark, K.; Classen, L.; Coenders, S.; Collin, G. H.; Conrad, J. M.; Cowen, D. F.; Cross, R.; Day, M.; de André, J. P. A. M.; De Clercq, C.; del Pino Rosendo, E.; Dembinski, H.; De Ridder, S.; Desiati, P.; de Vries, K. D.; de Wasseige, G.; de With, M.; DeYoung, T.; Díaz-Vélez, J. C.; di Lorenzo, V.; Dujmovic, H.; Dumm, J. P.; Dunkman, M.; Eberhardt, B.; Ehrhardt, T.; Eichmann, B.; Eller, P.; Euler, S.; Evenson, P. A.; Fahey, S.; Fazely, A. R.; Feintzeig, J.; Felde, J.; Filimonov, K.; Finley, C.; Flis, S.; Fösig, C.-C.; Franckowiak, A.; Franke, R.; Friedman, E.; Fuchs, T.; Gaisser, T. K.; Gallagher, J.; Gerhardt, L.; Ghorbani, K.; Giang, W.; Gladstone, L.; Glauch, T.; Glüsenkamp, T.; Goldschmidt, A.; Golup, G.; Gonzalez, J. G.; Grant, D.; Griffith, Z.; Haack, C.; Haj Ismail, A.; Hallgren, A.; Halzen, F.; Hansen, E.; Hansmann, T.; Hanson, K.; Hebecker, D.; Heereman, D.; Helbing, K.; Hellauer, R.; Hickford, S.; Hignight, J.; Hill, G. C.; Hoffman, K. D.; Hoffmann, R.; Holzapfel, K.; Hoshina, K.; Huang, F.; Huber, M.; Hultqvist, K.; In, S.; Ishihara, A.; Jacobi, E.; Japaridze, G. S.; Jeong, M.; Jero, K.; Jones, B. J. P.; Jurkovic, M.; Kappes, A.; Karg, T.; Karle, A.; Katz, U.; Kauer, M.; Keivani, A.; Kelley, J. L.; Kheirandish, A.; Kim, M.; Kintscher, T.; Kiryluk, J.; Kittler, T.; Klein, S. R.; Kohnen, G.; Koirala, R.; Kolanoski, H.; Konietz, R.; Köpke, L.; Kopper, C.; Kopper, S.; Koskinen, D. J.; Kowalski, M.; Krings, K.; Kroll, M.; Krückl, G.; Krüger, C.; Kunnen, J.; Kunwar, S.; Kurahashi, N.; Kuwabara, T.; Labare, M.; Lanfranchi, J. L.; Larson, M. J.; Lauber, F.; Lennarz, D.; Lesiak-Bzdak, M.; Leuermann, M.; Lu, L.; Lünemann, J.; Madsen, J.; Maggi, G.; Mahn, K. B. M.; Mancina, S.; Mandelartz, M.; Maruyama, R.; Mase, K.; Maunu, R.; McNally, F.; Meagher, K.; Medici, M.; Meier, M.; Meli, A.; Menne, T.; Merino, G.; Meures, T.; Miarecki, S.; Mohrmann, L.; Montaruli, T.; Moulai, M.; Nahnhauer, R.; Naumann, U.; Neer, G.; Niederhausen, H.; Nowicki, S. C.; Nygren, D. R.; Obertacke Pollmann, A.; Olivas, A.; O'Murchadha, A.; Palczewski, T.; Pandya, H.; Pankova, D. V.; Peiffer, P.; Penek, Ö.; Pepper, J. A.; Pérez de los Heros, C.; Pieloth, D.; Pinat, E.; Price, P. B.; Przybylski, G. T.; Quinnan, M.; Raab, C.; Rädel, L.; Rameez, M.; Rawlins, K.; Reimann, R.; Relethford, B.; Relich, M.; Resconi, E.; Rhode, W.; Richman, M.; Riedel, B.; Robertson, S.; Rongen, M.; Rott, C.; Ruhe, T.; Ryckbosch, D.; Rysewyk, D.; Sabbatini, L.; Sanchez Herrera, S. E.; Sandrock, A.; Sandroos, J.; Sarkar, S.; Satalecka, K.; Schlunder, P.; Schmidt, T.; Schoenen, S.; Schöneberg, S.; Schumacher, L.; Seckel, D.; Seunarine, S.; Soldin, D.; Song, M.; Spiczak, G. M.; Spiering, C.; Stanev, T.; Stasik, A.; Stettner, J.; Steuer, A.; Stezelberger, T.; Stokstad, R. G.; Stößl, A.; Ström, R.; Strotjohann, N. L.; Sullivan, G. W.; Sutherland, M.; Taavola, H.; Taboada, I.; Tatar, J.; Tenholt, F.; Ter-Antonyan, S.; Terliuk, A.; Tešić, G.; Tilav, S.; Toale, P. A.; Tobin, M. N.; Toscano, S.; Tosi, D.; Tselengidou, M.; Turcati, A.; Unger, E.; Usner, M.; Vandenbroucke, J.; van Eijndhoven, N.; Vanheule, S.; van Rossem, M.; van Santen, J.; Veenkamp, J.; Vehring, M.; Voge, M.; Vogel, E.; Vraeghe, M.; Walck, C.; Wallace, A.; Wallraff, M.; Wandkowsky, N.; Weaver, Ch.; Weiss, M. J.; Wendt, C.; Westerhoff, S.; Whelan, B. J.; Wickmann, S.; Wiebe, K.; Wiebusch, C. H.; Wille, L.; Williams, D. R.; Wills, L.; Wolf, M.; Wood, T. R.; Woolsey, E.; Woschnagg, K.; Xu, D. L.; Xu, X. W.; Xu, Y.; Yanez, J. P.; Yodh, G.; Yoshida, S.; Zoll, M.; MAGIC Collaboration; Ahnen, M. L.; Ansoldi, S.; Antonelli, L. A.; Antoranz, P.; Babic, A.; Banerjee, B.; Bangale, P.; Barres de Almeida, U.; Barrio, J. A.; Becerra González, J.; Bednarek, W.; Bernardini, E.; Berti, A.; Biasuzzi, B.; Biland, A.; Blanch, O.; Bonnefoy, S.; Bonnoli, G.; Borracci, F.; Bretz, T.; Buson, S.; Carosi, A.; Chatterjee, A.; Clavero, R.; Colin, P.; Colombo, E.; Contreras, J. L.; Cortina, J.; Covino, S.; Da Vela, P.; Dazzi, F.; De Angelis, A.; De Lotto, B.; de Oña Wilhelmi, E.; Di Pierro, F.; Doert, M.; Domínguez, A.; Dominis Prester, D.; Dorner, D.; Doro, M.; Einecke, S.; Eisenacher Glawion, D.; Elsaesser, D.; Engelkemeier, M.; Fallah Ramazani, V.; Fernández-Barral, A.; Fidalgo, D.; Fonseca, M. V.; Font, L.; Frantzen, K.; Fruck, C.; Galindo, D.; García López, R. J.; Garczarczyk, M.; Garrido Terrats, D.; Gaug, M.; Giammaria, P.; Godinović, N.; González Muñoz, A.; Góra, D.; Guberman, D.; Hadasch, D.; Hahn, A.; Hanabata, Y.; Hayashida, M.; Herrera, J.; Hose, J.; Hrupec, D.; Hughes, G.; Idec, W.; Kodani, K.; Konno, Y.; Kubo, H.; Kushida, J.; La Barbera, A.; Lelas, D.; Lindfors, E.; Lombardi, S.; Longo, F.; López, M.; López-Coto, R.; Majumdar, P.; Makariev, M.; Mallot, K.; Maneva, G.; Manganaro, M.; Mannheim, K.; Maraschi, L.; Marcote, B.; Mariotti, M.; Martínez, M.; Mazin, D.; Menzel, U.; Miranda, J. M.; Mirzoyan, R.; Moralejo, A.; Moretti, E.; Nakajima, D.; Neustroev, V.; Niedzwiecki, A.; Nievas Rosillo, M.; Nilsson, K.; Nishijima, K.; Noda, K.; Nogués, L.; Overkemping, A.; Paiano, S.; Palacio, J.; Palatiello, M.; Paneque, D.; Paoletti, R.; Paredes, J. M.; Paredes-Fortuny, X.; Pedaletti, G.; Peresano, M.; Perri, L.; Persic, M.; Poutanen, J.; Prada Moroni, P. G.; Prandini, E.; Puljak, I.; Reichardt, I.; Rhode, W.; Ribó, M.; Rico, J.; Rodriguez Garcia, J.; Saito, T.; Satalecka, K.; Schroeder, S.; Schultz, C.; Schweizer, T.; Sillanpää, A.; Sitarek, J.; Snidaric, I.; Sobczynska, D.; Stamerra, A.; Steinbring, T.; Strzys, M.; Surić, T.; Takalo, L.; Tavecchio, F.; Temnikov, P.; Terzić, T.; Tescaro, D.; Teshima, M.; Thaele, J.; Torres, D. F.; Toyama, T.; Treves, A.; Vanzo, G.; Verguilov, V.; Vovk, I.; Ward, J. E.; Will, M.; Wu, M. H.; Zanin, .; VERITAS Collaboration; Abeysekara, A. U.; Archambault, S.; Archer, A.; Benbow, W.; Bird, R.; Bourbeau, E.; Buchovecky, M.; Bugaev, V.; Byrum, K.; Cardenzana, J. V.; Cerruti, M.; Ciupik, L.; Connolly, M. P.; Cui, W.; Dickinson, H. J.; Dumm, J.; Eisch, J. D.; Errando, M.; Falcone, A.; Feng, Q.; Finley, J. P.; Fleischhack, H.; Flinders, A.; Fortson, L.; Furniss, A.; Gillanders, G. H.; Griffin, S.; Hütten, J. Grube M.; Håkansson, N.; Hervet, O.; Holder, J.; Humensky, T. B.; Johnson, C. A.; Kaaret, P.; Kar, P.; Kelley-Hoskins, N.; Kertzman, M.; Kieda, D.; Krause, M.; Krennrich, F.; Kumar, S.; Lang, M. J.; Maier, G.; McArthur, S.; McCann, A.; Moriarty, P.; Mukherjee, R.; Nguyen, T.; Nieto, D.; O'Brien, S.; Ong, R. A.; Otte, A. N.; Park, N.; Pohl, M.; Popkow, A.; Pueschel, E.; Quinn, J.; Ragan, K.; Reynolds, P. T.; Richards, G. T.; Roache, E.; Rulten, C.; Sadeh, I.; Santander, M.; Sembroski, G. H.; Shahinyan, K.; Staszak, D.; Telezhinsky, I.; Tucci, J. V.; Tyler, J.; Wakely, S. P.; Weinstein, A.; Wilcox, P.; Wilhelm, A.; Williams, D. A.; Zitzer, B.

2016-11-01

We describe and report the status of a neutrino-triggered program in IceCube that generates real-time alerts for gamma-ray follow-up observations by atmospheric-Cherenkov telescopes (MAGIC and VERITAS). While IceCube is capable of monitoring the whole sky continuously, high-energy gamma-ray telescopes have restricted fields of view and in general are unlikely to be observing a potential neutrino-flaring source at the time such neutrinos are recorded. The use of neutrino-triggered alerts thus aims at increasing the availability of simultaneous multi-messenger data during potential neutrino flaring activity, which can increase the discovery potential and constrain the phenomenological interpretation of the high-energy emission of selected source classes (e.g. blazars). The requirements of a fast and stable online analysis of potential neutrino signals and its operation are presented, along with first results of the program operating between 14 March 2012 and 31 December 2015.

CERN alerter—RSS based system for information broadcast to all CERN offices

NASA Astrophysics Data System (ADS)

Otto, R.

2008-07-01

Nearly every large organization uses a tool to broadcast messages and information across the internal campus (messages like alerts announcing interruption in services or just information about upcoming events). These tools typically allow administrators (operators) to send 'targeted' messages which are sent only to specific groups of users or computers, e/g only those located in a specified building or connected to a particular computing service. CERN has a long history of such tools: CERNVMS's SPM_quotMESSAGE command, Zephyr [2] and the most recent the NICE Alerter based on the NNTP protocol. The NICE Alerter used on all Windows-based computers had to be phased out as a consequence of phasing out NNTP at CERN. The new solution to broadcast information messages on the CERN campus continues to provide the service based on cross-platform technologies, hence minimizing custom developments and relying on commercial software as much as possible. The new system, called CERN Alerter, is based on RSS (Really Simple Syndication) [9] for the transport protocol and uses Microsoft SharePoint as the backend for database and posting interface. The windows-based client relies on Internet Explorer 7.0 with custom code to trigger the window pop-ups and the notifications for new events. Linux and Mac OS X clients could also rely on any RSS readers to subscribe to targeted notifications. The paper covers the architecture and implementation aspects of the new system.

Clinical reasoning in the context of active decision support during medication prescribing.

PubMed

Horsky, Jan; Aarts, Jos; Verheul, Leonie; Seger, Diane L; van der Sijs, Heleen; Bates, David W

2017-01-01

Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol. Tasks were recorded and analyzed to describe reasoning patterns about patient-risk assessment and strategies to avoid or mitigate it. We observed a total of 171 prescribing decisions. Clinicians actively sought to reduce risk when responding to high-severity alerts, mostly by monitoring patients and making dose adjustments (52 alerts, 40%). In contrast, they routinely left prescriptions unchanged after low-severity alerts when they felt confident that patients would tolerate the drug combination and that treatment benefits outweighed the risks (30 alerts, 71%). Clinicians used similar reasoning patterns regardless of the EHR used and differences in alert design. Clinicians conceptualized risk as a complex set of interdependent tradeoffs specific to individual patients and had a tendency not to follow advice they considered of low clinical value. Omission of patient-specific data, which was not shown in alerts or included in trigger logic, may have contributed to the constancy of reasoning and to similarities in risk-control strategies we observed despite significant differences in interface design and system function. Declining an alert suggestion was preceded by sometimes brief but often complex reasoning, prioritizing different aspects of care quality and safety, especially when the perceived risk was higher. Clinicians believed that the risk indicated in drug-drug interaction alerts needs to be interpreted as one factor in the broader context of care, specific to a patient. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: protocol for a systematic review and meta-analysis.

PubMed

Lachance, Philippe; Villeneuve, Pierre-Marc; Wilson, Francis P; Selby, Nicholas M; Featherstone, Robin; Rewa, Oleksa; Bagshaw, Sean M

2016-05-05

Acute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients. The impact of e-alerts on care processes, patient outcomes and health resource use, however, remains uncertain. We will perform a systematic review to describe and appraise e-alerts for AKI, and evaluate their impact on processes of care, clinical outcomes and health services use. In consultation with a research librarian, a search strategy will be developed and electronic databases (ie, MEDLINE, EMBASE, CINAHL, Cochrane Library and Inspec via Engineering Village) searched. Selected grey literature sources will also be searched. Search themes will focus on e-alerts and AKI. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary analysis will be narrative; however, where feasible, pooled analysis will be performed. Each e-alert will be described according to trigger, type of alert, target recipient and degree of intrusiveness. Pooled effect estimates will be described, where applicable. Our systematic review will synthesise the literature on the value of e-alerts to detect AKI, and their impact on processes, patient-centred outcomes and resource use, and also identify key knowledge gaps and barriers to implementation. This is a fundamental step in a broader research programme aimed to understand the ideal structure of e-alerts, target population and methods for implementation, to derive benefit. Research ethics approval is not required for this review. CRD42016033033. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Overview of the SVOM Gamma-Ray Burst mission under development with a focus on its Trigger system

NASA Astrophysics Data System (ADS)

Schanne, Stephane

2017-08-01

The SVOM mission (Space-based Variable Objects Monitor) is a Chinese-French satellite mission under development, devoted to collecting a complete sample of Gamma-Ray Bursts (GRBs) observed at multi-wavelengths with a high fraction of redshift determinations. In January 2017 the mission entered Phase C, starting officially construction, and the launch is foreseen in 2021. The SVOM satellite is equipped with 4 instruments, 2 of which cover the prompt GRB phase. The ECLAIRs coded-mask imager surveys a 2-sr large portion of the sky in the 4-150 keV energy range, well suited for the detection of X-ray rich and highly redshifted GRBs. The ECLAIRs trigger system continuously searches for GRBs using two algorithms, a count-rate trigger for short time scales and an image trigger for long time scales. In case of a localized new GRB candidate or a bright outburst of a known source, it promptly requests a satellite slew and sends an alert to ground. The onboard GRM (Gamma-Ray Monitor) extends the prompt energy coverage up to 5 MeV. After slew, 2 more onboard instruments study the GRB afterglow and refine the GRB localization: the MXT (Multi-pore optics X-ray Telescope) and the VT (Visible Telescope). Two types of ground telescopes are dedicated to SVOM. The GFTs (Ground Follow-up Telescopes) repoint autonomously to GRB alerts, refine their localization and provide photometric redshift. The SVOM observing strategy with roughly antisolar pointing combined with Galactic plane avoidance, ensures that most GRBs are quickly visible by the GFTs and large spectroscopic telescopes. The GWAC (Ground Wide Angle Camera) will observe the sky simultaneously with ECLAIRs to detect prompt optical GRB emissions. Today part of the GWAC is already operational. The SVOM GRB program is complemented by pre-planned target observations and ground-commanded targets of opportunity, e.g. to search for electromagnetic counterparts of gravity-wave events. On behalf of the SVOM and ECLAIRs teams, this paper presents an overview of SVOM with a focus on its GRB trigger system.

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions.

PubMed

Muench, Frederick; Baumel, Amit

2017-05-26

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger's target, trigger's structure, trigger's narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one's change goals is the first step in this development work. ©Frederick Muench, Amit Baumel. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.05.2017.

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

NASA Astrophysics Data System (ADS)

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

2010-12-01

The U.S. Geological Survey (USGS) has begun publicly releasing earthquake alerts for significant earthquakes around the globe based on estimates of potential casualties and economic losses. These estimates should significantly enhance the utility of the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) system that has been providing estimated ShakeMaps and computing population exposures to specific shaking intensities since 2007. Quantifying earthquake impacts and communicating loss estimates (and their uncertainties) to the public has been the culmination of several important new and evolving components of the system. First, the operational PAGER system now relies on empirically-based loss models that account for estimated shaking hazard, population exposure, and employ country-specific fatality and economic loss functions derived using analyses of losses due to recent and past earthquakes. In some countries, our empirical loss models are informed in part by PAGER’s semi-empirical and analytical loss models, and building exposure and vulnerability data sets, all of which are being developed in parallel to the empirical approach. Second, human and economic loss information is now portrayed as a supplement to existing intensity/exposure content on both PAGER summary alert (available via cell phone/email) messages and web pages. Loss calculations also include estimates of the economic impact with respect to the country’s gross domestic product. Third, in order to facilitate rapid and appropriate earthquake responses based on our probable loss estimates, in early 2010 we proposed a four-level Earthquake Impact Scale (EIS). Instead of simply issuing median estimates for losses—which can be easily misunderstood and misused—this scale provides ranges of losses from which potential responders can gauge expected overall impact from strong shaking. EIS is based on two complementary criteria: the estimated cost of damage, which is most suitable for U.S. domestic events; and estimated ranges of fatalities, which are generally more appropriate for global events, particularly in earthquake-vulnerable countries. Alert levels are characterized by alerts of green (little or no impact), yellow (regional impact and response), orange (national-scale impact and response), and red (international response). Corresponding fatality thresholds for yellow, orange, and red alert levels are 1, 100, and 1000, respectively. For damage impact, yellow, orange, and red thresholds are triggered when estimated US dollar losses reach 1 million, 100 million, and 1 billion+ levels, respectively. Finally, alerting protocols now explicitly support EIS-based alerts. Critical users can receive PAGER alerts i) based on the EIS-based alert level, in addition to or as an alternative to magnitude and population/intensity exposure-based alerts, and ii) optionally, based on user-selected regions of the world. The essence of PAGER’s impact-based alerting is that actionable loss information is now available in the immediate aftermath of significant earthquakes worldwide based on quantifiable, albeit uncertain, loss estimates provided by the USGS.

Autoblocker: a system for detecting and blocking of network scanning based on analysis of netflow data

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

Bobyshev, A.; Lamore, D.; Demar, P.

2004-12-01

In a large campus network, such at Fermilab, with tens of thousands of nodes, scanning initiated from either outside of or within the campus network raises security concerns. This scanning may have very serious impact on network performance, and even disrupt normal operation of many services. In this paper we introduce a system for detecting and automatic blocking excessive traffic of different kinds of scanning, DoS attacks, virus infected computers. The system, called AutoBlocker, is a distributed computing system based on quasi-real time analysis of network flow data collected from the border router and core switches. AutoBlocker also has anmore » interface to accept alerts from IDS systems (e.g. BRO, SNORT) that are based on other technologies. The system has multiple configurable alert levels for the detection of anomalous behavior and configurable trigger criteria for automated blocking of scans at the core or border routers. It has been in use at Fermilab for about 2 years, and has become a very valuable tool to curtail scan activity within the Fermilab campus network.« less

ATLAS trigger operations: Upgrades to ``Xmon'' rate prediction system

NASA Astrophysics Data System (ADS)

Myers, Ava; Aukerman, Andrew; Hong, Tae Min; Atlas Collaboration

2017-01-01

We present ``Xmon,'' a tool to monitor trigger rates in the Control Room of the ATLAS Experiment. We discuss Xmon's recent (1) updates, (2) upgrades, and (3) operations. (1) Xmon was updated to modify the tool written for the three-level trigger architecture in Run-1 (2009-2012) to adapt to the new two-level system for Run-2 (2015-current). The tool takes as input the beam luminosity to make a rate prediction, which is compared with incoming rates to detect anomalies that occur both globally throughout a run and locally within a run. Global offsets are more commonly caught by the predictions based upon past runs, where offline processing allows for function adjustments and fit quality through outlier rejection. (2) Xmon was upgraded to detect local offsets using on-the-fly predictions, which uses a sliding window of in-run rates to make predictions. (3) Xmon operations examples are given. Future work involves further automation of the steps to provide the predictive functions and for alerting shifters.

More Than a Text Message: Dismantling Digital Triggers to Curate Behavior Change in Patient-Centered Health Interventions

PubMed Central

2017-01-01

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change. However, little attention has been given to understanding the components of digital triggers. Using tailoring as an overarching framework, we separated digital triggers into 5 primary components: (1) who (sender), (2) how (stimulus type, delivery medium, heterogeneity), (3) when (delivered), (4) how much (frequency, intensity), and (5) what (trigger’s target, trigger’s structure, trigger’s narrative). We highlighted key considerations when tailoring each component and the pitfalls of ignoring common mistakes, such as alert fatigue and habituation. As evidenced throughout the paper, there is a broad literature base from which to draw when tailoring triggers to curate behavior change in health interventions. More research is needed, however, to examine differences in efficacy based on component tailoring, to best use triggers to facilitate behavior change over time, and to keep individuals engaged in physical and mental health behavior change efforts. Dismantling digital triggers into their component parts and reassembling them according to the gestalt of one’s change goals is the first step in this development work. PMID:28550001

Hazards in Motion: Development of Mobile Geofences for Use in Logging Safety

PubMed Central

Zimbelman, Eloise G.; Keefe, Robert F.; Strand, Eva K.; Kolden, Crystal A.; Wempe, Ann M.

2017-01-01

Logging is one of the most hazardous occupations in the United States. Real-time positioning that uses global navigation satellite system (GNSS) technology paired with radio frequency transmission (GNSS-RF) has the potential to reduce fatal and non-fatal accidents on logging operations through the use of geofences that define safe work areas. Until recently, most geofences have been static boundaries. The aim of this study was to evaluate factors affecting mobile geofence accuracy in order to determine whether virtual safety zones around moving ground workers or equipment are a viable option for improving situational awareness on active timber sales. We evaluated the effects of walking pace, transmission interval, geofence radius, and intersection angle on geofence alert delay using a replicated field experiment. Simulation was then used to validate field results and calculate the proportion of GNSS error bearings resulting in early alerts. The interaction of geofence radius and intersection angle affected safety geofence alert delay in the field experiment. The most inaccurate alerts were negative, representing early warning. The magnitude of this effect was largest at the greatest intersection angles. Simulation analysis supported these field results and also showed that larger GNSS error corresponded to greater variability in alert delay. Increasing intersection angle resulted in a larger proportion of directional GNSS error that triggered incorrect, early warnings. Because the accuracy of geofence alerts varied greatly depending on GNSS error and angle of approach, geofencing for occupational safety is most appropriate for general situational awareness unless real-time correction methods to improve accuracy or higher quality GNSS-RF transponders are used. PMID:28394303

Lack of utility of a decision support system to mitigate delays in admission from the operating room to the postanesthesia care unit.

PubMed

Ehrenfeld, Jesse M; Dexter, Franklin; Rothman, Brian S; Minton, Betty Sue; Johnson, Diane; Sandberg, Warren S; Epstein, Richard H

2013-12-01

When the phase I postanesthesia care unit (PACU) is at capacity, completed cases need to be held in the operating room (OR), causing a "PACU delay." Statistical methods based on historical data can optimize PACU staffing to achieve the least possible labor cost at a given service level. A decision support process to alert PACU charge nurses that the PACU is at or near maximum census might be effective in lessening the incidence of delays and reducing over-utilized OR time, but only if alerts are timely (i.e., neither too late nor too early to act upon) and the PACU slot can be cleared quickly. We evaluated the maximum potential benefit of such a system, using assumptions deliberately biased toward showing utility. We extracted 3 years of electronic PACU data from a tertiary care medical center. At this hospital, PACU admissions were limited by neither inadequate PACU staffing nor insufficient PACU beds. We developed a model decision support system that simulated alerts to the PACU charge nurse. PACU census levels were reconstructed from the data at a 1-minute level of resolution and used to evaluate if subsequent delays would have been prevented by such alerts. The model assumed there was always a patient ready for discharge and an available hospital bed. The time from each alert until the maximum census was exceeded ("alert lead time") was determined. Alerts were judged to have utility if the alert lead time fell between various intervals from 15 or 30 minutes to 60, 75, or 90 minutes after triggering. In addition, utility for reducing over-utilized OR time was assessed using the model by determining if 2 patients arrived from 5 to 15 minutes of each other when the PACU census was at 1 patient less than the maximum census. At most, 23% of alerts arrived 30 to 60 minutes prior to the admission that resulted in the PACU exceeding the specified maximum capacity. When the notification window was extended to 15 to 90 minutes, the maximum utility was <50%. At most, 45% of alerts potentially would have resulted in reassigning the last available PACU slot to 1 OR versus another within 15 minutes of the original assignment. Despite multiple biases that favored effectiveness, the maximum potential benefit of a decision support system to mitigate PACU delays on the day on the surgery was below the 70% minimum threshold for utility of automated decision support messages, previously established via meta-analysis. Neither reduction in PACU delays nor reassigning promised PACU slots based on reducing over-utilized OR time were realized sufficiently to warrant further development of the system. Based on these results, the only evidence-based method of reducing PACU delays is to adjust PACU staffing and staff scheduling using computational algorithms to match the historical workload (e.g., as developed in 2001).

Warning! fire in the ICU.

PubMed

Rispoli, Fabio; Iannuzzi, Michele; De Robertis, Edoardo; Piazza, Ornella; Servillo, Giuseppe; Tufano, Rosalba

2014-06-01

At 5:30 pm on December 17, 2010, shortly after a power failure, smoke filled the Intensive Care Unit (ICU) of Federico II University Hospital in Naples, Italy, triggering the hospital emergency alarm system. Immediately, staff began emergency procedures and alerted rescue teams. All patients were transferred without harm. The smoke caused pharyngeal and conjunctival irritation in some staff members. After a brief investigation, firefighters discovered the cause of the fire was a failure of the Uninterruptible Power Supply (UPS).

Pattern recognition applied to infrared images for early alerts in fog

NASA Astrophysics Data System (ADS)

Boucher, Vincent; Marchetti, Mario; Dumoulin, Jean; Cord, Aurélien

2014-09-01

Fog conditions are the cause of severe car accidents in western countries because of the poor induced visibility. Its forecast and intensity are still very difficult to predict by weather services. Infrared cameras allow to detect and to identify objects in fog while visibility is too low for eye detection. Over the past years, the implementation of cost effective infrared cameras on some vehicles has enabled such detection. On the other hand pattern recognition algorithms based on Canny filters and Hough transformation are a common tool applied to images. Based on these facts, a joint research program between IFSTTAR and Cerema has been developed to study the benefit of infrared images obtained in a fog tunnel during its natural dissipation. Pattern recognition algorithms have been applied, specifically on road signs which shape is usually associated to a specific meaning (circular for a speed limit, triangle for an alert, …). It has been shown that road signs were detected early enough in images, with respect to images in the visible spectrum, to trigger useful alerts for Advanced Driver Assistance Systems.

Space-Based Sensorweb Monitoring of Wildfires in Thailand

NASA Technical Reports Server (NTRS)

Chien, Steve; Doubleday, Joshua; Mclaren, David; Davies, Ashley; Tran, Daniel; Tanpipat, Veerachai; Akaakara, Siri; Ratanasuwan, Anuchit; Mandl, Daniel

2011-01-01

We describe efforts to apply sensorweb technologies to the monitoring of forest fires in Thailand. In this approach, satellite data and ground reports are assimilated to assess the current state of the forest system in terms of forest fire risk, active fires, and likely progression of fires and smoke plumes. This current and projected assessment can then be used to actively direct sensors and assets to best acquire further information. This process operates continually with new data updating models of fire activity leading to further sensing and updating of models. As the fire activity is tracked, products such as active fire maps, burn scar severity maps, and alerts are automatically delivered to relevant parties.We describe the current state of the Thailand Fire Sensorweb which utilizes the MODIS-based FIRMS system to track active fires and trigger Earth Observing One / Advanced Land Imager to acquire imagery and produce active fire maps, burn scar severity maps, and alerts. We describe ongoing work to integrate additional sensor sources and generate additional products.

Development and use of active clinical decision support for preemptive pharmacogenomics

PubMed Central

Bell, Gillian C; Crews, Kristine R; Wilkinson, Mark R; Haidar, Cyrine E; Hicks, J Kevin; Baker, Donald K; Kornegay, Nancy M; Yang, Wenjian; Cross, Shane J; Howard, Scott C; Freimuth, Robert R; Evans, William E; Broeckel, Ulrich; Relling, Mary V; Hoffman, James M

2014-01-01

Background Active clinical decision support (CDS) delivered through an electronic health record (EHR) facilitates gene-based drug prescribing and other applications of genomics to patient care. Objective We describe the development, implementation, and evaluation of active CDS for multiple pharmacogenetic test results reported preemptively. Materials and methods Clinical pharmacogenetic test results accompanied by clinical interpretations are placed into the patient's EHR, typically before a relevant drug is prescribed. Problem list entries created for high-risk phenotypes provide an unambiguous trigger for delivery of post-test alerts to clinicians when high-risk drugs are prescribed. In addition, pre-test alerts are issued if a very-high risk medication is prescribed (eg, a thiopurine), prior to the appropriate pharmacogenetic test result being entered into the EHR. Our CDS can be readily modified to incorporate new genes or high-risk drugs as they emerge. Results Through November 2012, 35 customized pharmacogenetic rules have been implemented, including rules for TPMT with azathioprine, thioguanine, and mercaptopurine, and for CYP2D6 with codeine, tramadol, amitriptyline, fluoxetine, and paroxetine. Between May 2011 and November 2012, the pre-test alerts were electronically issued 1106 times (76 for thiopurines and 1030 for drugs metabolized by CYP2D6), and the post-test alerts were issued 1552 times (1521 for TPMT and 31 for CYP2D6). Analysis of alert outcomes revealed that the interruptive CDS appropriately guided prescribing in 95% of patients for whom they were issued. Conclusions Our experience illustrates the feasibility of developing computational systems that provide clinicians with actionable alerts for gene-based drug prescribing at the point of care. PMID:23978487

Joint Seismic-Geodetic Algorithm for Finite-Fault Detection and Slip Inversion in the West Coast ShakeAlert System

NASA Astrophysics Data System (ADS)

Smith, D. E.; Felizardo, C.; Minson, S. E.; Boese, M.; Langbein, J. O.; Murray, J. R.

2016-12-01

Finite-fault source algorithms can greatly benefit earthquake early warning (EEW) systems. Estimates of finite-fault parameters provide spatial information, which can significantly improve real-time shaking calculations and help with disaster response. In this project, we have focused on integrating a finite-fault seismic-geodetic algorithm into the West Coast ShakeAlert framework. The seismic part is FinDer 2, a C++ version of the algorithm developed by Böse et al. (2012). It interpolates peak ground accelerations and calculates the best fault length and strike from template matching. The geodetic part is a C++ version of BEFORES, the algorithm developed by Minson et al. (2014) that uses a Bayesian methodology to search for the most probable slip distribution on a fault of unknown orientation. Ultimately, these two will be used together where FinDer generates a Bayesian prior for BEFORES via the methodology of Minson et al. (2015), and the joint solution will generate estimates of finite-fault extent, strike, dip, best slip distribution, and magnitude. We have created C++ versions of both FinDer and BEFORES using open source libraries and have developed a C++ Application Protocol Interface (API) for them both. Their APIs allow FinDer and BEFORES to contribute to the ShakeAlert system via an open source messaging system, ActiveMQ. FinDer has been receiving real-time data, detecting earthquakes, and reporting messages on the development system for several months. We are also testing FinDer extensively with Earthworm tankplayer files. BEFORES has been tested with ActiveMQ messaging in the ShakeAlert framework, and works off a FinDer trigger. We are finishing the FinDer-BEFORES connections in this framework, and testing this system via seismic-geodetic tankplayer files. This will include actual and simulated data.

Volcanic alert system (VAS) developed during the 2011-2014 El Hierro (Canary Islands) volcanic process

NASA Astrophysics Data System (ADS)

García, Alicia; Berrocoso, Manuel; Marrero, José M.; Fernández-Ros, Alberto; Prates, Gonçalo; De la Cruz-Reyna, Servando; Ortiz, Ramón

2014-06-01

The 2011 volcanic unrest at El Hierro Island illustrated the need for a Volcanic Alert System (VAS) specifically designed for the management of volcanic crises developing after long repose periods. The VAS comprises the monitoring network, the software tools for analysis of the monitoring parameters, the Volcanic Activity Level (VAL) management, and the assessment of hazard. The VAS presented here focuses on phenomena related to moderate eruptions, and on potentially destructive volcano-tectonic earthquakes and landslides. We introduce a set of new data analysis tools, aimed to detect data trend changes, as well as spurious signals related to instrumental failure. When data-trend changes and/or malfunctions are detected, a watchdog is triggered, issuing a watch-out warning (WOW) to the Monitoring Scientific Team (MST). The changes in data patterns are then translated by the MST into a VAL that is easy to use and understand by scientists, technicians, and decision-makers. Although the VAS was designed specifically for the unrest episodes at El Hierro, the methodologies may prove useful at other volcanic systems.

Thirty-one years of debris-flow observation and monitoring near La Honda, California, USA

USGS Publications Warehouse

Wieczorek, G.F.; Wilson, R.C.; Ellen, S.D.; Reid, M.E.; Jayko, A.S.

2007-01-01

From 1975 until 2006,18 intense storms triggered at least 248 debris flows within 10 km2 northwest of the town of La Honda within the Santa Cruz Mountains, California. In addition to mapping debris flows and other types of landslides, studies included soil sampling and geologic mapping, piezometric and tensiometer monitoring, and rainfall measurement and recording. From 1985 until 1995, a system with radio telemetered rain gages and piezometers within the La Honda region was used for issuing six debris-flow warnings within the San Francisco Bay region through the NOAA ALERT system. Depending upon the relative intensity of rainfall during storms, debris flows were generated from deep slumps, shallow slumps, shallow slides in colluvium and shallow slides over bedrock. Analysis shows the storms with abundant antecedent rainfall followed by several days of steady heavy intense rainfall triggered the most abundant debris flows. ?? 2007 millpress.

Development of Tools for the Rapid Assessment of Landslide Potential in Areas Exposed to Intense Storms, Earthquakes, and Other Triggering Mechanisms

NASA Astrophysics Data System (ADS)

Highland, Lynn

2014-05-01

Landslides frequently occur in connection with other types of hazardous phenomena such as earthquake or volcanic activity and intense rainstorms. Strong shaking, for example, often triggers extensive landslides in mountainous areas, which can then complicate response and compound socio-economic impacts over shaking losses alone. The U.S. Geological Survey (USGS) is exploring different ways to add secondary hazards to its Prompt Assessment of Global Earthquakes for Response (PAGER) system, which has been developed to deliver rapid earthquake impact and loss assessments following significant global earthquakes. The PAGER team found that about 22 percent of earthquakes with fatalities have deaths due to secondary causes, and the percentage of economic losses they incur has not been widely studied, but is probably significant. The current approach for rapid assessment and reporting of the potential and distribution of secondary earthquake-induced landslides involves empirical models that consider ground acceleration, slope, and rock-strength. A complementary situational awareness tool being developed is a region-specific landslide database for the U.S. The latter will be able to define, in a narrative form, the landslide types (debris flows, rock avalanches, shallow versus deep) that generally occur in each area, along with the type of soils, geology and meteorological effects that could have a bearing on soil saturation, and thus susceptibility. When a seismic event occurs in the U.S. and the PAGER system generates web-based earthquake information, these landslide narratives will simultaneously be made available, which will help in the assessment of the nature of landslides in that particular region. This landslide profile database could also be applied to landslide events that are not triggered by earthquake shaking, in conjunction with National Weather Service Alerts and other landslide/debris-flow alerting systems. Currently, prototypes are being developed for both the slope-based and the narrative assessment of landslide susceptibility and hazard.

Rapid exposure and loss estimates for the May 12, 2008 Mw 7.9 Wenchuan earthquake provided by the U.S. Geological Survey's PAGER system

USGS Publications Warehouse

Earle, P.S.; Wald, D.J.; Allen, T.I.; Jaiswal, K.S.; Porter, K.A.; Hearne, M.G.

2008-01-01

One half-hour after the May 12th Mw 7.9 Wenchuan, China earthquake, the U.S. Geological Survey’s Prompt Assessment of Global Earthquakes for Response (PAGER) system distributed an automatically generated alert stating that 1.2 million people were exposed to severe-to-extreme shaking (Modified Mercalli Intensity VIII or greater). It was immediately clear that a large-scale disaster had occurred. These alerts were widely distributed and referenced by the major media outlets and used by governments, scientific, and relief agencies to guide their responses. The PAGER alerts and Web pages included predictive ShakeMaps showing estimates of ground shaking, maps of population density, and a list of estimated intensities at impacted cities. Manual, revised alerts were issued in the following hours that included the dimensions of the fault rupture. Within a half-day, PAGER’s estimates of the population exposed to strong shaking levels stabilized at 5.2 million people. A coordinated research effort is underway to extend PAGER’s capability to include estimates of the number of casualties. We are pursuing loss models that will allow PAGER the flexibility to use detailed inventory and engineering results in regions where these data are available while also calculating loss estimates in regions where little is known about the type and strength of the built infrastructure. Prototype PAGER fatality estimates are currently implemented and can be manually triggered. In the hours following the Wenchuan earthquake, these models predicted fatalities in the tens of thousands.

Neutrino detection of transient sources with optical follow-up observations

NASA Astrophysics Data System (ADS)

Dornic, D.; Ageron, M.; Al Samarai, I.; Basa, S.; Bertin, V.; Brunner, J.; Busto, J.; Escoffier, S.; Schussler, F.; Vallage, B.; Vecchi, M.

2010-12-01

The ANTARES telescope has the opportunity to detect transient neutrino sources,such as gamma-ray bursts,core-collapse supernovae,flares of active galactic nuclei. To enhance the sensitivity to these sources, a new detection method based on coincident observations of neutrinos and optical signals has been developed. For this purpose the ANTARES Collaboration has implemented a fast on-line muon track reconstruction with a good angular resolution. These characteristics allow to trigger a network of optical telescopes in order to identify the nature of the neutrino sources. An optical follow-up of special events, such as neutrino doublets, coincident in time and direction, or single neutrinos with a very high energy, would not only give access to the nature of their sources but also improve the sensitivity for neutrino detection. The alert system is operational since early 2009, and as of September 2010, 22 alerts have been sent to the TAROT and ROTSE telescopes.

FLaapLUC: A pipeline for the generation of prompt alerts on transient Fermi-LAT γ-ray sources

NASA Astrophysics Data System (ADS)

Lenain, J.-P.

2018-01-01

The large majority of high energy sources detected with Fermi-LAT are blazars, which are known to be very variable sources. High cadence long-term monitoring simultaneously at different wavelengths being prohibitive, the study of their transient activities can help shedding light on our understanding of these objects. The early detection of such potentially fast transient events is the key for triggering follow-up observations at other wavelengths. A Python tool, FLaapLUC, built on top of the Science Tools provided by the Fermi Science Support Center and the Fermi-LAT collaboration, has been developed using a simple aperture photometry approach. This tool can effectively detect relative flux variations in a set of predefined sources and alert potential users. Such alerts can then be used to trigger target of opportunity observations with other facilities. It is shown that FLaapLUC is an efficient tool to reveal transient events in Fermi-LAT data, providing quick results which can be used to promptly organise follow-up observations. Results from this simple aperture photometry method are also compared to full likelihood analyses. The FLaapLUC package is made available on GitHub and is open to contributions by the community.

Swift-BAT: The First Year of Gamma-Ray Burst Detections

NASA Technical Reports Server (NTRS)

Krimm, Hans A.

2006-01-01

The Burst Alert Telescope (BAT) on the Swift has been detecting gamma-ray bursts (GRBs) since Dec. 17,2004 and automated burst alerts have been distributed since Feb. 14,2005. Since commissioning the BAT has triggered on more than 100 GRBs, nearly all of which have been followed up by the narrow-field instruments on Swift through automatic repointing, and by ground and other satellite telescopes after rapid notification. Within seconds of a trigger the BAT produces and relays to the ground a position good to three arc minutes and a four channel light curve. A full ten minutes of event data follows on subsequent ground station passes. The burst archive has allowed us to determine ensemble burst parameters such as fluence, peak flux and duration. An overview of the properties of BAT bursts and BAT'S performance as a burst monitor will be presented in this talk. BAT is a coded aperture imaging system with a wide (approx.2 sr) field of view consisting of a large coded mask located 1 m above a 5200 cm2 array of 32.768 CdZnTe detectors. All electronics and other hardware systems on the BAT have been operating well since commissioning and there is no sign of any degradation on orbit. The flight and ground software have proven similarly robust and allow the real time localization of all bursts and the rapid derivation of burst light curves, spectra and spectral fits on the ground.

Revealing the functional neuroanatomy of intrinsic alertness using fMRI: methodological peculiarities.

PubMed

Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander T; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

2011-01-01

Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that--as a methodological artifact--left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the functional neuroanatomy of intrinsic alertness with a block design in fMRI studies.

Revealing the Functional Neuroanatomy of Intrinsic Alertness Using fMRI: Methodological Peculiarities

PubMed Central

Clemens, Benjamin; Zvyagintsev, Mikhail; Sack, Alexander; Heinecke, Armin; Willmes, Klaus; Sturm, Walter

2011-01-01

Clinical observations and neuroimaging data revealed a right-hemisphere fronto-parietal-thalamic-brainstem network for intrinsic alertness, and additional left fronto-parietal activity during phasic alertness. The primary objective of this fMRI study was to map the functional neuroanatomy of intrinsic alertness as precisely as possible in healthy participants, using a novel assessment paradigm already employed in clinical settings. Both the paradigm and the experimental design were optimized to specifically assess intrinsic alertness, while at the same time controlling for sensory-motor processing. The present results suggest that the processing of intrinsic alertness is accompanied by increased activity within the brainstem, thalamus, anterior cingulate gyrus, right insula, and right parietal cortex. Additionally, we found increased activation in the left hemisphere around the middle frontal gyrus (BA 9), the insula, the supplementary motor area, and the cerebellum. Our results further suggest that rather minute aspects of the experimental design may induce aspects of phasic alertness, which in turn might lead to additional brain activation in left-frontal areas not normally involved in intrinsic alertness. Accordingly, left BA 9 activation may be related to co-activation of the phasic alertness network due to the switch between rest and task conditions functioning as an external warning cue triggering the phasic alertness network. Furthermore, activation of the intrinsic alertness network during fixation blocks due to enhanced expectancy shortly before the switch to the task block might, when subtracted from the task block, lead to diminished activation in the typical right hemisphere intrinsic alertness network. Thus, we cautiously suggest that – as a methodological artifact – left frontal activations might show up due to phasic alertness involvement and intrinsic alertness activations might be weakened due to contrasting with fixation blocks, when assessing the functional neuroanatomy of intrinsic alertness with a block design in fMRI studies. PMID:21984928

Triggering Interventions for Influenza: The ALERT Algorithm

PubMed Central

Reich, Nicholas G.; Cummings, Derek A. T.; Lauer, Stephen A.; Zorn, Martha; Robinson, Christine; Nyquist, Ann-Christine; Price, Connie S.; Simberkoff, Michael; Radonovich, Lewis J.; Perl, Trish M.

2015-01-01

Background. Early, accurate predictions of the onset of influenza season enable targeted implementation of control efforts. Our objective was to develop a tool to assist public health practitioners, researchers, and clinicians in defining the community-level onset of seasonal influenza epidemics. Methods. Using recent surveillance data on virologically confirmed infections of influenza, we developed the Above Local Elevated Respiratory Illness Threshold (ALERT) algorithm, a method to identify the period of highest seasonal influenza activity. We used data from 2 large hospitals that serve Baltimore, Maryland and Denver, Colorado, and the surrounding geographic areas. The data used by ALERT are routinely collected surveillance data: weekly case counts of laboratory-confirmed influenza A virus. The main outcome is the percentage of prospective seasonal influenza cases identified by the ALERT algorithm. Results. When ALERT thresholds designed to capture 90% of all cases were applied prospectively to the 2011–2012 and 2012–2013 influenza seasons in both hospitals, 71%–91% of all reported cases fell within the ALERT period. Conclusions. The ALERT algorithm provides a simple, robust, and accurate metric for determining the onset of elevated influenza activity at the community level. This new algorithm provides valuable information that can impact infection prevention recommendations, public health practice, and healthcare delivery. PMID:25414260

Safety at The William Quarrier Scottish Epilepsy Centre.

PubMed

Anderson, James; Grant, Victoria; Elgammal, Mariam; Campbell, Alison; Hampshire, Julia; Hansen, Stig; Russell, Aline J C

2017-12-01

We examined the yield from EMFIT bed alarms and staff response time to generalised seizure in a medium term residential assessment unit for epilepsy. The Scottish Epilpesy Centre (SEC) has a Video Observation System (VOS) that provides continuous recording of all patient spaces (external and internal) and allows retention of clinically relevant events. A retrospective audit of daily EMFIT test records, nursing seizure record sheets (seizure type and EMFIT alert status), clinical incident reporting systems and the VOS database of retained clinical events was conducted for an 9 month period from April 1st 2016 till December 31st 2016. All generalized tonic clonic seizures (GTCS) were noted by patient, time and location and staff response time to GTCS was calculated. There were 85 people admitted during the audit period who had 61 GTCS. 50 events were in bed and EMFIT alert status was recorded. On 8 occasions the EMFIT did not alert: 5 events were not of sufficient duration or frequency, in 2 the patient fell from the bed early and 1 event the alarm did not trigger. The average response time to GTCS was 23s. The longest response time was 69s (range, 0-69s, sd 15.76.). The EMFIT bed alarm appears to be a valuable adjunct to safety systems. Within the novel environment of the SEC it is possible to maintain a response time to GTCS that is comparable to hospital based UK video telemetry units. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

MAXI/GSC detection of a possible new X-ray nova MAXI J1621-501 on the galactic plane

NASA Astrophysics Data System (ADS)

Hashimoto, T.; Negoro, H.; Ueno, S.; Tomida, H.; Ishikawa, M.; Sugawara, Y.; Isobe, N.; Shimomukai, R.; Mihara, T.; Sugizaki, M.; Nakahira, S.; Iwakiri, W.; Shidatsu, M.; Yatabe, F.; Takao, Y.; Matsuoka, M.; Kawai, N.; Sugita, S.; Yoshii, T.; Tachibana, Y.; Harita, S.; Morita, K.; Yoshida, A.; Sakamoto, T.; Serino, M.; Kawakubo, Y.; Kitaoka, Y.; Tsunemi, H.; Yoneyama, T.; Nakajima, M.; Kawase, T.; Sakamaki, A.; Ueda, Y.; Hori, T.; Tanimoto, A.; Oda, S.; Tsuboi, Y.; Nakamura, Y.; Sasaki, R.; Kawai, H.; Yamauchi, M.; Hanyu, C.; Hidaka, K.; Kawamuro, T.; Yamaoka, K.

2017-10-01

The MAXI/GSC nova alert system triggered on a bright uncatalogued X-ray transient source at 05:45 UT on 2017 October 19. Using GSC camera GSC_5 data of 4 scan transits from 04:12 to 08:50, we obtain the source position at (R.A., Dec) = (245.260 deg, -50.185 deg) = (16 21 02, -50 11 06) (J2000) with a statistical 90% C.L. elliptical error region with long and short radii of 0.23 deg and 0.22 deg, respectively.

Temporal separation and self-rating of alertness as indicators of driver fatigue in commercial motor vehicle operators.

PubMed

Belz, Steven M; Robinson, Gary S; Casali, John G

2004-01-01

This on-road field investigation employed, for the first time, a completely automated trigger-based data collection system capable of evaluating driver performance in an extended-duration real-world commercial motor vehicle environment. The study examined the use of self-assessment of fatigue (Karolinska Sleepiness Scale) and temporal separation (minimum time to collision, minimum headway, and mean headway) as indicators of driver fatigue. Without exception, the correlation analyses for both the self-rating of alertness and temporal separation yielded models low in associative ability; neither metric was found to be a valid indicator of driver fatigue. In addition, based upon the data collected for this research, preliminary evidence suggests that driver fatigue onset within a real-world driving environment does not appear to follow the standard progression of events associated with the onset of fatigue within a simulated driving environment. Application of this research includes the development of an on-board driver performance/fatigue monitoring system that could potentially assist drivers in identifying the onset of fatigue.

Glycol leak detection system

NASA Astrophysics Data System (ADS)

Rabe, Paul; Browne, Keith; Brink, Janus; Coetzee, Christiaan J.

2016-07-01

MonoEthylene glycol coolant is used extensively on the Southern African Large Telescope to cool components inside the telescope chamber. To prevent coolant leaks from causing serious damage to electronics and optics, a Glycol Leak Detection System was designed to automatically shut off valves in affected areas. After two years of research and development the use of leaf wetness sensors proved to work best and is currently operational. These sensors are placed at various critical points within the instrument payload that would trigger the leak detector controller, which closes the valves, and alerts the building management system. In this paper we describe the research of an initial concept and the final accepted implementation and the test results thereof.

Power line detection system

DOEpatents

Latorre, Victor R.; Watwood, Donald B.

1994-01-01

A short-range, radio frequency (RF) transmitting-receiving system that provides both visual and audio warnings to the pilot of a helicopter or light aircraft of an up-coming power transmission line complex. Small, milliwatt-level narrowband transmitters, powered by the transmission line itself, are installed on top of selected transmission line support towers or within existing warning balls, and provide a continuous RF signal to approaching aircraft. The on-board receiver can be either a separate unit or a portion of the existing avionics, and can also share an existing antenna with another airborne system. Upon receipt of a warning signal, the receiver will trigger a visual and an audio alarm to alert the pilot to the potential power line hazard.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management.

PubMed

Mathew, George; Kho, Abel; Dexter, Paul; Bloodworth, Nathaniel; Fantz, Corinne; Spell, Nathan; LaBorde, David V

2012-06-01

To develop a clinical decision support system activated at the time of discharge to reduce potentially inappropriate discharges from unidentified or unaddressed abnormal laboratory values. We identified 106 laboratory tests for possible inclusion in the discharge alert filter. We selected 7 labs as widely available, commonly obtained, and associated with high risk for potential morbidity or mortality within abnormal ranges. We identified trigger thresholds at levels that would capture significant laboratory abnormalities while avoiding excessive flag generation because of laboratory results that minimally deviate outside the normal reference range. We selected sodium (>155 or <125 mmol/L), potassium (<2.5 or >6 mEq/dL) phosphorous (<1.6 mg/dL), magnesium (<1.2 mg/dL), creatinine greater than 1.1 with a rise of 20% or more between the 2 most recent results, white blood cell count (>11,000 cells/mm with a rise of 20% or more between the 2 most recent results), and international normalized ratio greater than 4. A discharge alert filter that reliably and effectively identifies patients that may be discharged in unsafe situations because of unaddressed critical laboratory values can improve patient safety at discharge and potentially reduce the incidence of costly litigation. Further research is needed to validate whether the proposed discharge alert filter is effective at improving patient safety at discharge.

Debris flow hazards mitigation--Mechanics, prediction, and assessment

USGS Publications Warehouse

Chen, C.-L.; Major, J.J.

2007-01-01

These proceedings contain papers presented at the Fourth International Conference on Debris-Flow Hazards Mitigation: Mechanics, Prediction, and Assessment held in Chengdu, China, September 10-13, 2007. The papers cover a wide range of topics on debris-flow science and engineering, including the factors triggering debris flows, geomorphic effects, mechanics of debris flows (e.g., rheology, fluvial mechanisms, erosion and deposition processes), numerical modeling, various debris-flow experiments, landslide-induced debris flows, assessment of debris-flow hazards and risk, field observations and measurements, monitoring and alert systems, structural and non-structural countermeasures against debris-flow hazards and case studies. The papers reflect the latest devel-opments and advances in debris-flow research. Several studies discuss the development and appli-cation of Geographic Information System (GIS) and Remote Sensing (RS) technologies in debris-flow hazard/risk assessment. Timely topics presented in a few papers also include the development of new or innovative techniques for debris-flow monitoring and alert systems, especially an infra-sound acoustic sensor for detecting debris flows. Many case studies illustrate a wide variety of debris-flow hazards and related phenomena as well as their hazardous effects on human activities and settlements.

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

USGS Publications Warehouse

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

2013-01-01

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

Chemical Safety Alert: Safe Storage and Handling of Swimming Pool Chemicals

EPA Pesticide Factsheets

Hazards of pool water treatment and maintenance chemicals (e.g., chlorine), and the protective measures pool owners should take to prevent fires, toxic vapor releases, and injuries. Triggered by improper wetting, mixing, or self-reactivity over time.

Preventability of Voluntarily Reported or Trigger Tool-Identified Medication Errors in a Pediatric Institution by Information Technology: A Retrospective Cohort Study.

PubMed

Stultz, Jeremy S; Nahata, Milap C

2015-07-01

Information technology (IT) has the potential to prevent medication errors. While many studies have analyzed specific IT technologies and preventable adverse drug events, no studies have identified risk factors for errors still occurring that are not preventable by IT. The objective of this study was to categorize reported or trigger tool-identified errors and adverse events (AEs) at a pediatric tertiary care institution. Also, we sought to identify medication errors preventable by IT, determine why IT-preventable errors occurred, and to identify risk factors for errors that were not preventable by IT. This was a retrospective analysis of voluntarily reported or trigger tool-identified errors and AEs occurring from 1 July 2011 to 30 June 2012. Medication errors reaching the patients were categorized based on the origin, severity, and location of the error, the month in which they occurred, and the age of the patient involved. Error characteristics were included in a multivariable logistic regression model to determine independent risk factors for errors occurring that were not preventable by IT. A medication error was defined as a medication-related failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim. An IT-preventable error was defined as having an IT system in place to aid in prevention of the error at the phase and location of its origin. There were 936 medication errors (identified by voluntarily reporting or a trigger tool system) included and analyzed. Drug administration errors were identified most frequently (53.4% ), but prescribing errors most frequently caused harm (47.2 % of harmful errors). There were 470 (50.2 %) errors that were IT preventable at their origin, including 155 due to IT system bypasses, 103 due to insensitivity of IT alerting systems, and 47 with IT alert overrides. Dispensing, administration, and documentation errors had higher odds than prescribing errors for being not preventable by IT [odds ratio (OR) 8.0, 95 % CI 4.4-14.6; OR 2.4, 95 % CI 1.7-3.7; and OR 6.7, 95 % CI 3.3-14.5, respectively; all p < 0.001). Errors occurring in the operating room and in the outpatient setting had higher odds than intensive care units for being not preventable by IT (OR 10.4, 95 % CI 4.0-27.2, and OR 2.6, 95 % CI 1.3-5.0, respectively; all p ≤ 0.004). Despite extensive IT implementation at the studied institution, approximately one-half of the medication errors identified by voluntarily reporting or a trigger tool system were not preventable by the utilized IT systems. Inappropriate use of IT systems was a common cause of errors. The identified risk factors represent areas where IT safety features were lacking.

West-Coast Wide Expansion and Testing of the Geodetic Alarm System (G-larmS)

NASA Astrophysics Data System (ADS)

Ruhl, C. J.; Grapenthin, R.; Melgar, D.; Aranha, M. A.; Allen, R. M.

2016-12-01

The Geodetic Alarm System (G-larmS) was developed in collaboration between the Berkeley Seismological Laboratory (BSL) and New Mexico Tech for real-time Earthquake Early Warning (EEW). G-larmS has been in continuous operation at the BSL since 2014 using event triggers from the ShakeAlert EEW system and real-time position time series from a fully triangulated network consisting of BARD, PBO and USGS stations across northern California (CA). G-larmS has been extended to include southern CA and Cascadia, providing continuous west-coast wide coverage. G-larmS currently uses high rate (1 Hz), low latency (< 5 s), accurate positioning (cm level) time series data from a regional GPS network and P-wave event triggers from the ShakeAlert EEW system. It extracts static offsets from real-time GPS time series upon S-wave arrival and performs a least squares inversion on these offsets to determine slip on a finite fault. A key issue with geodetic EEW approaches is that unlike seismology-based algorithms that are routinely tested using frequent small-magnitude events, geodetic systems are not regularly exercised. Scenario ruptures are therefore important for testing the performance of G-larmS. We discuss results from scenario events on several large faults (capable of M>6.5) in CA and Cascadia built from realistic 3D geometries. Synthetic long-period 1Hz displacement waveforms were obtained from a new stochastic kinematic slip distribution generation method. Waveforms are validated by direct comparison to peak P-wave displacement scaling laws and to PGD GMPEs obtained from high-rate GPS observations of large events worldwide. We run the scenarios on real-time streams to systematically test the recovery of slip and magnitude by G-larmS. In addition to presenting these results, we will discuss new capabilities, such as implementing 2D geometry and the applicability of these results to GPS enhanced tsunami warning systems.

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

A key challenge to the routine, safe operation of unmanned aircraft systems (UAS) is the development of detect-and-avoid (DAA) systems to aid the UAS pilot in remaining "well clear" of nearby aircraft. The goal of this study is to investigate the effect of alerting criteria and pilot response delay on the safety and performance of UAS DAA systems in the context of routine civil UAS operations in the National Airspace System (NAS). A NAS-wide fast-time simulation study was conducted to assess UAS DAA system performance with a large number of encounters and a broad set of DAA alerting and guidance system parameters. Three attributes of the DAA system were controlled as independent variables in the study to conduct trade-off analyses: UAS trajectory prediction method (dead-reckoning vs. intent-based), alerting time threshold (related to predicted time to LoWC), and alerting distance threshold (related to predicted Horizontal Miss Distance, or HMD). A set of metrics, such as the percentage of true positive, false positive, and missed alerts, based on signal detection theory and analysis methods utilizing the Receiver Operating Characteristic (ROC) curves were proposed to evaluate the safety and performance of DAA alerting and guidance systems and aid development of DAA system performance standards. The effect of pilot response delay on the performance of DAA systems was evaluated using a DAA alerting and guidance model and a pilot model developed to support this study. A total of 18 fast-time simulations were conducted with nine different DAA alerting threshold settings and two different trajectory prediction methods, using recorded radar traffic from current Visual Flight Rules (VFR) operations, and supplemented with DAA-equipped UAS traffic based on mission profiles modeling future UAS operations. Results indicate DAA alerting distance threshold has a greater effect on DAA system performance than DAA alerting time threshold or ownship trajectory prediction method. Further analysis on the alert lead time (time in advance of predicted loss of well clear at which a DAA alert is first issued) indicated a strong positive correlation between alert lead time and DAA system performance (i.e. the ability of the UAS pilot to maneuver the unmanned aircraft to remain well clear). While bigger distance thresholds had beneficial effects on alert lead time and missed alert rate, it also generated a higher rate of false alerts. In the design and development of DAA alerting and guidance systems, therefore, the positive and negative effects of false alerts and missed alerts should be carefully considered to achieve acceptable alerting system performance by balancing false and missed alerts. The results and methodology presented in this study are expected to help stakeholders, policymakers and standards committees define the appropriate setting of DAA system parameter thresholds for UAS that ensure safety while minimizing operational impacts to the NAS and equipage requirements for its users before DAA operational performance standards can be finalized.

Development and validation of a pre-hospital "Red Flag" alert for activation of intra-hospital haemorrhage control response in blunt trauma.

PubMed

Hamada, Sophie Rym; Rosa, Anne; Gauss, Tobias; Desclefs, Jean-Philippe; Raux, Mathieu; Harrois, Anatole; Follin, Arnaud; Cook, Fabrice; Boutonnet, Mathieu; Attias, Arie; Ausset, Sylvain; Boutonnet, Mathieu; Dhonneur, Gilles; Duranteau, Jacques; Langeron, Olivier; Paugam-Burtz, Catherine; Pirracchio, Romain; de St Maurice, Guillaume; Vigué, Bernard; Rouquette, Alexandra; Duranteau, Jacques

2018-05-05

Haemorrhagic shock is the leading cause of early preventable death in severe trauma. Delayed treatment is a recognized prognostic factor that can be prevented by efficient organization of care. This study aimed to develop and validate Red Flag, a binary alert identifying blunt trauma patients with high risk of severe haemorrhage (SH), to be used by the pre-hospital trauma team in order to trigger an adequate intra-hospital standardized haemorrhage control response: massive transfusion protocol and/or immediate haemostatic procedures. A multicentre retrospective study of prospectively collected data from a trauma registry (Traumabase®) was performed. SH was defined as: packed red blood cell (RBC) transfusion in the trauma room, or transfusion ≥ 4 RBC in the first 6 h, or lactate ≥ 5 mmol/L, or immediate haemostatic surgery, or interventional radiology and/or death of haemorrhagic shock. Pre-hospital characteristics were selected using a multiple logistic regression model in a derivation cohort to develop a Red Flag binary alert whose performances were confirmed in a validation cohort. Among the 3675 patients of the derivation cohort, 672 (18%) had SH. The final prediction model included five pre-hospital variables: Shock Index ≥ 1, mean arterial blood pressure ≤ 70 mmHg, point of care haemoglobin ≤ 13 g/dl, unstable pelvis and pre-hospital intubation. The Red Flag alert was triggered by the presence of any combination of at least two criteria. Its predictive performances were sensitivity 75% (72-79%), specificity 79% (77-80%) and area under the receiver operating characteristic curve 0.83 (0.81-0.84) in the derivation cohort, and were not significantly different in the independent validation cohort of 2999 patients. The Red Flag alert developed and validated in this study has high performance to accurately predict or exclude SH.

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

PubMed Central

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

2011-01-01

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

Impact of a clinical decision support system for drug dosage in patients with renal failure.

PubMed

Desmedt, Sophie; Spinewine, Anne; Jadoul, Michel; Henrard, Séverine; Wouters, Dominique; Dalleur, Olivia

2018-05-21

Background A clinical decision support system (CDSS) linked to the computerized physician order entry may help improve prescription appropriateness in inpatients with renal insufficiency. Objective To evaluate the impact on prescription appropriateness of a CDSS prescriber alert for 85 drugs in renal failure patients. Setting Before-after study in a 975-bed academic hospital. Method Prescriptions of patients with renal failure were reviewed during two comparable periods of 6 days each, before and after the implementation of the CDSS (September 2009 and 2010). Main outcome measure The proportion of inappropriate dosages of 85 drugs included in the CDSS was compared in the pre- and post-implementation group. Results Six hundred and fifteen patients were included in the study (301 in pre- and 314 in post-implementation periods). In the pre- and post-implementation period, respectively 2882 and 3485 prescriptions were evaluated, of which 14.9 and 16.6% triggered an alert. Among these, the dosage was inappropriate in respectively 25.4 and 24.6% of prescriptions in the pre- and post-implementation periods (OR 0.97; 95% CI 0.72-1.29). The most frequently involved drugs were paracetamol, perindopril, tramadol and allopurinol. Conclusion The implementation of a CDSS did not significantly reduce the proportion of inappropriate drug dosages in patients with renal failure. Further research is required to investigate the reasons why prescribers override alerts. Collaboration with clinical pharmacists might improve compliance with the CDSS recommendations.

76 FR 80780 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

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

Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

PubMed Central

Alagiakrishnan, Kannayiram; Wilson, Patricia; Sadowski, Cheryl A; Rolfson, Darryl; Ballermann, Mark; Ausford, Allen; Vermeer, Karla; Mohindra, Kunal; Romney, Jacques; Hayward, Robert S

2016-01-01

Background Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. Methods Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR). The “Seniors Medication Alert and Review Technologies” (SMART) intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages) and active (order-entry alerts) prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed. Results Analysis of subjective data revealed that most clinicians agreed that CDS appeared at appropriate times during patient care. Although managing alerts incurred a modest time burden, most also agreed that workflow was not disrupted. Prevalent concerns related to clinician accountability and potential liability. Approximately 36% of eligible encounters triggered at least one SMART alert, with GFR alert, and most frequent medication warnings were with hypnotics and anticholinergics. Approximately 25% of alerts were overridden and ~15% elicited an evidence check. Conclusion While most SMART alerts validated clinician choices, they were received as valuable reminders for evidence-informed care and education. Data from this study may aid other attempts to implement Beers’ Criteria in ambulatory care EMRs. PMID:26869776

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

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

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

NASA Technical Reports Server (NTRS)

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

1997-01-01

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

MAXI/GSC detection of a probable new X-ray transient MAXI J1820+070

NASA Astrophysics Data System (ADS)

Kawamuro, T.; Negoro, H.; Yoneyama, T.; Ueno, S.; Tomida, H.; Ishikawa, M.; Sugawara, Y.; Isobe, N.; Shimomukai, R.; Mihara, T.; Sugizaki, M.; Nakahira, S.; Iwakiri, W.; Yatabe, F.; Takao, Y.; Matsuoka, M.; Kawai, N.; Sugita, S.; Yoshii, T.; Tachibana, Y.; Harita, S.; Morita, K.; Yoshida, A.; Sakamoto, T.; Serino, M.; Kawakubo, Y.; Kitaoka, Y.; Hashimoto, T.; Tsunemi, H.; Nakajima, M.; Kawase, T.; Sakamaki, A.; Maruyama, W.; Ueda, Y.; Hori, T.; Tanimoto, A.; Oda, S.; Morita, T.; Yamada, S.; Tsuboi, Y.; Nakamura, Y.; Sasaki, R.; Kawai, H.; Sato, T.; Yamauchi, M.; Hanyu, C.; Hidaka, K.; Yamaoka, K.; Shidatsu, M.

2018-03-01

The MAXI/GSC nova alert system triggered on a bright uncatalogued X-ray transient source at 12:50 UT on 2018 March 11. Using GSC camera GSC_2 and GSC_7 data of 5 scan transits from 2018-03-11 19:48 to 2018-03-12 02:04, we obtain the source position at (R.A., Dec) = (275.112 deg, 7.037 deg) = (18 20 26, +07 02 13) (J2000) with a statistical 90% C.L. elliptical error region with long and short radii of 0.47 deg and 0.38 deg, respectively.

MAXI/GSC discovery of a new X-ray transient MAXI J1727-203

NASA Astrophysics Data System (ADS)

Yoneyama, T.; Negoro, H.; Nakajima, M.; Sakamaki, A.; Maruyama, W.; Mihara, T.; Nakahira, S.; Yatabe, F.; Takao, Y.; Matsuoka, M.; Kawai, N.; Sugizaki, M.; Tachibana, Y.; Morita, K.; Sakamoto, T.; Serino, M.; Sugita, S.; Kawakubo, Y.; Hashimoto, T.; Yoshida, A.; Ueno, S.; Tomida, H.; Ishikawa, M.; Isobe, N.; Sugawara, Y.; Shimomukai, R.; Ueda, Y.; Tanimoto, A.; Morita, T.; Yamada, S.; Tsuboi, Y.; Iwakiri, W.; Sasaki, R.; Kawai, H.; Sato, T.; Tsunemi, H.; Yamauchi, M.; Hidaka, K.; Iwahori, S.; Kawamuro, T.; Yamaoka, K.; Shidatsu, M.

2018-06-01

The MAXI/GSC nova alert system (Negoro et al. 2016, PASJ, 68, S1) triggered on an uncatalogued X-ray transient source at 09:41 UT on 2018 June 05. Assuming that the source flux was constant over three scan transits from 9:41 to 12:46, we obtain the source position at (R.A., Dec) = (261.971 deg, -20.389 deg) = (17 27 53, -20 23 20) (J2000) with a statistical 90% C.L. elliptical error region with long and short radii of 0.33 deg and 0.28 deg, respectively.

Power line detection system

DOEpatents

Latorre, V.R.; Watwood, D.B.

1994-09-27

A short-range, radio frequency (RF) transmitting-receiving system that provides both visual and audio warnings to the pilot of a helicopter or light aircraft of an up-coming power transmission line complex. Small, milliwatt-level narrowband transmitters, powered by the transmission line itself, are installed on top of selected transmission line support towers or within existing warning balls, and provide a continuous RF signal to approaching aircraft. The on-board receiver can be either a separate unit or a portion of the existing avionics, and can also share an existing antenna with another airborne system. Upon receipt of a warning signal, the receiver will trigger a visual and an audio alarm to alert the pilot to the potential power line hazard. 4 figs.

Analysis of Alerting System Failures in Commercial Aviation Accidents

NASA Technical Reports Server (NTRS)

Mumaw, Randall J.

2017-01-01

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

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

NASA Technical Reports Server (NTRS)

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

2015-01-01

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

Remote monitoring of a Fire Protection System

NASA Astrophysics Data System (ADS)

Bauman, Steven; Vermeulen, Tom; Roberts, Larry; Matsushige, Grant; Gajadhar, Sarah; Taroma, Ralph; Elizares, Casey; Arruda, Tyson; Potter, Sharon; Hoffman, James

2011-03-01

Some years ago CFHT proposed developing a Remote Observing Environment aimed at producing Science Observations at their Observatory Facility on Mauna Kea from their Headquarters facility in Waimea, HI. This Remote Observing Project commonly referred to as OAP (Observatory Automation Project) was completed at the end of January 2011 and has been providing the majority of Science Data since. My poster will discuss the upgrades to the existing fire alarm protection system. With no one at the summit during nightly operations, the observatory facility required automated monitoring of the facility for safety to personnel and equipment in the case of a fire. An addressable analog fire panel was installed which utilizes digital communication protocol (DCP), intelligent communication with other devices, and an RS-232 interface which provides feedback and real-time monitoring of the system. Using the interface capabilities of the panel, it provides notifications when heat detectors, smoke sensors, manual pull stations, or the main observatory computer room fire suppression system has been activated. The notifications are sent out as alerts to staff in the form of test massages and emails and the observing control GUI interface alerts the remote telescope operator with a map showing the location of the fire occurrence and type of device that has been triggered. And all of this was accomplished without the need for an outside vendor to monitor the system and facilitate warnings or notifications regarding the system.

77 FR 41331 - Commercial Mobile Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

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

Leaf shedding as an anti-bacterial defense in Arabidopsis cauline leaves

PubMed Central

2017-01-01

Plants utilize an innate immune system to protect themselves from disease. While many molecular components of plant innate immunity resemble the innate immunity of animals, plants also have evolved a number of truly unique defense mechanisms, particularly at the physiological level. Plant’s flexible developmental program allows them the unique ability to simply produce new organs as needed, affording them the ability to replace damaged organs. Here we develop a system to study pathogen-triggered leaf abscission in Arabidopsis. Cauline leaves infected with the bacterial pathogen Pseudomonas syringae abscise as part of the defense mechanism. Pseudomonas syringae lacking a functional type III secretion system fail to elicit an abscission response, suggesting that the abscission response is a novel form of immunity triggered by effectors. HAESA/HAESA-like 2, INFLORESCENCE DEFICIENT IN ABSCISSION, and NEVERSHED are all required for pathogen-triggered abscission to occur. Additionally phytoalexin deficient 4, enhanced disease susceptibility 1, salicylic acid induction-deficient 2, and senescence-associated gene 101 plants with mutations in genes necessary for bacterial defense and salicylic acid signaling, and NahG transgenic plants with low levels of salicylic acid fail to abscise cauline leaves normally. Bacteria that physically contact abscission zones trigger a strong abscission response; however, long-distance signals are also sent from distal infected tissue to the abscission zone, alerting the abscission zone of looming danger. We propose a threshold model regulating cauline leaf defense where minor infections are handled by limiting bacterial growth, but when an infection is deemed out of control, cauline leaves are shed. Together with previous results, our findings suggest that salicylic acid may regulate both pathogen- and drought-triggered leaf abscission. PMID:29253890

Failure to detect critical auditory alerts in the cockpit: evidence for inattentional deafness.

PubMed

Dehais, Frédéric; Causse, Mickaël; Vachon, François; Régis, Nicolas; Menant, Eric; Tremblay, Sébastien

2014-06-01

The aim of this study was to test whether inattentional deafness to critical alarms would be observed in a simulated cockpit. The inability of pilots to detect unexpected changes in their auditory environment (e.g., alarms) is a major safety problem in aeronautics. In aviation, the lack of response to alarms is usually not attributed to attentional limitations, but rather to pilots choosing to ignore such warnings due to decision biases, hearing issues, or conscious risk taking. Twenty-eight general aviation pilots performed two landings in a flight simulator. In one scenario an auditory alert was triggered alone, whereas in the other the auditory alert occurred while the pilots dealt with a critical windshear. In the windshear scenario, II pilots (39.3%) did not report or react appropriately to the alarm whereas all the pilots perceived the auditory warning in the no-windshear scenario. Also, of those pilots who were first exposed to the no-windshear scenario and detected the alarm, only three suffered from inattentional deafness in the subsequent windshear scenario. These findings establish inattentional deafness as a cognitive phenomenon that is critical for air safety. Pre-exposure to a critical event triggering an auditory alarm can enhance alarm detection when a similar event is encountered subsequently. Case-based learning is a solution to mitigate auditory alarm misperception.

Twitter Seismology: Earthquake Monitoring and Response in a Social World

NASA Astrophysics Data System (ADS)

Bowden, D. C.; Earle, P. S.; Guy, M.; Smoczyk, G.

2011-12-01

The U.S. Geological Survey (USGS) is investigating how the social networking site Twitter, a popular service for sending and receiving short, public, text messages, can augment USGS earthquake response products and the delivery of hazard information. The potential uses of Twitter for earthquake response include broadcasting earthquake alerts, rapidly detecting widely felt events, qualitatively assessing earthquake damage effects, communicating with the public, and participating in post-event collaboration. Several seismic networks and agencies are currently distributing Twitter earthquake alerts including the European-Mediterranean Seismological Centre (@LastQuake), Natural Resources Canada (@CANADAquakes), and the Indonesian meteorological agency (@infogempabmg); the USGS will soon distribute alerts via the @USGSted and @USGSbigquakes Twitter accounts. Beyond broadcasting alerts, the USGS is investigating how to use tweets that originate near the epicenter to detect and characterize shaking events. This is possible because people begin tweeting immediately after feeling an earthquake, and their short narratives and exclamations are available for analysis within 10's of seconds of the origin time. Using five months of tweets that contain the word "earthquake" and its equivalent in other languages, we generate a tweet-frequency time series. The time series clearly shows large peaks correlated with the origin times of widely felt events. To identify possible earthquakes, we use a simple Short-Term-Average / Long-Term-Average algorithm similar to that commonly used to detect seismic phases. As with most auto-detection algorithms, the parameters can be tuned to catch more or less events at the cost of more or less false triggers. When tuned to a moderate sensitivity, the detector found 48 globally-distributed, confirmed seismic events with only 2 false triggers. A space-shuttle landing and "The Great California ShakeOut" caused the false triggers. This number of detections is very small compared to the 5,175 earthquakes in the USGS PDE global earthquake catalog for the same five month time period, and no accurate location or magnitude can be assigned based on Tweet data alone. However, Twitter earthquake detections are not without merit. The detections are generally caused by widely felt events that are of more immediate interest than those with no human impact. The detections are also fast; about 80% occurred within 2 minutes of the origin time. This is considerably faster than seismographic detections in poorly instrumented regions of the world. The tweets triggering the detections also provided (very) short first-impression narratives from people who experienced the shaking. The USGS will continue investigating how to use Twitter and other forms of social media to augment is current suite of seismographically derived products.

Plant cell wall-mediated immunity: cell wall changes trigger disease resistance responses.

PubMed

Bacete, Laura; Mélida, Hugo; Miedes, Eva; Molina, Antonio

2018-02-01

Plants have evolved a repertoire of monitoring systems to sense plant morphogenesis and to face environmental changes and threats caused by different attackers. These systems integrate different signals into overreaching triggering pathways which coordinate developmental and defence-associated responses. The plant cell wall, a dynamic and complex structure surrounding every plant cell, has emerged recently as an essential component of plant monitoring systems, thus expanding its function as a passive defensive barrier. Plants have a dedicated mechanism for maintaining cell wall integrity (CWI) which comprises a diverse set of plasma membrane-resident sensors and pattern recognition receptors (PRRs). The PRRs perceive plant-derived ligands, such as peptides or wall glycans, known as damage-associated molecular patterns (DAMPs). These DAMPs function as 'danger' alert signals activating DAMP-triggered immunity (DTI), which shares signalling components and responses with the immune pathways triggered by non-self microbe-associated molecular patterns that mediate disease resistance. Alteration of CWI by impairment of the expression or activity of proteins involved in cell wall biosynthesis and/or remodelling, as occurs in some plant cell wall mutants, or by wall damage due to colonization by pathogens/pests, activates specific defensive and growth responses. Our current understanding of how these alterations of CWI are perceived by the wall monitoring systems is scarce and few plant sensors/PRRs and DAMPs have been characterized. The identification of these CWI sensors and PRR-DAMP pairs will help us to understand the immune functions of the wall monitoring system, and might allow the breeding of crop varieties and the design of agricultural strategies that would enhance crop disease resistance. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

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

PubMed

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

2017-01-01

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

77 FR 33661 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

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

Air-Flow-Driven Triboelectric Nanogenerators for Self-Powered Real-Time Respiratory Monitoring.

PubMed

Wang, Meng; Zhang, Jiahao; Tang, Yingjie; Li, Jun; Zhang, Baosen; Liang, Erjun; Mao, Yanchao; Wang, Xudong

2018-06-04

Respiration is one of the most important vital signs of humans, and respiratory monitoring plays an important role in physical health management. A low-cost and convenient real-time respiratory monitoring system is extremely desirable. In this work, we demonstrated an air-flow-driven triboelectric nanogenerator (TENG) for self-powered real-time respiratory monitoring by converting mechanical energy of human respiration into electric output signals. The operation of the TENG was based on the air-flow-driven vibration of a flexible nanostructured polytetrafluoroethylene (n-PTFE) thin film in an acrylic tube. This TENG can generate distinct real-time electric signals when exposed to the air flow from different breath behaviors. It was also found that the accumulative charge transferred in breath sensing corresponds well to the total volume of air exchanged during the respiration process. Based on this TENG device, an intelligent wireless respiratory monitoring and alert system was further developed, which used the TENG signal to directly trigger a wireless alarm or dial a cell phone to provide timely alerts in response to breath behavior changes. This research offers a promising solution for developing self-powered real-time respiratory monitoring devices.

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

PubMed

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

2017-11-01

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

PRESSCA: A regional operative Early Warning System for landslides risk scenario assessment

NASA Astrophysics Data System (ADS)

Ponziani, Francesco; Stelluti, Marco; Berni, Nicola; Brocca, Luca; Moramarco, Tommaso

2013-04-01

The Italian national alert system for the hydraulic and hydrogeological risk is ensured by the National Civil Protection Department, through the "Functional Centres" Network, together with scientific/technical Support Centres, named "Competence Centres". The role of the Functional Centres is to alert regional/national civil protection network, to manage the prediction and the monitoring phases, thus ensuring the flow of data for the management of the emergency. The Umbria regional alerting procedure is based on three increasing warning levels of criticality for 6 sub-areas (~1200 km²). Specifically, for each duration (from 1 to 48 hours), three criticality levels are assigned to the rainfall values corresponding to a recurrence interval of 2, 5, and 10 years. In order to improve confidence on the daily work for hydrogeological risk assessment and management, a simple and operational early warning system for the prediction of shallow landslide triggering on regional scale was implemented. The system is primarily based on rainfall thresholds, which represent the main element of evaluation for the early-warning procedures of the Italian Civil Protection system. Following previous studies highlighting that soil moisture conditions play a key role on landslide triggering, a continuous physically-based soil water balance model was implemented for the estimation of soil moisture conditions over the whole regional territory. In fact, a decreasing trend between the cumulated rainfall values over 24, 36 and 48 hours and the soil moisture conditions prior to past landslide events was observed. This trend provides an easy-to-use tool to dynamically adjust the operational rainfall thresholds with the soil moisture conditions simulated by the soil water balance model prior to rainfall events. The application of this procedure allowed decreasing the uncertainties tied to the application of the rainfall thresholds only. The system is actually operational in real-time and it was recently coupled with quantitative rainfall and temperature forecasts (given by the COSMO ME local scale models for Umbria) to extend the prediction up to 72 hours forecast. The main output is constituted by four spatially distributed early warning indicators (normal, caution, warning, alarm), in compliance with national and regional law, based on the comparison between the observed (forecasted) rainfall and the dynamic thresholds. The early warning indicators, calculated over the whole regional territory, are combined with susceptibility and vulnerability layers using a WEB-GIS platform, in order to build a near real time risk scenario. The main outcome of the system is a spatially distributed landslide hazard map with the highlight of areas where local risk situations may arise due to landslides induced by the interaction between meteorological forcing and the presence of vulnerability elements. The System is inclusive of specific sections dedicated to areas with specific risks (as debris flows prone areas), with specific thresholds. The main purpose of this study is firstly to describe the operational early warning system. Then, the integration of near real-time soil moisture data obtained through the satellite sensor ASCAT (Advanced SCATterometer) within the system is shown. This could allow enhancing the reliability of the modelled soil moisture data over the regional territory. The recent rainfall event of 11-14 November 2012 is used as case study. Reported triggered landslides are studied and used in order to check/refine the early warning system.

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

PubMed Central

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

1996-01-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2013 CFR

2013-10-01

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

A Mobile Application for Monitoring and Management of Depressed Mood in a Vulnerable Pregnant Population.

PubMed

Hantsoo, Liisa; Criniti, Stephanie; Khan, Annum; Moseley, Marian; Kincler, Naomi; Faherty, Laura J; Epperson, C Neill; Bennett, Ian M

2018-01-01

This study tested whether a mood tracking and alert (MTA) mobile application (app) improved mental health care delivery in a high-risk obstetric population. Pregnant women with depressive symptomatology at <32 weeks gestation were followed for eight weeks after randomization to a control patient portal (PP) app alone or with the MTA app. The MTA app monitored activity, assessed mood, and alerted obstetric providers of signs of worsening mood. Seventy-two women enrolled (PP, N=24; MTA, N=48). MTA users had significantly more contacts addressing mental health, and as gestational age increased, they rated ability to manage their own health significantly better than women in the control group. Women who received telephone contact from a provider triggered by an MTA app alert were significantly more likely to receive a mental health specialist referral. A mobile MTA app improved service delivery and patient engagement among patients with perinatal depression symptoms.

Digital technology in respiratory diseases: Promises, (no) panacea and time for a new paradigm.

PubMed

Pinnock, Hilary; McKinstry, Brian

2016-05-01

In a world where digital technology has revolutionized the way we work, shop and manage our finances it is unsurprising that digital systems are suggested as potential solutions to delivering clinically and cost-effective care for an aging population with one or more long-term conditions. However, recent evidence suggesting that telehealth may not be quite the panacea that was promised, has led to discussions on the mechanisms and role of digital technology in respiratory care. Implementation in rural and remote settings offers significant benefits in terms of convenient access to care, but is contingent on technical and organizational infrastructure. Telemonitoring systems rely on algorithms to detect deterioration and trigger alerts; machine learning may enable telemonitoring of the future to develop personalized systems that are sensitive to clinical status whilst reducing false alerts. By providing access to information, offering convenient and flexible modes of communication and enabling the transfer of monitoring data to support professional assessment, telehealth can support self-management. At present, all too often, expensive 'off the shelf' systems are purchased and given to clinicians to use. It is time for the paradigm to shift. As clinicians we should identify the specific challenges we face in delivering care, and expect flexible systems that can be customized to individual patients' requirements and adapted to our diverse healthcare contexts. © The Author(s) 2016.

The potential role of real-time geodetic observations in tsunami early warning

NASA Astrophysics Data System (ADS)

Tinti, Stefano; Armigliato, Alberto

2016-04-01

Tsunami warning systems (TWS) have the final goal to launch a reliable alert of an incoming dangerous tsunami to coastal population early enough to allow people to flee from the shore and coastal areas according to some evacuation plans. In the last decade, especially after the catastrophic 2004 Boxing Day tsunami in the Indian Ocean, much attention has been given to filling gaps in the existing TWSs (only covering the Pacific Ocean at that time) and to establishing new TWSs in ocean regions that were uncovered. Typically, TWSs operating today work only on earthquake-induced tsunamis. TWSs estimate quickly earthquake location and size by real-time processing seismic signals; on the basis of some pre-defined "static" procedures (either based on decision matrices or on pre-archived tsunami simulations), assess the tsunami alert level on a large regional scale and issue specific bulletins to a pre-selected recipients audience. Not unfrequently these procedures result in generic alert messages with little value. What usually operative TWSs do not do, is to compute earthquake focal mechanism, to calculate the co-seismic sea-floor displacement, to assess the initial tsunami conditions, to input these data into tsunami simulation models and to compute tsunami propagation up to the threatened coastal districts. This series of steps is considered nowadays too time consuming to provide the required timely alert. An equivalent series of steps could start from the same premises (earthquake focal parameters) and reach the same result (tsunami height at target coastal areas) by replacing the intermediate steps of real-time tsunami simulations with proper selection from a large archive of pre-computed tsunami scenarios. The advantage of real-time simulations and of archived scenarios selection is that estimates are tailored to the specific occurring tsunami and alert can be more detailed (less generic) and appropriate for local needs. Both these procedures are still at an experimental or testing stage and haven't been implemented yet in any standard TWS operations. Nonetheless, this is seen to be the future and the natural TWS evolving enhancement. In this context, improvement of the real-time estimates of tsunamigenic earthquake focal mechanism is of fundamental importance to trigger the appropriate computational chain. Quick discrimination between strike-slip and thrust-fault earthquakes, and equally relevant, quick assessment of co-seismic on-fault slip distribution, are exemplary cases to which a real-time geodetic monitoring system can contribute significantly. Robust inversion of geodetic data can help to reconstruct the sea floor deformation pattern especially if two conditions are met: the source is not too far from network stations and is well covered azimuthally. These two conditions are sometimes hard to satisfy fully, but in certain regions, like the Mediterranean and the Caribbean sea, this is quite possible due to the limited size of the ocean basins. Close cooperation between the Global Geodetic Observing System (GGOS) community, seismologists, tsunami scientists and TWS operators is highly recommended to obtain significant progresses in the quick determination of the earthquake source, which can trigger a timely estimation of the ensuing tsunami and a more reliable and detailed assessment of the tsunami size at the coast.

Development and implementation of sepsis alert systems

PubMed Central

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

2016-01-01

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

Wireless clinical alerts for physiologic, laboratory and medication data.

PubMed Central

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

2000-01-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2010-01-01

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

MASTER OT J015539.85+485955.6 was detected during Fermi alert inspection 3.5h after the trigger time

NASA Astrophysics Data System (ADS)

Rebolo, R.; Lipunov, V.; Gorbovskoy, E.; Serra, M.; Lodieu, N.; Israelian, G.; Suarez-Andres, L.; Shumkov, V.; Tyurina, N.; Kornilov, V.; Balanutsa, P.; Kuznetsov, A.; Vlasenko, D.; Gorbunov, I.; Vladimirov, V.; Popova, E.; Buckley, D.; Potter, S.; Kniazev, A.; Kotze, M.; Tlatov, A.; Parhomenko, A. V.; Dormidontov, D.; Senik, V.; Gress, O.; Ivanov, K.; Budnev, N. M.; Yurkov, V.; Sergienko, Yu.; Gabovich, A.; Sinyakov, E.; Krushinski, V.; Zalozhnih, I.; Shurpakov, S.

2015-11-01

MASTER-IAC, MASTER-Kislovodsk and MASTER-SAAO was pointed to the FERMI GBM GRB151107B (Stanbro, Meegan, GCN #18570 ) at 2015-11-07 20:25:52(/59s/58s) UT (R.Rebolo et al., GCN #18576 ). There were the prompt pointing observations because duration of the GRB was ~140s . After 5 minutes of the alert observations of the error-box center, MASTER telescopes in IAC and Kislovodsk started the inspect survey inside large Fermi error box (ra=00 42 28 dec=+48 48 58 r=4.533300) obtained by GCN socket.

Radar based autonomous sensor module

NASA Astrophysics Data System (ADS)

Styles, Tim

2016-10-01

Most surveillance systems combine camera sensors with other detection sensors that trigger an alert to a human operator when an object is detected. The detection sensors typically require careful installation and configuration for each application and there is a significant burden on the operator to react to each alert by viewing camera video feeds. A demonstration system known as Sensing for Asset Protection with Integrated Electronic Networked Technology (SAPIENT) has been developed to address these issues using Autonomous Sensor Modules (ASM) and a central High Level Decision Making Module (HLDMM) that can fuse the detections from multiple sensors. This paper describes the 24 GHz radar based ASM, which provides an all-weather, low power and license exempt solution to the problem of wide area surveillance. The radar module autonomously configures itself in response to tasks provided by the HLDMM, steering the transmit beam and setting range resolution and power levels for optimum performance. The results show the detection and classification performance for pedestrians and vehicles in an area of interest, which can be modified by the HLDMM without physical adjustment. The module uses range-Doppler processing for reliable detection of moving objects and combines Radar Cross Section and micro-Doppler characteristics for object classification. Objects are classified as pedestrian or vehicle, with vehicle sub classes based on size. Detections are reported only if the object is detected in a task coverage area and it is classified as an object of interest. The system was shown in a perimeter protection scenario using multiple radar ASMs, laser scanners, thermal cameras and visible band cameras. This combination of sensors enabled the HLDMM to generate reliable alerts with improved discrimination of objects and behaviours of interest.

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

PubMed

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

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

INITIATE: An Intelligent Adaptive Alert Environment.

PubMed

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

2015-01-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

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

An automated DICOM database capable of arbitrary data mining (including radiation dose indicators) for quality monitoring.

PubMed

Wang, Shanshan; Pavlicek, William; Roberts, Catherine C; Langer, Steve G; Zhang, Muhong; Hu, Mengqi; Morin, Richard L; Schueler, Beth A; Wellnitz, Clinton V; Wu, Teresa

2011-04-01

The U.S. National Press has brought to full public discussion concerns regarding the use of medical radiation, specifically x-ray computed tomography (CT), in diagnosis. A need exists for developing methods whereby assurance is given that all diagnostic medical radiation use is properly prescribed, and all patients' radiation exposure is monitored. The "DICOM Index Tracker©" (DIT) transparently captures desired digital imaging and communications in medicine (DICOM) tags from CT, nuclear imaging equipment, and other DICOM devices across an enterprise. Its initial use is recording, monitoring, and providing automatic alerts to medical professionals of excursions beyond internally determined trigger action levels of radiation. A flexible knowledge base, aware of equipment in use, enables automatic alerts to system administrators of newly identified equipment models or software versions so that DIT can be adapted to the new equipment or software. A dosimetry module accepts mammography breast organ dose, skin air kerma values from XA modalities, exposure indices from computed radiography, etc. upon receipt. The American Association of Physicists in Medicine recommended a methodology for effective dose calculations which are performed with CT units having DICOM structured dose reports. Web interface reporting is provided for accessing the database in real-time. DIT is DICOM-compliant and, thus, is standardized for international comparisons. Automatic alerts currently in use include: email, cell phone text message, and internal pager text messaging. This system extends the utility of DICOM for standardizing the capturing and computing of radiation dose as well as other quality measures.

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

DTIC Science & Technology

2016-03-11

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

Jetliner Alert Systems

NASA Technical Reports Server (NTRS)

1983-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

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

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

PubMed

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

2018-01-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

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

UWB Monitoring System for AAL Applications

PubMed Central

Kolakowski, Jerzy

2017-01-01

Independent living of elderly persons in their homes requires support that can be provided with modern assistive technologies. Monitoring of elderly persons behaviour delivers valuable information that can be used for diagnosis and detection of health problems as well as triggering alerts in emergency situations. The paper includes a description of the ultra wideband system developed within Networked InfrasTructure for Innovative home Care Solutions (NITICS) Active and Assisted Living (AAL) project. The system can be used as a component of AAL platforms. It delivers data on users localization and has a fall detector functionality. The system also provides access to raw measurement results from Microelectromechanical Systems (MEMS) sensors embedded in the device worn by the monitored person. These data can be used in solutions intended for elderly person’s behaviour investigation. The system was investigated under laboratory conditions as well as in home environment. The detailed system description and results of performed tests are included in the article. PMID:28895917

VizieR Online Data Catalog: Short GRBs with Fermi GBM and Swift BAT (Burns+, 2016)

NASA Astrophysics Data System (ADS)

Burns, E.; Connaughton, V.; Zhang, B.-B.; Lien, A.; Briggs, M. S.; Goldstein, A.; Pelassa, V.; Troja, E.

2018-01-01

Compact binary system mergers are expected to generate gravitational radiation detectable by ground-based interferometers. A subset of these, the merger of a neutron star with another neutron star or a black hole, are also the most popular model for the production of short gamma-ray bursts (GRBs). The Swift Burst Alert Telescope (BAT) and the Fermi Gamma-ray Burst Monitor (GBM) trigger on short GRBs (SGRBs) at rates that reflect their relative sky exposures, with the BAT detecting 10 per year compared to about 45 for GBM. We examine the SGRB populations detected by Swift BAT and Fermi GBM. (4 data files).

Immediate financial impact of computerized clinical decision support for long-term care residents with renal insufficiency: a case study.

PubMed

Subramanian, Sujha; Hoover, Sonja; Wagner, Joann L; Donovan, Jennifer L; Kanaan, Abir O; Rochon, Paula A; Gurwitz, Jerry H; Field, Terry S

2012-01-01

In a randomized trial of a clinical decision support system for drug prescribing for residents with renal insufficiency in a large long-term care facility, analyses were conducted to estimate the system's immediate, direct financial impact. We determined the costs that would have been incurred if drug orders that triggered the alert system had actually been completed compared to the costs of the final submitted orders and then compared intervention units to control units. The costs incurred by additional laboratory testing that resulted from alerts were also estimated. Drug orders were conservatively assigned a duration of 30 days of use for a chronic drug and 10 days for antibiotics. It was determined that there were modest reductions in drug costs, partially offset by an increase in laboratory-related costs. Overall, there was a reduction in direct costs (US$1391.43, net 7.6% reduction). However, sensitivity analyses based on alternative estimates of duration of drug use suggested a reduction as high as US$7998.33 if orders for non-antibiotic drugs were assumed to be continued for 180 days. The authors conclude that the immediate and direct financial impact of a clinical decision support system for medication ordering for residents with renal insufficiency is modest and that the primary motivation for such efforts must be to improve the quality and safety of medication ordering.

Provider acceptance of an automated electronic alert for acute kidney injury

PubMed Central

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

2016-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

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

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

Comparison of Overridden Medication-related Clinical Decision Support in the Intensive Care Unit between a Commercial System and a Legacy System.

PubMed

Wong, Adrian; Wright, Adam; Seger, Diane L; Amato, Mary G; Fiskio, Julie M; Bates, David

2017-08-23

Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement. To compare the two systems and identify areas for potential improvement with the new commercial system at a single institution. Overridden medication-related CDS alerts were included from October to December of the systems' respective years (legacy, 2011; commercial, 2015), restricted to three intensive care units. The two systems were compared with regards to CDS presentation and override rates for four types of CDS: drug-allergy, drug-drug interaction (DDI), geriatric and renal alerts. A post hoc analysis to evaluate for adverse drug events (ADEs) potentially resulting from overridden alerts was performed for 'contraindicated' DDIs via chart review. There was a significant increase in provider exposure to alerts and alert overrides in the commercial system (commercial: n=5,535; legacy: n=1,030). Rates of overrides were higher for the allergy and DDI alerts (p<0.001) in the commercial system. Geriatric and renal alerts were significantly different in incidence and presentation between the two systems. No ADEs were identified in an analysis of 43 overridden contraindicated DDI alerts. The vendor system had much higher rates of both alerts and overrides, although we did not find evidence of harm in a review of DDIs which were overridden. We propose recommendations for improving our current system which may be helpful to other similar institutions; improving both alert presentation and the underlying knowledge base appear important.

The Changing Work Force. Trends and Issues Alerts.

ERIC Educational Resources Information Center

Lankard, Bettina A.

Economic pressures, work force diversity, and advances in technology are changing the nature of work and organizational policy and management. A predicted decline in the annual growth in gross national product is expected to trigger a slowdown in the labor force, especially in occupations that employ workers with only a high school education.…

Search for neutrinos from transient sources with the ANTARES telescope and optical follow-up observations

NASA Astrophysics Data System (ADS)

Ageron, Michel; Al Samarai, Imen; Akerlof, Carl; Basa, Stéphane; Bertin, Vincent; Boer, Michel; Brunner, Juergen; Busto, Jose; Dornic, Damien; Klotz, Alain; Schussler, Fabian; Vallage, Bertrand; Vecchi, Manuela; Zheng, Weikang

2012-11-01

The ANTARES telescope is well suited to detect neutrinos produced in astrophysical transient sources as it can observe a full hemisphere of the sky at all the times with a duty cycle close to unity and an angular resolution better than 0.5°. Potential sources include gamma-ray bursts (GRBs), core collapse supernovae (SNe), and flaring active galactic nuclei (AGNs). To enhance the sensitivity of ANTARES to such sources, a new detection method based on coincident observations of neutrinos and optical signals has been developed. A fast online muon track reconstruction is used to trigger a network of small automatic optical telescopes. Such alerts are generated one or two times per month for special events such as two or more neutrinos coincident in time and direction or single neutrinos of very high energy. Since February 2009, ANTARES has sent 37 alert triggers to the TAROT and ROTSE telescope networks, 27 of them have been followed. First results on the optical images analysis to search for GRBs are presented.

Exploring radar and lightning variables associated with the Lightning Jump. Can we predict the size of the hail?

NASA Astrophysics Data System (ADS)

Farnell, C.; Rigo, T.; Pineda, N.

2018-04-01

Severe weather regularly hits the Lleida Plain (western part of Catalonia, NE of Iberian Peninsula), causing important damage to the local agriculture. In order to help severe weather surveillance tasks, the Meteorological Service of Catalonia (SMC) implemented in 2016 the Lightning Jump (LJ) algorithm as operative warning tool after an exhaustive validation phase of several months. The present study delves into the analysis of the relationship between Lightning Jump alerts and hail occurrence, through the analysis of lightning and radar variables in the moment when the warning is issued. Overall, the study has consisted of the analysis of 149 cases, grouping them into two categories according to hail size: small and large hail, with a threshold of 2 cm of diameter. The thunderstorms related to big sized hail presented remarkable differences in some of the variables analysed that could help forecast the size of hail when the LJ alert is triggered. Moreover, other variables have been allowed to observe and to corroborate how the LJ algorithm works during the 13 min before the warning is triggered.

47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-participation in CMAS. 10.240 Section 10.240 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.240... EMERGENCY ALERTS (Commercial Mobile Alert Service) [[CMS provider

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2013 CFR

2013-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2012 CFR

2012-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

Code of Federal Regulations, 2014 CFR

2014-10-01

...), and Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1...) “Common Alerting Protocol, v. 1.2 USA Integrated Public Alert and Warning System Profile Version 1.0” (Oct...

Development and Implementation of Sepsis Alert Systems.

PubMed

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

2016-06-01

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

Pilot Non-Conformance to Alerting System Commands

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1997-01-01

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

Automating slope monitoring in mines with terrestrial lidar scanners

NASA Astrophysics Data System (ADS)

Conforti, Dario

2014-05-01

Static terrestrial laser scanners (TLS) have been an important component of slope monitoring for some time, and many solutions for monitoring the progress of a slide have been devised over the years. However, all of these solutions have required users to operate the lidar equipment in the field, creating a high cost in time and resources, especially if the surveys must be performed very frequently. This paper presents a new solution for monitoring slides, developed using a TLS and an automated data acquisition, processing and analysis system. In this solution, a TLS is permanently mounted within sight of the target surface and connected to a control computer. The control software on the computer automatically triggers surveys according to a user-defined schedule, parses data into point clouds, and compares data against a baseline. The software can base the comparison against either the original survey of the site or the most recent survey, depending on whether the operator needs to measure the total or recent movement of the slide. If the displacement exceeds a user-defined safety threshold, the control computer transmits alerts via SMS text messaging and/or email, including graphs and tables describing the nature and size of the displacement. The solution can also be configured to trigger the external visual/audio alarm systems. If the survey areas contain high-traffic areas such as roads, the operator can mark them for exclusion in the comparison to prevent false alarms. To improve usability and safety, the control computer can connect to a local intranet and allow remote access through the software's web portal. This enables operators to perform most tasks with the TLS from their office, including reviewing displacement reports, downloading survey data, and adjusting the scan schedule. This solution has proved invaluable in automatically detecting and alerting users to potential danger within the monitored areas while lowering the cost and work required for monitoring. An explanation of the entire system and a post-acquisition data demonstration will be presented.

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

75 FR 81512 - Airworthiness Directives; Various Aviation Communication & Surveillance Systems (ACSS) Traffic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) Units AGENCY... & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance System (TCAS) units during a flight test over... applies to Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and Collision Avoidance...

Visual Alert System

NASA Technical Reports Server (NTRS)

1985-01-01

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

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

PubMed

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

2014-01-01

Computerized alert and reminder systems have been widely accepted and applied to various patient care settings, with increasing numbers of clinical laboratories communicating critical laboratory test values to professionals via either manual notification or automated alerting systems/computerized reminders. Warfarin, an oral anticoagulant, exhibits narrow therapeutic range between treatment response and adverse events. It requires close monitoring of prothrombin time (PT)/international normalized ratio (INR) to ensure patient safety. This study was aimed to evaluate clinical outcomes of patients on warfarin therapy following implementation of a Personal Handy-phone System-based (PHS) alert system capable of generating and delivering text messages to communicate critical PT/INR laboratory results to practitioners' mobile phones in a large tertiary teaching hospital. A retrospective analysis was performed comparing patient clinical outcomes and physician prescribing behavior following conversion from a manual laboratory result alert system to an automated system. Clinical outcomes and practitioner responses to both alert systems were compared. Complications to warfarin therapy, warfarin utilization, and PT/INR results were evaluated for both systems, as well as clinician time to read alert messages, time to warfarin therapy modification, and monitoring frequency. No significant differences were detected in major hemorrhage and thromboembolism, warfarin prescribing patterns, PT/INR results, warfarin therapy modification, or monitoring frequency following implementation of the PHS text alert system. In both study periods, approximately 80% of critical results led to warfarin discontinuation or dose reduction. Senior physicians' follow-up response time to critical results was significantly decreased in the PHS alert study period (46.3% responded within 1 day) compared to the manual notification study period (24.7%; P = 0.015). No difference in follow-up response time was detected for junior physicians. Implementation of an automated PHS-based text alert system did not adversely impact clinical or safety outcomes of patients on warfarin therapy. Approximately 80% immediate recognition of text alerts was achieved. The potential benefits of an automated PHS alert for senior physicians were demonstrated.

77 FR 26701 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

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

The Virtual Quake earthquake simulator: a simulation-based forecast of the El Mayor-Cucapah region and evidence of predictability in simulated earthquake sequences

NASA Astrophysics Data System (ADS)

Yoder, Mark R.; Schultz, Kasey W.; Heien, Eric M.; Rundle, John B.; Turcotte, Donald L.; Parker, Jay W.; Donnellan, Andrea

2015-12-01

In this manuscript, we introduce a framework for developing earthquake forecasts using Virtual Quake (VQ), the generalized successor to the perhaps better known Virtual California (VC) earthquake simulator. We discuss the basic merits and mechanics of the simulator, and we present several statistics of interest for earthquake forecasting. We also show that, though the system as a whole (in aggregate) behaves quite randomly, (simulated) earthquake sequences limited to specific fault sections exhibit measurable predictability in the form of increasing seismicity precursory to large m > 7 earthquakes. In order to quantify this, we develop an alert-based forecasting metric, and show that it exhibits significant information gain compared to random forecasts. We also discuss the long-standing question of activation versus quiescent type earthquake triggering. We show that VQ exhibits both behaviours separately for independent fault sections; some fault sections exhibit activation type triggering, while others are better characterized by quiescent type triggering. We discuss these aspects of VQ specifically with respect to faults in the Salton Basin and near the El Mayor-Cucapah region in southern California, USA and northern Baja California Norte, Mexico.

The Virtual Quake Earthquake Simulator: Earthquake Probability Statistics for the El Mayor-Cucapah Region and Evidence of Predictability in Simulated Earthquake Sequences

NASA Astrophysics Data System (ADS)

Schultz, K.; Yoder, M. R.; Heien, E. M.; Rundle, J. B.; Turcotte, D. L.; Parker, J. W.; Donnellan, A.

2015-12-01

We introduce a framework for developing earthquake forecasts using Virtual Quake (VQ), the generalized successor to the perhaps better known Virtual California (VC) earthquake simulator. We discuss the basic merits and mechanics of the simulator, and we present several statistics of interest for earthquake forecasting. We also show that, though the system as a whole (in aggregate) behaves quite randomly, (simulated) earthquake sequences limited to specific fault sections exhibit measurable predictability in the form of increasing seismicity precursory to large m > 7 earthquakes. In order to quantify this, we develop an alert based forecasting metric similar to those presented in Keilis-Borok (2002); Molchan (1997), and show that it exhibits significant information gain compared to random forecasts. We also discuss the long standing question of activation vs quiescent type earthquake triggering. We show that VQ exhibits both behaviors separately for independent fault sections; some fault sections exhibit activation type triggering, while others are better characterized by quiescent type triggering. We discuss these aspects of VQ specifically with respect to faults in the Salton Basin and near the El Mayor-Cucapah region in southern California USA and northern Baja California Norte, Mexico.

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

PubMed

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

2017-09-01

To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness. Twenty-three studies describing 32 alerts classified into 11 alert categories were identified. The most common alert categories studied were drug-condition interaction (n=6), drug-drug interaction alerts (n=6) and corollary order alerts (n=6). All 23 papers investigated the effect of the intervention alert on at least one outcome measure of prescriber behavior. Just over half of the studies (53%, n=17) reported a statistically significant beneficial effect from the intervention alert; 34% (n=11) reported no statistically significant effect, and 6% (n=2) reported a significant detrimental effect. Two studies also evaluated the effect of alerts on patient outcome measures; neither finding that patient outcomes significantly improved following alert implementation (6%, n=2). The greatest volume of evidence relates to three alert categories: drug-condition, drug-drug and corollary order alerts. Of these, drug-condition alerts had the greatest number of studies reporting positive effects (five out of six studies). Only two of six studies of drug-drug interaction and one of six of corollary alerts reported positive benefits. The current evidence-base does not show a clear indication that particular categories of alerts are more effective than others. While the majority of alert categories were shown to improve outcomes in some studies, there were also many cases where outcomes did not improve. This lack of evidence hinders decisions about the amount and type of decision support that should be integrated into CPOE systems to increase safety while reducing the risk of alert fatigue. Virtually no studies have sought to investigate the impact on changes to prescriber behavior and outcomes overall when alerts from multiple categories are incorporated within the same system. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysing trends and forecasting malaria epidemics in Madagascar using a sentinel surveillance network: a web-based application.

PubMed

Girond, Florian; Randrianasolo, Laurence; Randriamampionona, Lea; Rakotomanana, Fanjasoa; Randrianarivelojosia, Milijaona; Ratsitorahina, Maherisoa; Brou, Télesphore Yao; Herbreteau, Vincent; Mangeas, Morgan; Zigiumugabe, Sixte; Hedje, Judith; Rogier, Christophe; Piola, Patrice

2017-02-13

The use of a malaria early warning system (MEWS) to trigger prompt public health interventions is a key step in adding value to the epidemiological data routinely collected by sentinel surveillance systems. This study describes a system using various epidemic thresholds and a forecasting component with the support of new technologies to improve the performance of a sentinel MEWS. Malaria-related data from 21 sentinel sites collected by Short Message Service are automatically analysed to detect malaria trends and malaria outbreak alerts with automated feedback reports. Roll Back Malaria partners can, through a user-friendly web-based tool, visualize potential outbreaks and generate a forecasting model. The system already demonstrated its ability to detect malaria outbreaks in Madagascar in 2014. This approach aims to maximize the usefulness of a sentinel surveillance system to predict and detect epidemics in limited-resource environments.

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

NASA Technical Reports Server (NTRS)

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

1980-01-01

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

76 FR 3064 - Travelers Information Stations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

... phone numbers when local 911 systems fail, terror threat alert levels, public health warnings ``and all... Alerts, alternate phone numbers when local 911 systems fail, terror threat alert levels, public health..., alternate phone numbers to 911, terror threat alert levels, and public health warnings--do not appear to be...

National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

NASA Astrophysics Data System (ADS)

Tardy, A. O.; Corcus, I.; Guirguis, K.

2015-12-01

The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the collaboration was to better define temperature thresholds relative to local climate, levels of heat related responses and activation, as well as to develop standardized terminology on public notifications. In 2014, the County of San Diego Office of Emergency Services incorporated heat alerts into the emergency push notification system for 2 significant heat waves.

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

PubMed

Wickens, Christopher; Colcombe, Angela

2007-10-01

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

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

PubMed Central

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

2011-01-01

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

77 FR 8181 - Airworthiness Directives; Fokker Services B.V. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... hydraulic system and accompanying alerts for ``hydraulic system 1 low quantity'' and ``hydraulic system 2... of the hydraulic system and accompanying alerts for ``hydraulic system 1 low quantity'' and... for these alerts may give the false impression that the stabiliser is still hydraulically controllable...

Alert Triage v 0.1 beta

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

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

2016-01-06

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

75 FR 25842 - Notice of a Grant With the Public Broadcasting Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... development of the Commercial Mobile Alert System (CMAS), a national system to distribute emergency alert...-27 (Feb. 8, 2006) (establishing the National Alert and Tsunami Warning Program); Section 606 of the... requirements to support the distribution of geographically targeted alerts by commercial mobile service...

77 FR 28387 - Federal Advisory Committee Act; Communications Security, Reliability, and Interoperability Council

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... practice recommendations on emergency alerting systems such as promoting E9-1-1 reliability and alerting platforms--Emergency Alert System and Common Alerting Protocol. DATES: June 6, 2012. ADDRESSES: Federal... Advisory Committee that will provide recommendations to the FCC regarding best practices and actions the...

Health monitoring of offshore structures using wireless sensor network: experimental investigations

NASA Astrophysics Data System (ADS)

Chandrasekaran, Srinivasan; Chitambaram, Thailammai

2016-04-01

This paper presents a detailed methodology of deploying wireless sensor network in offshore structures for structural health monitoring (SHM). Traditional SHM is carried out by visual inspections and wired systems, which are complicated and requires larger installation space to deploy while decommissioning is a tedious process. Wireless sensor networks can enhance the art of health monitoring with deployment of scalable and dense sensor network, which consumes lesser space and lower power consumption. Proposed methodology is mainly focused to determine the status of serviceability of large floating platforms under environmental loads using wireless sensors. Data acquired by the servers will analyze the data for their exceedance with respect to the threshold values. On failure, SHM architecture will trigger an alarm or an early warning in the form of alert messages to alert the engineer-in-charge on board; emergency response plans can then be subsequently activated, which shall minimize the risk involved apart from mitigating economic losses occurring from the accidents. In the present study, wired and wireless sensors are installed in the experimental model and the structural response, acquired is compared. The wireless system comprises of Raspberry pi board, which is programmed to transmit the acquired data to the server using Wi-Fi adapter. Data is then hosted in the webpage for further post-processing, as desired.

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

PubMed

Faure, D; Payrastre, O; Auchet, P

2005-01-01

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

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

PubMed Central

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

1997-01-01

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

Implementation of a Seismic Early Warning System in Portugal Mainland

NASA Astrophysics Data System (ADS)

Madureira, Guilherme; Carrilho, Fernando

2017-04-01

Portugal mainland is located near the border between the Eurasian and Nubian plates, whose interaction is the main responsible for a significant seismic activity in the area, with historical occurrence of several catastrophic events (e.g. Lisbon 1755 earthquake [Mag 8.7]), most of which haviguilhng epicenter rise in submerged area, located in the Cadiz Gulf and Southwest of San Vincent Cape. Early Warning Systems (EEWS) is presently a very effective concept to be applied in the mitigation of the effects caused by large earthquakes. For the mentioned area a feasibility study of a EEWS was made in the ALERT-ES project. It was found that the system could be effective to protect cities and infrastructures located at larger distances (ex: Lisbon) from the areas, located south and southwest of PT mainland, where the larger earthquakes are expected to be originated. Considering the use of a new strong-motion network recently implemented in the south of PT mainland, we concluded that the lead-times could be improved. We opted by the implementation of the well known computational platform PRESTO. In the adaptation of the mentioned platform to the local reality one of the challenges was the computation of fast moment magnitude estimates, because regional attenuation must be properly considered, and a specific study was made on this issue. The several simulations that were performed showed a reasonably good performance of the system, both on magnitude evaluation and epicentre location. However we also noted that the problems in the acquisition instruments are a very important source of disturbance in the performance of the EEWS, pointing to a need of a very accurate quality control of the strong-motion network. Considering end-users, we are also developing specific software for intensity estimation at the target places and to trigger visual and audio alerts in accordance to the expected level of shaking. This work is supported by the EU project TSUMAPS-NEAM, Agreement Number: ECHO/SUB/2015/718568/PREV26.

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

DOT National Transportation Integrated Search

2014-02-01

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

Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

NASA Astrophysics Data System (ADS)

Gerber, M.

2011-12-01

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

Disentangling the attention network test: behavioral, event related potentials, and neural source analyses

PubMed Central

Galvao-Carmona, Alejandro; González-Rosa, Javier J.; Hidalgo-Muñoz, Antonio R.; Páramo, Dolores; Benítez, María L.; Izquierdo, Guillermo; Vázquez-Marrufo, Manuel

2014-01-01

Background: The study of the attentional system remains a challenge for current neuroscience. The “Attention Network Test” (ANT) was designed to study simultaneously three different attentional networks (alerting, orienting, and executive) based in subtraction of different experimental conditions. However, some studies recommend caution with these calculations due to the interactions between the attentional networks. In particular, it is highly relevant that several interpretations about attentional impairment have arisen from these calculations in diverse pathologies. Event related potentials (ERPs) and neural source analysis can be applied to disentangle the relationships between these attentional networks not specifically shown by behavioral measures. Results: This study shows that there is a basic level of alerting (tonic alerting) in the no cue (NC) condition, represented by a slow negative trend in the ERP trace prior to the onset of the target stimuli. A progressive increase in the CNV amplitude related to the amount of information provided by the cue conditions is also shown. Neural source analysis reveals specific modulations of the CNV related to a task-related expectancy presented in the NC condition; a late modulation triggered by the central cue (CC) condition and probably representing a generic motor preparation; and an early and late modulation for spatial cue (SC) condition suggesting specific motor and sensory preactivation. Finally, the first component in the information processing of the target stimuli modulated by the interaction between orienting network and the executive system can be represented by N1. Conclusions: The ANT is useful as a paradigm to study specific attentional mechanisms and their interactions. However, calculation of network effects is based in subtractions with non-comparable experimental conditions, as evidenced by the present data, which can induce misinterpretations in the study of the attentional capacity in human subjects. PMID:25352800

Complacency and Automation Bias in the Use of Imperfect Automation.

PubMed

Wickens, Christopher D; Clegg, Benjamin A; Vieane, Alex Z; Sebok, Angelia L

2015-08-01

We examine the effects of two different kinds of decision-aiding automation errors on human-automation interaction (HAI), occurring at the first failure following repeated exposure to correctly functioning automation. The two errors are incorrect advice, triggering the automation bias, and missing advice, reflecting complacency. Contrasts between analogous automation errors in alerting systems, rather than decision aiding, have revealed that alerting false alarms are more problematic to HAI than alerting misses are. Prior research in decision aiding, although contrasting the two aiding errors (incorrect vs. missing), has confounded error expectancy. Participants performed an environmental process control simulation with and without decision aiding. For those with the aid, automation dependence was created through several trials of perfect aiding performance, and an unexpected automation error was then imposed in which automation was either gone (one group) or wrong (a second group). A control group received no automation support. The correct aid supported faster and more accurate diagnosis and lower workload. The aid failure degraded all three variables, but "automation wrong" had a much greater effect on accuracy, reflecting the automation bias, than did "automation gone," reflecting the impact of complacency. Some complacency was manifested for automation gone, by a longer latency and more modest reduction in accuracy. Automation wrong, creating the automation bias, appears to be a more problematic form of automation error than automation gone, reflecting complacency. Decision-aiding automation should indicate its lower degree of confidence in uncertain environments to avoid the automation bias. © 2015, Human Factors and Ergonomics Society.

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

DOT National Transportation Integrated Search

2010-08-01

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

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

PubMed Central

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

2014-01-01

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

Wearable PPG sensor based alertness scoring system.

PubMed

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

2017-07-01

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

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

PubMed Central

Norris, Patrick R.; Dawant, Benoit M.

2002-01-01

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

SNEWS The SuperNova Early Warning System

NASA Astrophysics Data System (ADS)

SNEWS Group

2005-06-01

SNEWS is a cooperative effort between the world's neutrino detection experiments to spread the news that a star in our galaxy has just experienced a core-collapse and is about to be seen as a Supernova. This project exploits the ˜hours time difference between neutrinos promptly escaping the nascent supernova and photons originating when the shock wave breaks through the stellar photosphere, to give the world a chance to get ready to observe such an exciting event at the earliest possible time. A coincidence trigger between experiments is used to eliminate potential local false alarms, allowing a rapid, automated alert. SNEWS is currently operational and ready, and this poster presents the procedures in use.

Search for neutrinos from core-collapse supernova from the global network of detectors

NASA Astrophysics Data System (ADS)

Habig, Alec; Snews working Group

2010-01-01

The Supernova Early Warning System (SNEWS) is a cooperative effort between the world's neutrino detection experiments to spread the news that a star in our galaxy has just experienced a core-collapse event and is about to become a Type II Supernova. This project exploits the ~hours time difference between neutrinos promptly escaping the nascent supernova and photons which originate when the shock wave breaks through the stellar photosphere, to give the world a chance to get ready to observe such an exciting event at the earliest possible time. A coincidence trigger between experiments is used to eliminate potential local false alarms, allowing a rapid, automated alert.

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

PubMed Central

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

2018-01-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2014 CFR

2014-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2013 CFR

2013-07-01

... communication devices. (a) Alert Systems. Alert systems, such as the ship security alert system required in... part 104, 105, or 106 of this subchapter. (b) Automated Identification Systems (AIS). AIS may be used... plan under part 104 of this subchapter. See 33 CFR part 164 for additional information on AIS device...

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics.

PubMed

Ly, Sovann; Arashiro, Takeshi; Ieng, Vanra; Tsuyuoka, Reiko; Parry, Amy; Horwood, Paul; Heng, Seng; Hamid, Sarah; Vandemaele, Katelijn; Chin, Savuth; Sar, Borann; Arima, Yuzo

2017-01-01

To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza.

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Real-time alerts and reminders using information systems.

PubMed

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

2011-09-01

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

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

PubMed

Källhammer, Jan-Erik; Smith, Kip

2012-08-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Comparative analytics of infusion pump data across multiple hospital systems.

PubMed

Catlin, Ann Christine; Malloy, William X; Arthur, Karen J; Gaston, Cindy; Young, James; Fernando, Sudheera; Fernando, Ruchith

2015-02-15

A Web-based analytics system for conducting inhouse evaluations and cross-facility comparisons of alert data generated by smart infusion pumps is described. The Infusion Pump Informatics (IPI) project, a collaborative effort led by research scientists at Purdue University, was launched in 2009 to provide advanced analytics and tools for workflow analyses to assist hospitals in determining the significance of smart-pump alerts and reducing nuisance alerts. The IPI system allows facility-specific analyses of alert patterns and trends, as well as cross-facility comparisons of alert data uploaded by more than 55 participating institutions using different types of smart pumps. Tools accessible through the IPI portal include (1) charts displaying aggregated or breakout data on the top drugs associated with alerts, numbers of alerts per device or care area, and override-to-alert ratios, (2) investigative reports that can be used to characterize and analyze pump-programming errors in a variety of ways (e.g., by drug, by infusion type, by time of day), and (3) "drill-down" workflow analytics enabling users to evaluate alert patterns—both internally and in relation to patterns at other hospitals—in a quick and efficient stepwise fashion. The formation of the IPI analytics system to support a community of hospitals has been successful in providing sophisticated tools for member facilities to review, investigate, and efficiently analyze smart-pump alert data, not only within a member facility but also across other member facilities, to further enhance smart pump drug library design. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

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

PubMed

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

1994-12-01

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

78 FR 16806 - The Commercial Mobile Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2014 CFR

2014-10-01

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

IR panoramic alerting sensor concepts and applications

NASA Astrophysics Data System (ADS)

de Jong, Arie N.; Schwering, Piet B. W.

2003-09-01

During the last decade, protection of military and civilian operational platforms against weapons like guns, grenades, missiles, Unmanned Combat Aerial (and surface) Vehicles (UCAV's) and mines, has been an issue of increased importance due to the improved kill-probability of these threats. The standard countermeasure package of armour, guns, decoys, jammers, camouflage nets and smokes is inadequate when not accompanied by a suitable sensor package, primarily consisting of an alerting device, triggering consecutive steps in the countermeasure-chain. In this process of alert four different detection techniques are considered: pre-alert, giving the directions of possible attack, detection of an action of attack, identification of the threat and finally the precise localization (3-D). The design of the alerting device is greatly depending on the platform, on which it will be used, the associated and affordable cost and the nature of the threat. A number of sensor packages, considered, developed and evaluated at TNO-FEL is presented for simple, medium size and large and expensive platforms. In recent years the requirements for these sensors have become more and more strigent due to the growing number of scenarios. The attack can practically be from any direction, implying the need for a large Field of Regard (FOR), the attack range can vary considerably and the type of threat can be very diverse, implying great flexibility and dynamic range and rapid response of the sensor. Especially the localization at short ranges is a challenging issue. Various configurations including advantages and drawbacks are discussed.

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

PubMed Central

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

2001-01-01

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

Lessons from Hawaii: A Blessing in Disguise.

PubMed

Deitchman, Scott; Dallas, Cham E; Burkle, Frederick

2018-03-20

On January 13, 2018, Hawaii experienced an erroneous alert that falsely warned of an imminent ballistic missile strike. Rather than focus on the inconvenience caused by the false alert, we used reporting of the event to identify the missing elements that would characterize a system that could save lives by alerting and informing the public in a nuclear detonation. These include warnings that contain essential information rather than directing recipients to secondary sources; a system that issues alerts directly from federal agencies that will have the earliest warning; a robust multimodal alerting system that can deliver messages before and after the detonation; and swift activation of federal agencies immediately upon warning.

Alert generation and cockpit presentation for an integrated microburst alerting system

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

78 FR 61445 - Seventy-Sixth Meeting: RTCA Special Committee 147, Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

... Committee 147, Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Traffic Alert and Collision Avoidance Systems Airborne Equipment. SUMMARY: The FAA is issuing this notice... Performance Standards for Traffic Alert and Collision Avoidance Systems Airborne Equipment. DATES: The meeting...

78 FR 66419 - Seventy Sixth Meeting: RTCA Special Committee 147, Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... Committee 147, Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Traffic Alert and Collision Avoidance Systems Airborne Equipment. SUMMARY: The FAA is issuing this notice... Performance Standards for Traffic Alert and Collision Avoidance Systems Airborne Equipment. DATES: The meeting...

77 FR 29749 - 74th Meeting: RTCA Special Committee 147, Minimal Operations Performance Standards for Traffic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-18

... 147, Minimal Operations Performance Standards for Traffic Alert and Collision Avoidance Systems... Traffic Alert and Collision Avoidance Systems Airborne Equipment. SUMMARY: The FAA is issuing this notice... Performance Standards for Traffic Alert and Collision Avoidance Systems Airborne Equipment. DATES: The meeting...

78 FR 6401 - Seventy Fifth Meeting: RTCA Special Committee 147, Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... Committee 147, Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Traffic Alert and Collision Avoidance Systems Airborne Equipment. SUMMARY: The FAA is issuing this notice... Performance Standards for Traffic Alert and Collision Avoidance Systems Airborne Equipment. DATES: The meeting...

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

DTIC Science & Technology

1984-12-01

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

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

PubMed

Degnan, Dan; Merryfield, Dave; Hultgren, Steve

2004-01-01

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

Modeling, Analyzing, and Mitigating Dissonance Between Alerting Systems

NASA Technical Reports Server (NTRS)

Song, Lixia; Kuchar, James K.

2003-01-01

Alerting systems are becoming pervasive in process operations, which may result in the potential for dissonance or conflict in information from different alerting systems that suggests different threat levels and/or actions to resolve hazards. Little is currently available to help in predicting or solving the dissonance problem. This thesis presents a methodology to model and analyze dissonance between alerting systems, providing both a theoretical foundation for understanding dissonance and a practical basis from which specific problems can be addressed. A state-space representation of multiple alerting system operation is generalized that can be tailored across a variety of applications. Based on the representation, two major causes of dissonance are identified: logic differences and sensor error. Additionally, several possible types of dissonance are identified. A mathematical analysis method is developed to identify the conditions for dissonance originating from logic differences. A probabilistic analysis methodology is developed to estimate the probability of dissonance originating from sensor error, and to compare the relative contribution to dissonance of sensor error against the contribution from logic differences. A hybrid model, which describes the dynamic behavior of the process with multiple alerting systems, is developed to identify dangerous dissonance space, from which the process can lead to disaster. Methodologies to avoid or mitigate dissonance are outlined. Two examples are used to demonstrate the application of the methodology. First, a conceptual In-Trail Spacing example is presented. The methodology is applied to identify the conditions for possible dissonance, to identify relative contribution of logic difference and sensor error, and to identify dangerous dissonance space. Several proposed mitigation methods are demonstrated in this example. In the second example, the methodology is applied to address the dissonance problem between two air traffic alert and avoidance systems: the existing Traffic Alert and Collision Avoidance System (TCAS) vs. the proposed Airborne Conflict Management system (ACM). Conditions on ACM resolution maneuvers are identified to avoid dynamic dissonance between TCAS and ACM. Also included in this report is an Appendix written by Lee Winder about recent and continuing work on alerting systems design. The application of Markov Decision Process (MDP) theory to complex alerting problems is discussed and illustrated with an abstract example system.

Decoupled tracking and thermal monitoring of non-stationary targets.

PubMed

Tan, Kok Kiong; Zhang, Yi; Huang, Sunan; Wong, Yoke San; Lee, Tong Heng

2009-10-01

Fault diagnosis and predictive maintenance address pertinent economic issues relating to production systems as an efficient technique can continuously monitor key health parameters and trigger alerts when critical changes in these variables are detected, before they lead to system failures and production shutdowns. In this paper, we present a decoupled tracking and thermal monitoring system which can be used on non-stationary targets of closed systems such as machine tools. There are three main contributions from the paper. First, a vision component is developed to track moving targets under a monitor. Image processing techniques are used to resolve the target location to be tracked. Thus, the system is decoupled and applicable to closed systems without the need for a physical integration. Second, an infrared temperature sensor with a built-in laser for locating the measurement spot is deployed for non-contact temperature measurement of the moving target. Third, a predictive motion control system holds the thermal sensor and follows the moving target efficiently to enable continuous temperature measurement and monitoring.

Reducing co-administration of proton pump inhibitors and antibiotics using a computerized order entry alert and prospective audit and feedback.

PubMed

Kandel, Christopher E; Gill, Suzanne; McCready, Janine; Matelski, John; Powis, Jeff E

2016-07-22

Antibiotics and proton pump inhibitors (PPIs) are associated with Clostridium difficile infection (CDI). Both a computer order entry alert to highlight this association as well as antimicrobial stewardship directed prospective audit and feedback represent novel interventions to reduce the co-administration of antibiotics and PPIs among hospitalized patients. Consecutive patients admitted to two General Internal Medicine wards from October 1, 2010 until March 31, 2013 at a teaching hospital in Toronto, Ontario, Canada were evaluated. The baseline observation period was followed by the first phase, which involved the creation of a computerized order entry alert that was triggered when either a PPI or an antibiotic was ordered in the presence of the other. The second phase consisted of the introduction of an antibiotic stewardship-initiated prospective audit and feedback strategy. The primary outcome was the co-administration of antibiotics and PPIs during each phase. This alert led to a significant reduction in the co-administration of antibiotics and PPIs adjusted for month and secular trends, expressed as days of therapy per 100 patient days (4.99 vs. 3.14, p < 0.001) The subsequent introduction of the antibiotic stewardship program further reduced the co-administration (3.14 vs. 1.80, p <0.001). No change was observed in adjusted monthly CDI rates per 100 patient care days between the baseline and alert cohorts (0.12 vs. 0.12, p = 0.99) or the baseline and antibiotic stewardship phases (0.12 vs. 0.13, p = 0.97). Decreasing the co-administration of PPIs and antibiotics can be achieved using a simple automatic alert followed by prospective audit and feedback.

Using a Medical Intranet of Things System to Prevent Bed Falls in an Acute Care Hospital: A Pilot Study.

PubMed

Balaguera, Henri U; Wise, Diana; Ng, Chun Yin; Tso, Han-Wen; Chiang, Wan-Lin; Hutchinson, Aimee M; Galvin, Tracy; Hilborne, Lee; Hoffman, Cathy; Huang, Chi-Cheng; Wang, C Jason

2017-05-04

Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital. Patients 18 years and older with a Morse fall score of 45 or greater were recruited from a 35-bed medical-surgical ward in a 317-bed Massachusetts teaching hospital. Eligible patients were recruited between August 4, 2015 and July 31, 2016. Participants received a sensor pad placed between the top of their mattress and bed sheet. The sensor pad was positioned to monitor movement from patients' shoulders to their thighs. The SensableCare System was evaluated for monitoring patient movement and delivering timely alerts to nursing staff via mobile devices when there appeared to be a bed-exit attempt. Sensor pad data were collected automatically from the system. The primary outcomes included number of falls, time to turn off bed-exit alerts, and the number of attempted bed-exit events. Data on patient falls were collected by clinical research assistants and confirmed with the unit nurse manager. Explanatory variables included room locations (zones 1-3), day of the week, nursing shift, and Morse Fall Scale (ie, positive fall history, positive secondary diagnosis, positive ambulatory aid, weak impaired gait/transfer, positive IV/saline lock, mentally forgets limitations). We also assessed user experience via nurse focus groups. Qualitative data regarding staff interactions with the system were collected during two focus groups with 25 total nurses, each lasting approximately 1.5 hours. A total of 91 patients used the system for 234.0 patient-days and experienced no bed falls during the study period. On average, patients were assisted/returned to bed 46 seconds after the alert system was triggered. Response times were longer during the overnight nursing shift versus day shift (P=.005), but were independent of the patient's location on the unit. Focus groups revealed that nurses found the system integrated well into the clinical nursing workflow and the alerts were helpful in patient monitoring. A medical IoT system can be integrated into the existing nursing workflow and may reduce patient bed fall risk in acute care hospitals, a high priority but an elusive patient safety challenge. By using an alerting system that sends notifications directly to nurses' mobile devices, nurses can equally respond to unassisted bed-exit attempts wherever patients are located on the ward. Further study, including a fully powered randomized controlled trial, is needed to assess effectiveness across hospital settings. ©Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.05.2017.

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

USGS Publications Warehouse

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

2014-01-01

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

Monitoring of Northern dwarf novae for radio jets campaign

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2014-10-01

Ms. Deanne Coppejans (PhD candidate, Radboud University Nijmegen (Netherlands) and University of Cape Town) and colleagues have requested AAVSO observer assistance in monitoring nine Northern dwarf novae in support of their campaign to observe them in outburst with the Very Large Array (VLA) to search for radio jets. They will observe 5 targets from the following list: U Gem*, EX Dra, Z Cam*, RX And*, EM Cyg, AB Dra, SY Cnc, SU UMa*, and YZ Cnc*. Stars with an asterisk (*) will be given higher priority. The campaign will begin now, starting with monitoring of RX And and EM Cyg, and run through September 2015, or until all five VLA triggers have been used. This campaign is similar to previous AAVSO campaigns, namely the 2007 campaign to monitor a sample of 10 dwarf novae (AAVSO Alert Notice 345), which resulted in the first detection of a radio jet in a dwarf nova system (Koerding et al. 2008, Science, 320, 1318), and the ones carried out at the request of Dr. James Miller-Jones and colleagues on SS Cyg in 2010-2011 (AAVSO Special Notices #204, #206, Alert Notice 445). The latter resulted in an accurate distance determination to SS Cyg, thereby reconciling its behavior with our understanding of accretion disc theory in accreting compact objects (Miller-Jones et al. 2013, Science, 340, 950). Ms. Coppejans writes: "The relation between accretion and outflow is one of the basic problems in modern astrophysics. It has long been thought that CVs are the only accreting systems that do not produce jets, and this notion has even been used to constrain jet models. However, there are now some indications that CVs do show jets, possibly allowing a universal link between accretion and ejection. Radio observations provide the best unambiguous tracer of the corresponding jet or directed outflow, but there are only two clear detections. By observing a more extensive sample of cataclysmic variables in outburst we will determine the existence of jets or other outflows in these accreting binary systems. These observations will decide if either CVs do show jets and thus support a universal link between accretion and ejection, or if they do not show jets, further constraining future jet models." The radio jet, if it exists in any of these nine systems, is expected to be seen shortly after the beginning of the outburst (as it was in SS Cyg). Catching the outburst as it is just starting and reporting that information to AAVSO HQ immediately is crucial, as the astronomers need to be alerted, make their decision whether to trigger the VLA observations, and allow enough time for the VLA to start the observations. Please observe these systems NIGHTLY (visual, CCD V) and report all observations as soon as is practical. In the event of an outburst, please report your observations as quickly as you can via WebObs, and also notify Dr. Matthew Templeton and Elizabeth Waagen at AAVSO Headquarters and Deanne Coppejans. Finder charts with sequence may be created using the AAVSO Variable Star Plotter (http://www.aavso.org/vsp). Observations should be submitted to the AAVSO International Database. See full Alert Notice for more details and information on the targets.

Investigating the contribution of short wavelengths in the alerting effect of bright light.

PubMed

Sasseville, Alexandre; Martin, Jeanne Sophie; Houle, Jérôme; Hébert, Marc

2015-11-01

Short-wavelengths can have an acute impact on alertness, which is allegedly due to their action on intrinsically photosensitive retinal ganglion cells. Classical photoreceptors cannot, however, be excluded at this point in time as contributors to the alerting effect of light. The objective of this study was to compare the alerting effect at night of a white LED light source while wearing blue-blockers or not, in order to establish the contribution of short-wavelengths. 20 participants stayed awake under dim light (< 5 lx) from 23:00 h to 04:00 h on two consecutive nights. On the second night, participants were randomly assigned to one light condition for 30 min starting at 3:00 h. Group A (5M/5F) was exposed to 500 μW/cm(2) of unfiltered LED light, while group B (4M/6F) was required to wear blue-blocking glasses, while exposed to 1500 μW/cm(2) from the same light device in order to achieve 500 μW/cm(2) at eye level (as measured behind the glasses). Subjective alertness, energy, mood and anxiety were assessed for both nights at 23:30 h, 01:30 h and 03:30 h using a visual analog scale (VAS). Subjective sleepiness was assessed with the Stanford Sleepiness Scale (SSS). Subjects also performed the Conners' Continuous Performance Test II (CPT-II) in order to assess objective alertness. Mixed model analysis was used to compare VAS, SSS and CPT-II parameters. No difference between group A and group B was observed for subjective alertness, energy, mood, anxiety and sleepiness, as well as CPT-II parameters. Subjective alertness (p < 0.001), energy (p < 0.001) and sleepiness (p < 0.05) were, however improved after light exposure on the second night independently of the light condition. The current study shows that when sleepiness is high, the alerting effect of light can still be triggered at night in the absence of short-wavelengths with a 30 minute light pulse of 500 μW/cm(2). This suggests that the underlying mechanism by which a brief polychromatic light exposure improves alertness is not solely due to short-wavelengths through intrinsically photosensitive retinal ganglion cells.

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

PubMed Central

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

2016-01-01

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

Auditory alert systems with enhanced detectability

NASA Technical Reports Server (NTRS)

Begault, Durand R. (Inventor)

2008-01-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2014 CFR

2014-10-01

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

Alerts Visualization and Clustering in Network-based Intrusion Detection

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

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

2010-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2014-11-01

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

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

PubMed

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

2002-10-01

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

NASA aviation safety reporting system

NASA Technical Reports Server (NTRS)

1978-01-01

An analytical study of reports relating to cockpit altitude alert systems was performed. A recent change in the Federal Air Regulation permits the system to be modified so that the alerting signal approaching altitude has only a visual component; the auditory signal would continue to be heard if a deviation from an assigned altitude occurred. Failure to observe altitude alert signals and failure to reset the system were the commonest cause of altitude deviations related to this system. Cockpit crew distraction was the most frequent reason for these failures. It was noted by numerous reporters that the presence of altitude alert system made them less aware of altitude; this lack of altitude awareness is discussed. Failures of crew coordination were also noted. It is suggested that although modification of the altitude alert system may be highly desirable in short-haul aircraft, it may not be desirable for long-haul aircraft in which cockpit workloads are much lower for long periods of time. In these cockpits, the aural alert approaching altitudes is perceived as useful and helpful. If the systems are to be modified, it appears that additional emphasis on altitude awareness during recurrent training will be necessary; it is also possible that flight crew operating procedures during climb and descent may need examination with respect to monitoring responsibilities. A selection of alert bulletins and responses to them is presented.

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

PubMed

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

2017-09-01

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

Uric acid as a danger signal in gout and its comorbidities

PubMed Central

Rock, Kenneth L.; Kataoka, Hiroshi; Lai, Jiann-Jyh

2013-01-01

Uric acid is a waste product of purine catabolism. This molecule comes to clinical attention when it nucleates to form crystals of monosodium urate (MSU) in joints or other tissues and thereby causes the inflammatory disease of gout. Patients with gout also frequently suffer from a number of co-morbid conditions including hypertension, diabetes mellitus and cardiovascular disease. Why MSU crystals trigger inflammation and are associated with comorbidities of gout has been unclear, but recent studies provide new insights these issues. Rather than simply being a waste product, uric acid could serve a pathophysiological role as a local alarm signal that alerts the immune system to cell injury and helps to trigger both innate and adaptive immune responses. The inflammatory component of these immune responses is caused when urate crystals trigger both inflammasome-dependent and independent pathways to generate the proinflammatory cytokine IL-1. The resulting bioactive IL-1 stimulates the inflammation of gout and might contribute to the development of other comorbidities. Surprisingly, the same mechanisms underlie the inflammatory response to a number of irritant particles, many of which also cause disease. These new insights help to explain the pathogenesis of gout and point to potential new therapeutic targets for this and other sterile inflammatory diseases. PMID:22945591

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

PubMed

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

2012-08-27

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

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

PubMed Central

2012-01-01

The article presents a Web-based platform for collecting and storing toxicological structural alerts from literature and for virtual screening of chemical libraries to flag potentially toxic chemicals and compounds that can cause adverse side effects. An alert is uniquely identified by a SMARTS template, a toxicological endpoint, and a publication where the alert was described. Additionally, the system allows storing complementary information such as name, comments, and mechanism of action, as well as other data. Most importantly, the platform can be easily used for fast virtual screening of large chemical datasets, focused libraries, or newly designed compounds against the toxicological alerts, providing a detailed profile of the chemicals grouped by structural alerts and endpoints. Such a facility can be used for decision making regarding whether a compound should be tested experimentally, validated with available QSAR models, or eliminated from consideration altogether. The alert-based screening can also be helpful for an easier interpretation of more complex QSAR models. The system is publicly accessible and tightly integrated with the Online Chemical Modeling Environment (OCHEM, http://ochem.eu). The system is open and expandable: any registered OCHEM user can introduce new alerts, browse, edit alerts introduced by other users, and virtually screen his/her data sets against all or selected alerts. The user sets being passed through the structural alerts can be used at OCHEM for other typical tasks: exporting in a wide variety of formats, development of QSAR models, additional filtering by other criteria, etc. The database already contains almost 600 structural alerts for such endpoints as mutagenicity, carcinogenicity, skin sensitization, compounds that undergo metabolic activation, and compounds that form reactive metabolites and, thus, can cause adverse reactions. The ToxAlerts platform is accessible on the Web at http://ochem.eu/alerts, and it is constantly growing. PMID:22876798

Maximizing Trust in the Wireless Emergency Alerts (WEA) Service

DTIC Science & Technology

2014-02-01

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

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

PubMed

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

2017-11-01

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

Testing the Feasibility of Remote Patient Monitoring in Prenatal Care Using a Mobile App and Connected Devices: A Prospective Observational Trial.

PubMed

Marko, Kathryn I; Krapf, Jill M; Meltzer, Andrew C; Oh, Julia; Ganju, Nihar; Martinez, Anjali G; Sheth, Sheetal G; Gaba, Nancy D

2016-11-18

Excessive weight gain and elevated blood pressure are significant risk factors for adverse pregnancy outcomes such as gestational diabetes, premature birth, and preeclampsia. More effective strategies to facilitate adherence to gestational weight gain goals and monitor blood pressure may have a positive health benefit for pregnant women and their babies. The impact of utilizing a remote patient monitoring system to monitor blood pressure and weight gain as a component of prenatal care has not been previously assessed. The objective of this study is to determine the feasibility of monitoring patients remotely in prenatal care using a mobile phone app and connected digital devices. In this prospective observational study, 8 women with low risk pregnancy in the first trimester were recruited at an urban academic medical center. Participants received a mobile phone app with a connected digital weight scale and blood pressure cuff for at-home data collection for the duration of pregnancy. At-home data was assessed for abnormal values of blood pressure or weight to generate clinical alerts to the patient and provider. As measures of the feasibility of the system, participants were studied for engagement with the app, accuracy of remote data, efficacy of alert system, and patient satisfaction. Patient engagement with the mobile app averaged 5.5 times per week over the 6-month study period. Weight data collection and blood pressure data collection averaged 1.5 times and 1.1 times per week, respectively. At-home measurements of weight and blood pressure were highly accurate compared to in-office measurements. Automatic clinical alerts identified two episodes of abnormal weight gain with no false triggers. Patients demonstrated high satisfaction with the system. In this pilot study, we demonstrated that a system using a mobile phone app coupled to remote monitoring devices is feasible for prenatal care. ©Kathryn I Marko, Jill M Krapf, Andrew C Meltzer, Julia Oh, Nihar Ganju, Anjali G Martinez, Sheetal G Sheth, Nancy D Gaba. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.11.2016.

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.410 - Prioritization.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Prioritization. 10.410 Section 10.410 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message... required to transmit Imminent Threat Alerts and AMBER Alerts on a first in-first out (FIFO) basis. ...

Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.

2000-01-01

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

75 FR 20671 - Seventieth Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... RTCA Special Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision...

Comparative Analysis of ACAS-Xu and DAIDALUS Detect-and-Avoid Systems

NASA Technical Reports Server (NTRS)

Davies, Jason T.; Wu, Minghong G.

2018-01-01

The Detect and Avoid (DAA) capability of a recent version (Run 3) of the Airborne Collision Avoidance System-Xu (ACAS-Xu) is measured against that of the Detect and AvoID Alerting Logic for Unmanned Systems (DAIDALUS), a reference algorithm for the Phase 1 Minimum Operational Performance Standards (MOPS) for DAA. This comparative analysis of the two systems' alerting and horizontal guidance outcomes is conducted through the lens of the Detect and Avoid mission using flight data of scripted encounters from a recent flight test. Results indicate comparable timelines and outcomes between ACAS-Xu's Remain Well Clear alert and guidance and DAIDALUS's corrective alert and guidance, although ACAS-Xu's guidance appears to be more conservative. ACAS-Xu's Collision Avoidance alert and guidance occurs later than DAIDALUS's warning alert and guidance, and overlaps with DAIDALUS's timeline of maneuver to remain Well Clear. Interesting discrepancies between ACAS-Xu's directive guidance and DAIDALUS's "Regain Well Clear" guidance occur in some scenarios.

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

75 FR 49368 - Airworthiness Directives; Rolls-Royce plc (RR) RB211-Trent 900 Series Turbofan Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...-Royce Trent 900 Series Propulsion Systems Alert Non- Modification Service Bulletin (NMSB) RB.211-72... Propulsion Systems Alert NMSB RB.211-72-AG329, Revision 1, dated January 13, 2010. The actions described in... Series Propulsion Systems Alert Non-Modification Service Bulletin (NMSB) RB.211-72-AG329, Revision 1...

The Supernova Early Warning System (SNEWS)

NASA Astrophysics Data System (ADS)

Habig, A.; SNEWS Collaboration

2005-05-01

SNEWS is a cooperative effort between the world's neutrino detection experiments to spread the news that a star in our galaxy has just experienced a core-collapse event and is about to become a Type-II Supernova. This project exploits the ˜hours time difference between neutrinos promptly escaping the nascent supernova and photons which originate when the shock wave breaks through the stellar photosphere, to give the world a chance to get ready to observe such an exciting event at the earliest possible time. A coincidence trigger between experiments is used to eliminate potential local false alarms, allowing a rapid, automated alert. SNEWS is currently operational and ready, and this poster presents the procedures in use. SNEWS work is supported by NSF collaborative grant #0302166.

Automated detection of physiologic deterioration in hospitalized patients

PubMed Central

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-01-01

Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. PMID:25164256

Development and Application of a Clinical Microsystem Simulation Methodology for Human Factors-Based Research of Alarm Fatigue.

PubMed

Kobayashi, Leo; Gosbee, John W; Merck, Derek L

2017-07-01

(1) To develop a clinical microsystem simulation methodology for alarm fatigue research with a human factors engineering (HFE) assessment framework and (2) to explore its application to the comparative examination of different approaches to patient monitoring and provider notification. Problems with the design, implementation, and real-world use of patient monitoring systems result in alarm fatigue. A multidisciplinary team is developing an open-source tool kit to promote bedside informatics research and mitigate alarm fatigue. Simulation, HFE, and computer science experts created a novel simulation methodology to study alarm fatigue. Featuring multiple interconnected simulated patient scenarios with scripted timeline, "distractor" patient care tasks, and triggered true and false alarms, the methodology incorporated objective metrics to assess provider and system performance. Developed materials were implemented during institutional review board-approved study sessions that assessed and compared an experimental multiparametric alerting system with a standard monitor telemetry system for subject response, use characteristics, and end-user feedback. A four-patient simulation setup featuring objective metrics for participant task-related performance and response to alarms was developed along with accompanying structured HFE assessment (questionnaire and interview) for monitor systems use testing. Two pilot and four study sessions with individual nurse subjects elicited true alarm and false alarm responses (including diversion from assigned tasks) as well as nonresponses to true alarms. In-simulation observation and subject questionnaires were used to test the experimental system's approach to suppressing false alarms and alerting providers. A novel investigative methodology applied simulation and HFE techniques to replicate and study alarm fatigue in controlled settings for systems assessment and experimental research purposes.

Development of a Low Cost Earthquake Early Warning System in Taiwan

NASA Astrophysics Data System (ADS)

Wu, Y. M.

2017-12-01

The National Taiwan University (NTU) developed an earthquake early warning (EEW) system for research purposes using low-cost accelerometers (P-Alert) since 2010. As of 2017, a total of 650 stations have been deployed and configured. The NTU system can provide earthquake information within 15 s of an earthquake occurrence. Thus, this system may provide early warnings for cities located more than 50 km from the epicenter. Additionally, the NTU system also has an onsite alert function that triggers a warning for incoming P-waves greater than a certain magnitude threshold, thus providing a 2-3 s lead time before peak ground acceleration (PGA) for regions close to an epicenter. Detailed shaking maps are produced by the NTU system within one or two minutes after an earthquake. Recently, a new module named ShakeAlarm has been developed. Equipped with real-time acceleration signals and the time-dependent anisotropic attenuation relationship of the PGA, ShakingAlarm can provide an accurate PGA estimation immediately before the arrival of the observed PGA. This unique advantage produces sufficient lead time for hazard assessment and emergency response, which is unavailable for traditional shakemap, which are based on only the PGA observed in real time. The performance of ShakingAlarm was tested with six M > 5.5 inland earthquakes from 2013 to 2016. Taking the 2016 M6.4 Meinong earthquake simulation as an example, the predicted PGA converges to a stable value and produces a predicted shake map and an isocontour map of the predicted PGA within 16 seconds of earthquake occurrence. Compared with traditional regional EEW system, ShakingAlarm can effectively identify possible damage regions and provide valuable early warning information (magnitude and PGA) for risk mitigation.

The COMESEP Alert System

NASA Astrophysics Data System (ADS)

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

2014-05-01

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

75 FR 52590 - Seventy-First Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... RTCA Special Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision...

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

PubMed

Breighner, Crystal M; Kashani, Kianoush B

2017-09-01

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

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

PubMed

Wasser, Tobias D; Fox, Patrick K

2013-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2007-01-01

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

Context-Sensitive Clinical Alert Packages Written in Arden Syntax.

PubMed

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

2017-01-01

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

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

PubMed

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

2015-11-01

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

Performance Evaluation of Evasion Maneuvers for Parallel Approach Collision Avoidance

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.; Waller, Marvin (Technical Monitor)

2000-01-01

Current plans for independent instrument approaches to closely spaced parallel runways call for an automated pilot alerting system to ensure separation of aircraft in the case of a "blunder," or unexpected deviation from the a normal approach path. Resolution advisories by this system would require the pilot of an endangered aircraft to perform a trained evasion maneuver. The potential performance of two evasion maneuvers, referred to as the "turn-climb" and "climb-only," was estimated using an experimental NASA alerting logic (AILS) and a computer simulation of relative trajectory scenarios between two aircraft. One aircraft was equipped with the NASA alerting system, and maneuvered accordingly. Observation of the rates of different types of alerting failure allowed judgement of evasion maneuver performance. System Operating Characteristic (SOC) curves were used to assess the benefit of alerting with each maneuver.

Participatory design for drug-drug interaction alerts.

PubMed

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

2015-01-01

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

76 FR 14797 - Airworthiness Directives; Rolls-Royce plc (RR) RB211-Trent 900 Series Turbofan Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

.... Relevant Service Information Rolls-Royce plc has issued Trent 900 Series Propulsion Systems Alert Service... incorporating software 10.6 can be found in Rolls-Royce plc Trent 900 Series Propulsion Systems Alert Service... Propulsion Systems Alert SB No. RB.211-73-AG639, dated December 3, 2010, for related information. (i) Contact...

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

PubMed

Baiguini, Alessandro; Colletta, Stefano; Rebella, Valentina

2011-01-01

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

76 FR 32367 - Agency Information Collection Activities, Proposed Collection; Comment Request; Integrated Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-06

...; Integrated Public Alert and Warning Systems (IPAWS) Inventory AGENCY: Federal Emergency Management Agency... proposed revision of the information collection concerning public alert and warning systems at the Federal... evaluation and assessment of existing public alert and warning resources and their integration with the...

76 FR 72306 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... Appraiser Roster regulations by replacing the obsolete references to the Credit Alert Interactive Voice Response System (CAIVRS) with references to its successor, the online-based Credit Alert Verification... propose the elimination references to the Credit Alert Interactive Voice Response System (CAIVRS). On July...

76 FR 54245 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, Integrated...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

... Request, Integrated Public Alert and Warning Systems (IPAWS) Inventory AGENCY: Federal Emergency... system to alert and warn the American people in situations of war, terrorist attack, natural disaster, or... inventory of public alert and warning resources, capabilities, and the degree of integration at the Federal...

76 FR 41441 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

... the FHA Appraiser Roster by replacing the obsolete references to the Credit Alert Interactive Voice Response System with references to its successor, the online-based Credit Alert Verification Reporting...'s Limited Denial of Participation list, or in HUD's Credit Alert Interactive Voice Response System...

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

PubMed

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

2017-08-01

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

Modeling Pilot State in Next Generation Aircraft Alert Systems

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

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

PubMed

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

2016-04-01

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

Applications for detection of acute kidney injury using electronic medical records and clinical information systems: workgroup statements from the 15(th) ADQI Consensus Conference.

PubMed

James, Matthew T; Hobson, Charles E; Darmon, Michael; Mohan, Sumit; Hudson, Darren; Goldstein, Stuart L; Ronco, Claudio; Kellum, John A; Bagshaw, Sean M

2016-01-01

Electronic medical records and clinical information systems are increasingly used in hospitals and can be leveraged to improve recognition and care for acute kidney injury. This Acute Dialysis Quality Initiative (ADQI) workgroup was convened to develop consensus around principles for the design of automated AKI detection systems to produce real-time AKI alerts using electronic systems. AKI alerts were recognized by the workgroup as an opportunity to prompt earlier clinical evaluation, further testing and ultimately intervention, rather than as a diagnostic label. Workgroup members agreed with designing AKI alert systems to align with the existing KDIGO classification system, but recommended future work to further refine the appropriateness of AKI alerts and to link these alerts to actionable recommendations for AKI care. The consensus statements developed in this review can be used as a roadmap for development of future electronic applications for automated detection and reporting of AKI.

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

PubMed

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

2015-03-01

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

"Isn't the Trigger the Thing that Sets the Rest of It on Fire?" Causation Maps: Emphasising Chronology in Causation Exercises

ERIC Educational Resources Information Center

Rogers, Rick

2011-01-01

Analogies for teaching about causation abound. Rick Rogers is alert, however, to the risks inherent in drawing on everyday ideas to explain historical processes. What most often gets lost is the importance of the chronological dimension; both the length of time during which some contributory causes may have been present, and the ways in which they…

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

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

Managing the Alert Process at NewYork-Presbyterian Hospital

PubMed Central

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

2005-01-01

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

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

PubMed

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

2014-01-01

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

A Heat Warning System to Reduce Heat Illness in San Diego County

NASA Astrophysics Data System (ADS)

Tardy, A. O.; Corcus, I.; Guirguis, K.; Gershunov, A.; Basu, R.; Stepanski, B.

2016-12-01

The National Weather Service (NWS) has issued official heat alerts to the public and decision making partners for many years by developing a single criterion or regional criteria from heat indices which combine temperature and humidity. The criteria have typically relied on fixed thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality, population acclimatization, or impacts on the most vulnerable subgroups. In 2013, the NWS San Diego office began modifying their criteria to account for local climatology with much less dependence on humidity or the heat index. These local changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system (EPIC), which document heat health impacts. The Scripps Institution of Oceanography (SIO) in collaboration with the California Environmental Protection Agency's Office of Environmental Health Hazard Assessment and the NWS completed a study of hospital visits during heat waves in California showing significant health impacts occurred in the past when no regional heat warning was issued. Therefore, the results supported the need for an exploratory project to implement significant modification of the traditional local criteria. To understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch (EMS), which is provided by the County's Public Health Officer to monitor heat-related illness and injury daily during specific heat episodes. The data were combined with SIO research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services (OES). The collaboration was the development of a local Heat Health Impact and Public Notification System prototype. This system incorporates better temperature thresholds defined relative to local climate, levels of heat related responses and activation, as well as a standardized alerting terminology for public notifications.

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

PubMed Central

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

1999-01-01

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

Implementation and Initial Analysis of a Laboratory-Based Weekly Biosurveillance System, Provence-Alpes-Côte d’Azur, France

PubMed Central

Bedubourg, Gabriel; Abat, Cédric; Colson, Philippe; Rolain, Jean Marc; Chaudet, Hervé; Fournier, Pierre Edouard; Raoult, Didier; Deparis, Xavier

2017-01-01

We describe the implementation of an automated infectious disease surveillance system that uses data collected from 210 microbiologic laboratories throughout the Provence-Alpes-Côte d’Azur region in France. Each week, these facilities report bacterial species that have been isolated from patients in their area. An alarm is triggered whenever the case count for a bacterial species infection exceeds 2 SDs of the historical mean for that species at the participating laboratory. At its inception in July 2013, the system monitored 611 bacterial species. During July 1, 2013–March 20, 2016, weekly analyses of incoming surveillance data generated 34 alarms signaling possible infectious disease outbreaks; after investigation, 14 (41%) of these alarms resulted in health alerts declared by the regional health authority. We are currently improving the system by developing an Internet-based surveillance platform and extending our surveillance to include more laboratories in the region. PMID:28322712

High-priority and low-priority drug-drug interactions in different international electronic health record systems: A comparative study.

PubMed

Cornu, Pieter; Phansalkar, Shobha; Seger, Diane L; Cho, Insook; Pontefract, Sarah; Robertson, Alexandra; Bates, David W; Slight, Sarah P

2018-03-01

To investigate whether alert warnings for high-priority and low-priority drug-drug interactions (DDIs) were present in five international electronic health record (EHR) systems, to compare and contrast the severity level assigned to them, and to establish the proportion of alerts that were overridden. We conducted a comparative, retrospective, multinational study using a convenience sample of 5 EHRs from the U.S., U.K., Republic of Korea and Belgium. Of the 15 previously defined, high-priority, class-based DDIs, alert warnings were found to exist for 11 in both the Korean and UK systems, 9 in the Belgian system, and all 15 in the two US systems. The specific combinations that were included in these class-based DDIs varied considerably in number, type and level of severity amongst systems. Alerts were only active for 8.4% (52/619) and 52.4% (111/212) of the specific drug-drug combinations contained in the Belgian and UK systems, respectively. Hard stops (not possible to override) existed in the US and UK systems only. The override rates for high-priority alerts requiring provider action ranged from 56.7% to 83.3%. Of the 33 previously defined low-priority DDIs, active alerts existed only in the US systems, for three class-based DDIs. The majority were non-interruptive. Alert warnings existed for most of the high-priority DDIs in the different EHRs but overriding them was easy in most of the systems. In addition to validating the high- and low-priority DDIs, this study reported a lack of standardization in DDI levels across different international knowledge bases. Copyright © 2017. Published by Elsevier B.V.

Drivers of Emerging Infectious Disease Events as a Framework for Digital Detection.

PubMed

Olson, Sarah H; Benedum, Corey M; Mekaru, Sumiko R; Preston, Nicholas D; Mazet, Jonna A K; Joly, Damien O; Brownstein, John S

2015-08-01

The growing field of digital disease detection, or epidemic intelligence, attempts to improve timely detection and awareness of infectious disease (ID) events. Early detection remains an important priority; thus, the next frontier for ID surveillance is to improve the recognition and monitoring of drivers (antecedent conditions) of ID emergence for signals that precede disease events. These data could help alert public health officials to indicators of elevated ID risk, thereby triggering targeted active surveillance and interventions. We believe that ID emergence risks can be anticipated through surveillance of their drivers, just as successful warning systems of climate-based, meteorologically sensitive diseases are supported by improved temperature and precipitation data. We present approaches to driver surveillance, gaps in the current literature, and a scientific framework for the creation of a digital warning system. Fulfilling the promise of driver surveillance will require concerted action to expand the collection of appropriate digital driver data.

One vendor's experience: preliminary development of a reminder system based on the Arden Syntax.

PubMed

Spates, R P; Aller, K C

1994-09-01

This article reviews the efforts of HBO & Company in the production of a first phase clinical alerting system based on the Arden Syntax. The alerting system was integrated with a clinical data repository and clinical workstation to process returning laboratory results. Investigations with expert systems resulted in a C language alerting system. GUI prototyping of an authoring environment led to a Smalltalk language authoring system. Future development is expected to broaden the system scope and address the evolution of the Arden Syntax.

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

ERIC Educational Resources Information Center

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

2008-01-01

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

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

PubMed

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

2018-05-15

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

Warning Alert HITL Experiment Results

NASA Technical Reports Server (NTRS)

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

2018-01-01

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

A new, ultra-low latency data transmission protocol for Earthquake Early Warning Systems

NASA Astrophysics Data System (ADS)

Hill, P.; Hicks, S. P.; McGowan, M.

2016-12-01

One measure used to assess the performance of Earthquake Early Warning Systems (EEWS) is the delay time between earthquake origin and issued alert. EEWS latency is dependent on a number of sources (e.g. P-wave propagation, digitisation, transmission, receiver processing, triggering, event declaration). Many regional seismic networks use the SEEDlink protocol; however, packet size is fixed to 512-byte miniSEED records, resulting in transmission latencies of >0.5 s. Data packetisation is seen as one of the main sources of delays in EEWS (Brown et al., 2011). Optimising data-logger and telemetry configurations is a cost-effective strategy to improve EEWS alert times (Behr et al., 2015). Digitisers with smaller, selectable packets can result in faster alerts (Sokos et al., 2016). We propose a new seismic protocol for regional seismic networks benefiting low-latency applications such as EEWS. The protocol, based on Güralp's existing GDI-link format is an efficient and flexible method to exchange data between seismic stations and data centers for a range of network configurations. The main principle is to stream data sample-by-sample instead of fixed-length packets to minimise transmission latency. Self-adaptive packetisation with compression maximises available telemetry bandwidth. Highly flexible metadata fields within GDI-link are compatible with existing miniSEED definitions. Data is sent as integers or floats, supporting a wide range of data formats, including discrete parameters such as Pd & τC for on-site earthquake early warning. Other advantages include: streaming station state-of-health information, instrument control, support of backfilling and fail-over strategies during telemetry outages. Based on tests carried out on the Güralp Minimus data-logger, we show our new protocol can reduce transmission latency to as low as 1 ms. The low-latency protocol is currently being implemented with common processing packages. The results of these tests will help to highlight latency levels that can be achieved with next-generation EEWS.

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

PubMed

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

2016-07-01

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

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

PubMed

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

2012-01-01

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

Rapid MODIS-based detection of tree cover loss

NASA Astrophysics Data System (ADS)

Wheeler, David; Guzder-Williams, Brook; Petersen, Rachael; Thau, David

2018-07-01

This paper reports on recent improvements made to the FORMA (Hammer et al., 2014a) data product. The resulting system, FORMA250, is a 250-m alerting system updated daily. FORMA250 alerts are available through Global Forest Watch. These alerts can empower law enforcement officials, government agencies responsible for protecting forests, nongovernmental organizations, companies committed to sustainable forest management practices and supply chains, indigenous groups and forest-dependent communities. In addition, the alerts provide useful information for researchers who study temporal and spatial patterns of forest clearing.

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

Earthquake Early Warning ShakeAlert System: Testing and certification platform

USGS Publications Warehouse

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

2017-01-01

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

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

NASA Astrophysics Data System (ADS)

Espinosa Aranda, J.

2013-05-01

Originally the Seismic Alert System of Mexico (SASMEX) was proposed to integrate the Seismic Alert System of Mexico City (SAS), operating since 1991, with the Seismic Alert System of Oaxaca City (SASO), in services since 2003. And today, after the intense big earthquake activity observed in our world during 2010 and 2011, local governments of Mexico City, Oaxaca Estate, and the Mexican Ministry of the Interior have been promoting the expansion of this technological EEW development. Until 2012 SASMEX better coverage includes 48 new field seismic sensors (FS) deployed over the seismic region of Jalisco, Colima, Michoacan and Puebla, with someone enhancements over Guerrero and Oaxaca, to reach 97 FS. During 2013, 35 new FS has been proposed to SASMEX enhancements covering the Chiapas and Veracruz seismic regions. The SASMEX, with the support of the Mexico Valley Broadcasters Association (ARVM) since 1993, automatically issue Public and Preventive earthquake early warning signals in the Cities of Mexico, Toluca, Acapulco, Chilpancingo, and Oaxaca. The seismic warning range in each case is seated in accordance with local Civil Protection Authorities: Public Alert, if they expect strong earthquake effects, and Preventive Alert one, the effect could be moderated. Now the SASMEX warning time opportunity could be different to the 60 sec. average typically generated when SAS warned earthquake effects coming from Guerrero to Mexico City valley. Mexican EEW issued today reach: 16 Public and 62 Preventive Alert in Mexico City; 25 Public and 19 Preventive Alerts in Oaxaca City; also 14 Public and 4 Preventive Alerts in Acapulco; 14 Public and 5 Preventive Alerts in Chilpancingo. The earthquakes events registered by SASMEX FS until now reach 3448. With the support of private and Federal telecommunications infrastructure like, TELMEX, Federal Electric Commission, and the Mexican Security Ministry, it was developed a redundant communication system with pads to link the different Cities, trough VHF and UHF radio signals, Fiber Optics, and Satellite technologies, to reach more reliability and availability SASMEX functions and services. To increase the seismic early warning efficiency the Mexico City Historical Center Authorities, promoted the installation of the NOAA VHF radio transmitters system to cover the Mexico City valley, operating with the Specific Area Message Encoding (SAME) called NWR-SAME, and with the Emergency Alert Systems (EAS) protocol of United States. As an enhancement of the NOAA receiver protocol, it was innovated to permit fast Public Alert issue, in no more than 2 sec. The new receiver applied in Mexico is called SARMEX™. Local and federal authorities acquired 90,000 SARMEX™ receivers to be distributed manly in public schools of Mexican cities covered by the SASMEX™ signals; the measure with the aim to promote better natural hazard prevention attitude in the Mexican young population segment.

Potential Drug-Drug Interactions in a Cohort of Elderly, Polymedicated Primary Care Patients on Antithrombotic Treatment.

PubMed

Schneider, Katharina Luise; Kastenmüller, Kathrin; Weckbecker, Klaus; Bleckwenn, Markus; Böhme, Miriam; Stingl, Julia Carolin

2018-06-01

Drug-drug interactions (DDIs) are an important risk factor for adverse drug reactions. Older, polymedicated patients are particularly affected. Although antithrombotics have been detected as high-risk drugs for DDIs, data on older patients exposed to them are scarce. Baseline data of 365 IDrug study outpatients (≥ 60 years, use of an antithrombotic and one or more additional long-term drug) were analyzed regarding potential drug-drug interactions (pDDIs) with a clinical decision support system. Data included prescription and self-medication drugs. The prevalence of having one or more pDDI was 85.2%. The median number of alerts per patient was three (range 0-17). For 58.4% of the patients, potential severe/contraindicated interactions were detected. Antiplatelets and non-steroidal anti-inflammatory drugs (NSAIDs) showed the highest number of average pDDI alert involvements per use (2.9 and 2.2, respectively). For NSAIDs, also the highest average number of severe/contraindicated alert involvements per use (1.2) was observed. 91.8% of all pDDI involvements concerned the 25 most frequently used drug classes. 97.5% of the severe/contraindicated pDDIs were attributed to only nine different potential clinical manifestations. The most common management recommendation for severe/contraindicated pDDIs was to intensify monitoring. Number of drugs was the only detected factor significantly associated with increased number of pDDIs (p < 0.001). The findings indicate a high risk for pDDIs in older, polymedicated patients on antithrombotics. As a consequence of patients' frequently similar drug regimens, the variety of potential clinical manifestations was small. Awareness of these pDDI symptoms and the triggering drugs as well as patients' self-medication use may contribute to increased patient safety.

Automated detection of physiologic deterioration in hospitalized patients.

PubMed

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-03-01

Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Nurses reported the positive predictive value of alerts was 91-100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before-after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Tactical Conflict Detection in Terminal Airspace

NASA Technical Reports Server (NTRS)

Tang, Huabin; Robinson, John E.; Denery, Dallas G.

2010-01-01

Air traffic systems have long relied on automated short-term conflict prediction algorithms to warn controllers of impending conflicts (losses of separation). The complexity of terminal airspace has proven difficult for such systems as it often leads to excessive false alerts. Thus, the legacy system, called Conflict Alert, which provides short-term alerts in both en-route and terminal airspace currently, is often inhibited or degraded in areas where frequent false alerts occur, even though the alerts are provided only when an aircraft is in dangerous proximity of other aircraft. This research investigates how a minimal level of flight intent information may be used to improve short-term conflict detection in terminal airspace such that it can be used by the controller to maintain legal aircraft separation. The flight intent information includes a site-specific nominal arrival route and inferred altitude clearances in addition to the flight plan that includes the RNAV (Area Navigation) departure route. A new tactical conflict detection algorithm is proposed, which uses a single analytic trajectory, determined by the flight intent and the current state information of the aircraft, and includes a complex set of current, dynamic separation standards for terminal airspace to define losses of separation. The new algorithm is compared with an algorithm that imitates a known en-route algorithm and another that imitates Conflict Alert by analysis of false-alert rate and alert lead time with recent real-world data of arrival and departure operations and a large set of operational error cases from Dallas/Fort Worth TRACON (Terminal Radar Approach Control). The new algorithm yielded a false-alert rate of two per hour and an average alert lead time of 38 seconds.

Web-based Tsunami Early Warning System: a case study of the 2010 Kepulaunan Mentawai Earthquake and Tsunami

NASA Astrophysics Data System (ADS)

Ulutas, E.; Inan, A.; Annunziato, A.

2012-06-01

This study analyzes the response of the Global Disasters Alerts and Coordination System (GDACS) in relation to a case study: the Kepulaunan Mentawai earthquake and related tsunami, which occurred on 25 October 2010. The GDACS, developed by the European Commission Joint Research Center, combines existing web-based disaster information management systems with the aim to alert the international community in case of major disasters. The tsunami simulation system is an integral part of the GDACS. In more detail, the study aims to assess the tsunami hazard on the Mentawai and Sumatra coasts: the tsunami heights and arrival times have been estimated employing three propagation models based on the long wave theory. The analysis was performed in three stages: (1) pre-calculated simulations by using the tsunami scenario database for that region, used by the GDACS system to estimate the alert level; (2) near-real-time simulated tsunami forecasts, automatically performed by the GDACS system whenever a new earthquake is detected by the seismological data providers; and (3) post-event tsunami calculations using GCMT (Global Centroid Moment Tensor) fault mechanism solutions proposed by US Geological Survey (USGS) for this event. The GDACS system estimates the alert level based on the first type of calculations and on that basis sends alert messages to its users; the second type of calculations is available within 30-40 min after the notification of the event but does not change the estimated alert level. The third type of calculations is performed to improve the initial estimations and to have a better understanding of the extent of the possible damage. The automatic alert level for the earthquake was given between Green and Orange Alert, which, in the logic of GDACS, means no need or moderate need of international humanitarian assistance; however, the earthquake generated 3 to 9 m tsunami run-up along southwestern coasts of the Pagai Islands where 431 people died. The post-event calculations indicated medium-high humanitarian impacts.

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

NASA Astrophysics Data System (ADS)

Li, Chao

2017-04-01

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

Long-range traveling waves of activity triggered by local dichoptic stimulation in V1 of behaving monkeys

PubMed Central

Yang, Zhiyong; Heeger, David J.; Blake, Randolph

2014-01-01

Traveling waves of cortical activity, in which local stimulation triggers lateral spread of activity to distal locations, have been hypothesized to play an important role in cortical function. However, there is conflicting physiological evidence for the existence of spreading traveling waves of neural activity triggered locally. Dichoptic stimulation, in which the two eyes view dissimilar monocular patterns, can lead to dynamic wave-like fluctuations in visual perception and therefore, provides a promising means for identifying and studying cortical traveling waves. Here, we used voltage-sensitive dye imaging to test for the existence of traveling waves of activity in the primary visual cortex of awake, fixating monkeys viewing dichoptic stimuli. We find clear traveling waves that are initiated by brief, localized contrast increments in one of the monocular patterns and then, propagate at speeds of ∼30 mm/s. These results demonstrate that under an appropriate visual context, circuitry in visual cortex in alert animals is capable of supporting long-range traveling waves triggered by local stimulation. PMID:25343785

The neuronal and molecular basis of quinine-dependent bitter taste signaling in Drosophila larvae

PubMed Central

Apostolopoulou, Anthi A.; Mazija, Lorena; Wüst, Alexander; Thum, Andreas S.

2014-01-01

The sensation of bitter substances can alert an animal that a specific type of food is harmful and should not be consumed. However, not all bitter compounds are equally toxic and some may even be beneficial in certain contexts. Thus, taste systems in general may have a broader range of functions than just in alerting the animal. In this study we investigate bitter sensing and processing in Drosophila larvae using quinine, a substance perceived by humans as bitter. We show that behavioral choice, feeding, survival, and associative olfactory learning are all directly affected by quinine. On the cellular level, we show that 12 gustatory sensory receptor neurons that express both GR66a and GR33a are required for quinine-dependent choice and feeding behavior. Interestingly, these neurons are not necessary for quinine-dependent survival or associative learning. On the molecular receptor gene level, the GR33a receptor, but not GR66a, is required for quinine-dependent choice behavior. A screen for gustatory sensory receptor neurons that trigger quinine-dependent choice behavior revealed that a single GR97a receptor gene expressing neuron located in the peripheral terminal sense organ is partially necessary and sufficient. For the first time, we show that the elementary chemosensory system of the Drosophila larva can serve as a simple model to understand the neuronal basis of taste information processing on the single cell level with respect to different behavioral outputs. PMID:24478653

ShakeAlert Users Transition to the Production Prototype System

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

An Obstacle Alerting System for Agricultural Application

NASA Technical Reports Server (NTRS)

DeMaio, Joe

2003-01-01

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

Using a claims data-based sentinel system to improve compliance with clinical guidelines: results of a randomized prospective study.

PubMed

Javitt, Jonathan C; Steinberg, Gregory; Locke, Todd; Couch, James B; Jacques, Jeffrey; Juster, Iver; Reisman, Lonny

2005-02-01

To demonstrate the potential effect of deploying a sentinel system that scans administrative claims information and clinical data to detect and mitigate errors in care and deviations from best medical practices. Members (n = 39 462; age range, 12-64 years) of a midwestern managed care plan were randomly assigned to an intervention or a control group. The sentinel system was programmed with more than 1000 decision rules that were capable of generating clinical recommendations. Clinical recommendations triggered for subjects in the intervention group were relayed to treating physicians, and those for the control group were deferred to study end. Nine hundred eight clinical recommendations were issued to the intervention group. Among those in both groups who triggered recommendations, there were 19% fewer hospital admissions in the intervention group compared with the control group (P < .001). Charges among those whose recommendations were communicated were dollar 77.91 per member per month (pmpm) lower and paid claims were dollar 68.08 pmpm lower than among controls compared with the baseline values (P = .003 for both). Paid claims for the entire intervention group (with or without recommendations) were dollar 8.07 pmpm lower than those for the entire control group. In contrast, the intervention cost dollar 1.00 pmpm, suggesting an 8-fold return on investment. Ongoing use of a sentinel system to prompt clinically actionable, patient-specific alerts generated from administratively derived clinical data was associated with a reduction in hospitalization, medical costs, and morbidity.

Role of biomolecular logic systems in biosensors and bioactuators

NASA Astrophysics Data System (ADS)

Mailloux, Shay; Katz, Evgeny

2014-09-01

An overview of recent advances in biosensors and bioactuators based on biocomputing systems is presented. Biosensors digitally process multiple biochemical signals through Boolean logic networks of coupled biomolecular reactions and produce an output in the form of a YES/NO response. Compared to traditional single-analyte sensing devices, the biocomputing approach enables high-fidelity multianalyte biosensing, which is particularly beneficial for biomedical applications. Multisignal digital biosensors thus promise advances in rapid diagnosis and treatment of diseases by processing complex patterns of physiological biomarkers. Specifically, they can provide timely detection and alert medical personnel of medical emergencies together with immediate therapeutic intervention. Application of the biocomputing concept has been successfully demonstrated for systems performing logic analysis of biomarkers corresponding to different injuries, particularly as exemplified for liver injury. Wide-ranging applications of multianalyte digital biosensors in medicine, environmental monitoring, and homeland security are anticipated. "Smart" bioactuators, for signal-triggered drug release, for example, were designed by interfacing switchable electrodes with biocomputing systems. Integration of biosensing and bioactuating systems with biomolecular information processing systems advances the potential for further scientific innovations and various practical applications.

CISN ShakeAlert: Using early warnings for earthquakes in California

NASA Astrophysics Data System (ADS)

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

2009-12-01

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

Alert Exchange Process Protocol

NASA Technical Reports Server (NTRS)

Groen, Frank

2015-01-01

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

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

NASA Technical Reports Server (NTRS)

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

2015-01-01

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

47 CFR 10.410 - Prioritization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Prioritization. 10.410 Section 10.410 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.410 Prioritization. A Participating CMS Provider is required to transmit Presidential Alerts...

75 FR 19559 - Public Safety and Homeland Security Bureau Seeks Informal Comment Regarding Revisions to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-15

..., cell phones and electronic highway signs. CAP will also allow an alert initiator to send alerts... CAP-formatted alerts delivered via any new delivery systems, whether wireline, internet, satellite, or...

A prototype for the real-time analysis of the Cherenkov Telescope Array

NASA Astrophysics Data System (ADS)

Bulgarelli, Andrea; Fioretti, Valentina; Zoli, Andrea; Aboudan, Alessio; Rodríguez-Vázquez, Juan José; Maier, Gernot; Lyard, Etienne; Bastieri, Denis; Lombardi, Saverio; Tosti, Gino; De Rosa, Adriano; Bergamaschi, Sonia; Interlandi, Matteo; Beneventano, Domenico; Lamanna, Giovanni; Jacquemier, Jean; Kosack, Karl; Antonelli, Lucio Angelo; Boisson, Catherine; Burkowski, Jerzy; Buson, Sara; Carosi, Alessandro; Conforti, Vito; Contreras, Jose Luis; De Cesare, Giovanni; de los Reyes, Raquel; Dumm, Jon; Evans, Phil; Fortson, Lucy; Fuessling, Matthias; Graciani, Ricardo; Gianotti, Fulvio; Grandi, Paola; Hinton, Jim; Humensky, Brian; Knödlseder, Jürgen; Malaguti, Giuseppe; Marisaldi, Martino; Neyroud, Nadine; Nicastro, Luciano; Ohm, Stefan; Osborne, Julian; Rosen, Simon; Tacchini, Alessandro; Torresi, Eleonora; Testa, Vincenzo; Trifoglio, Massimo; Weinstein, Amanda

2014-07-01

The Cherenkov Telescope Array (CTA) observatory will be one of the biggest ground-based very-high-energy (VHE) γ- ray observatory. CTA will achieve a factor of 10 improvement in sensitivity from some tens of GeV to beyond 100 TeV with respect to existing telescopes. The CTA observatory will be capable of issuing alerts on variable and transient sources to maximize the scientific return. To capture these phenomena during their evolution and for effective communication to the astrophysical community, speed is crucial. This requires a system with a reliable automated trigger that can issue alerts immediately upon detection of γ-ray flares. This will be accomplished by means of a Real-Time Analysis (RTA) pipeline, a key system of the CTA observatory. The latency and sensitivity requirements of the alarm system impose a challenge because of the anticipated large data rate, between 0.5 and 8 GB/s. As a consequence, substantial efforts toward the optimization of highthroughput computing service are envisioned. For these reasons our working group has started the development of a prototype of the Real-Time Analysis pipeline. The main goals of this prototype are to test: (i) a set of frameworks and design patterns useful for the inter-process communication between software processes running on memory; (ii) the sustainability of the foreseen CTA data rate in terms of data throughput with different hardware (e.g. accelerators) and software configurations, (iii) the reuse of nonreal- time algorithms or how much we need to simplify algorithms to be compliant with CTA requirements, (iv) interface issues between the different CTA systems. In this work we focus on goals (i) and (ii).

Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

PubMed

Pfeiffer, Yvonne; Schwappach, David

2016-01-01

National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

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

PubMed

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

2014-11-01

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

Reducing duplicate testing: a comparison of two clinical decision support tools.

PubMed

Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

2015-05-01

Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

VEB-1 Extended-Spectrum β-lactamase–producing Acinetobacter baumannii, France1

PubMed Central

Coignard, Bruno; Carbonne, Anne; Blanckaert, Karine; Bajolet, Odile; Bernet, Claude; Verdeil, Xavier; Astagneau, Pascal; Desenclos, Jean-Claude; Nordmann, Patrice

2006-01-01

VEB-1 extended-spectrum β-lactamase–producing Acinetobacter baumannii was responsible for an outbreak in hospitals in France. A national alert was triggered in September 2003 when 4 hospitals reported clusters of A. baumannii infection with similar susceptibility profiles. Case definitions and laboratory guidelines were disseminated, and prospective surveillance was implemented; strains were sent to a single laboratory for characterization and typing. From April 2003 through June 2004, 53 hospitals reported 290 cases of A. baumannii infection or colonization; 275 isolates were blaVEB-1-positive and clonally related. Cases were first reported in 5 districts of northern France, then in 10 other districts in 4 regions. Within a region, interhospital spread was associated with patient transfer. In northern France, investigation and control measures led to a reduction of reported cases after January 2004. The national alert enabled early control of new clusters, demonstrating the usefulness of early warning about antimicrobial drug resistance. PMID:16965700

A controlled evaluation of case clinical effect coding by poison center specialists for detection of WMD scenarios.

PubMed

Beuhler, Michael C; Wittler, Mary A; Ford, Marsha; Dulaney, Anna R

2011-08-01

Many public health entities employ computer-based syndromic surveillance to monitor for aberrations including possible exposures to weapons of mass destruction (WMD). Often, this is done by screening signs and symptoms reported for cases against syndromic definitions. Poison centers (PCs) may offer significant contributions to public health surveillance because of their detailed clinical effect data field coding and real-time data entry. Because improper clinical effect coding may impede syndromic surveillance, it is important to assess this accuracy for PCs. An AAPCC-certified regional PC assessed the accuracy of clinical effect coding by specialists in poison information (SPIs) listening to audio recordings of standard cases. Eighteen different standardized cases were used, consisting of six cyanide, six botulism, and six control cases. Cases were scripted to simulate clinically relevant telephone conversations and converted to audio recordings. Ten SPIs were randomly selected from the center's staff to listen to and code case information from the recorded cases. Kappa scores and the percentage of correctly coding a present clinical effect were calculated for individual clinical effects summed over all test cases along with corresponding 95% confidence intervals. The rate of the case coding by the SPIs triggering the PC's automated botulism and cyanide alerts was also determined. The kappa scores and the percentage of correctly coding a present clinical effect varied depending on the specific clinical effect, with greater accuracy observed for the clinical effects of vomiting and agitation/irritability, and poor accuracy observed for the clinical effects of visual defect and anion gap increase. Lack of correct coding resulted in only 60 and 86% of the cases that met the botulism and cyanide surveillance definitions, respectively, triggering the corresponding alert. There was no difference observed in the percentage of coding a present clinical effect between certified (9.0 years experience) and non-certified (2.4 years experience) specialists. There were no cases of coding errors that resulted in the triggering of a false positive alert. The success of syndromic surveillance depends on accurate coding of signs and symptoms. Although PCs generally contribute high-quality data to public health surveillance, it is important to recognize this potential weak link in surveillance methods.

Cockpit display of hazardous weather information

NASA Technical Reports Server (NTRS)

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

1991-01-01

Information transfer and display issues associated with the dissemination of hazardous weather warnings are studied in the context of wind shear alerts. Operational and developmental wind shear detection systems are briefly reviewed. The July 11, 1988 microburst events observed as part of the Denver Terminal Doppler Weather Radar (TDWR) operational evaluation are analyzed in terms of information transfer and the effectiveness of the microburst alerts. Information transfer, message content and display issues associated with microburst alerts generated from ground based sources (Doppler Radar, Low Level Wind Shear Alert System, and Pilot Reports) are evaluated by means fo pilot opinion surveys and part task simulator studies.

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

Dengue outlook for the World Cup in Brazil: an early warning model framework driven by real-time seasonal climate forecasts.

PubMed

Lowe, Rachel; Barcellos, Christovam; Coelho, Caio A S; Bailey, Trevor C; Coelho, Giovanini Evelim; Graham, Richard; Jupp, Tim; Ramalho, Walter Massa; Carvalho, Marilia Sá; Stephenson, David B; Rodó, Xavier

2014-07-01

With more than a million spectators expected to travel among 12 different cities in Brazil during the football World Cup, June 12-July 13, 2014, the risk of the mosquito-transmitted disease dengue fever is a concern. We addressed the potential for a dengue epidemic during the tournament, using a probabilistic forecast of dengue risk for the 553 microregions of Brazil, with risk level warnings for the 12 cities where matches will be played. We obtained real-time seasonal climate forecasts from several international sources (European Centre for Medium-Range Weather Forecasts [ECMWF], Met Office, Meteo-France and Centro de Previsão de Tempo e Estudos Climáticos [CPTEC]) and the observed dengue epidemiological situation in Brazil at the forecast issue date as provided by the Ministry of Health. Using this information we devised a spatiotemporal hierarchical Bayesian modelling framework that enabled dengue warnings to be made 3 months ahead. By assessing the past performance of the forecasting system using observed dengue incidence rates for June, 2000-2013, we identified optimum trigger alert thresholds for scenarios of medium-risk and high-risk of dengue. Our forecasts for June, 2014, showed that dengue risk was likely to be low in the host cities Brasília, Cuiabá, Curitiba, Porto Alegre, and São Paulo. The risk was medium in Rio de Janeiro, Belo Horizonte, Salvador, and Manaus. High-risk alerts were triggered for the northeastern cities of Recife (p(high)=19%), Fortaleza (p(high)=46%), and Natal (p(high)=48%). For these high-risk areas, particularly Natal, the forecasting system did well for previous years (in June, 2000-13). This timely dengue early warning permits the Ministry of Health and local authorities to implement appropriate, city-specific mitigation and control actions ahead of the World Cup. European Commission's Seventh Framework Research Programme projects DENFREE, EUPORIAS, and SPECS; Conselho Nacional de Desenvolvimento Científico e Tecnológico and Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro. Copyright © 2014 Elsevier Ltd. All rights reserved.

SU-C-202-03: A Tool for Automatic Calculation of Delivered Dose Variation for Off-Line Adaptive Therapy Using Cone Beam CT

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

Zhang, B; Lee, S; Chen, S

Purpose: Monitoring the delivered dose is an important task for the adaptive radiotherapy (ART) and for determining time to re-plan. A software tool which enables automatic delivered dose calculation using cone-beam CT (CBCT) has been developed and tested. Methods: The tool consists of four components: a CBCT Colleting Module (CCM), a Plan Registration Moduel (PRM), a Dose Calculation Module (DCM), and an Evaluation and Action Module (EAM). The CCM is triggered periodically (e.g. every 1:00 AM) to search for newly acquired CBCTs of patients of interest and then export the DICOM files of the images and related registrations defined inmore » ARIA followed by triggering the PRM. The PRM imports the DICOM images and registrations, links the CBCTs to the related treatment plan of the patient in the planning system (RayStation V4.5, RaySearch, Stockholm, Sweden). A pre-determined CT-to-density table is automatically generated for dose calculation. Current version of the DCM uses a rigid registration which regards the treatment isocenter of the CBCT to be the isocenter of the treatment plan. Then it starts the dose calculation automatically. The AEM evaluates the plan using pre-determined plan evaluation parameters: PTV dose-volume metrics and critical organ doses. The tool has been tested for 10 patients. Results: Automatic plans are generated and saved in the order of the treatment dates of the Adaptive Planning module of the RayStation planning system, without any manual intervention. Once the CTV dose deviates more than 3%, both email and page alerts are sent to the physician and the physicist of the patient so that one can look the case closely. Conclusion: The tool is capable to perform automatic dose tracking and to alert clinicians when an action is needed. It is clinically useful for off-line adaptive therapy to catch any gross error. Practical way of determining alarming level for OAR is under development.« less

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

PubMed

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

2015-11-01

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

A new method for determining a sector alert

DOT National Transportation Integrated Search

2008-09-29

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

A new approach to monitoring and alerting congestion in airspace sectors

DOT National Transportation Integrated Search

2014-09-28

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

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

PubMed

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

2018-05-08

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

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

PubMed Central

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

2013-01-01

The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and 22, and the information did not become available until EWs 23 and 24, when the peak of cases had already been reached. Although many of the partners reporting alerts during the peak of the cholera epidemic have since left Haiti, the A&R System has continued to function as an Early Warning (EWARN) System, and it continues to be developed with recent activities, such as the distribution of cell phones to enhance alert communication. PMID:24106196

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

PubMed

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

2013-10-01

The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and 22, and the information did not become available until EWs 23 and 24, when the peak of cases had already been reached. Although many of the partners reporting alerts during the peak of the cholera epidemic have since left Haiti, the A&R System has continued to function as an Early Warning (EWARN) System, and it continues to be developed with recent activities, such as the distribution of cell phones to enhance alert communication.

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

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

Biomolecular logic systems: applications to biosensors and bioactuators

NASA Astrophysics Data System (ADS)

Katz, Evgeny

2014-05-01

The paper presents an overview of recent advances in biosensors and bioactuators based on the biocomputing concept. Novel biosensors digitally process multiple biochemical signals through Boolean logic networks of coupled biomolecular reactions and produce output in the form of YES/NO response. Compared to traditional single-analyte sensing devices, biocomputing approach enables a high-fidelity multi-analyte biosensing, particularly beneficial for biomedical applications. Multi-signal digital biosensors thus promise advances in rapid diagnosis and treatment of diseases by processing complex patterns of physiological biomarkers. Specifically, they can provide timely detection and alert to medical emergencies, along with an immediate therapeutic intervention. Application of the biocomputing concept has been successfully demonstrated for systems performing logic analysis of biomarkers corresponding to different injuries, particularly exemplified for liver injury. Wide-ranging applications of multi-analyte digital biosensors in medicine, environmental monitoring and homeland security are anticipated. "Smart" bioactuators, for example for signal-triggered drug release, were designed by interfacing switchable electrodes and biocomputing systems. Integration of novel biosensing and bioactuating systems with the biomolecular information processing systems keeps promise for further scientific advances and numerous practical applications.

Identification of COPD patients' health status using an intelligent system in the CHRONIOUS wearable platform.

PubMed

Bellos, Christos C; Papadopoulos, Athanasios; Rosso, Roberto; Fotiadis, Dimitrios I

2014-05-01

The CHRONIOUS system offers an integrated platform aiming at the effective management and real-time assessment of the health status of the patient suffering from chronic obstructive pulmonary disease (COPD). An intelligent system is developed for the analysis and the real-time evaluation of patient's condition. A hybrid classifier has been implemented on a personal digital assistant, combining a support vector machine, a random forest, and a rule-based system to provide a more advanced categorization scheme for the early and in real-time characterization of a COPD episode. This is followed by a severity estimation algorithm which classifies the identified pathological situation in different levels and triggers an alerting mechanism to provide an informative and instructive message/advice to the patient and the clinical supervisor. The system has been validated using data collected from 30 patients that have been annotated by experts indicating 1) the severity level of the current patient's health status, and 2) the COPD disease level of the recruited patients according to the GOLD guidelines. The achieved characterization accuracy has been found 94%.

Behavioral characteristics of Internet gamblers who trigger corporate responsible gambling interventions.

PubMed

Gray, Heather M; LaPlante, Debi A; Shaffer, Howard J

2012-09-01

As the worldwide popularity of Internet gambling increases, concerns about the potential for gambling-related harm also increase. This paper reports the results of a study examining actual Internet gambling behavior during 10 years of play. We examined the electronic gambling records of subscribers (N=2,066) who triggered a responsible gaming alert system at a large international online gaming company. We compared these cases with control subscribers (N=2,066) who had the same amount of exposure to the Internet gambling service provider. We used discriminant function analysis to explore what aspects of gambling behavior distinguish cases from controls. Indices of the intensity of gambling activity (e.g., total number of bets made, number of bets per betting day) best distinguished cases from controls, particularly in the case of live-action sports betting. Control group players evidenced behavior similar to the population of players using this service. These results add to our understanding of behavioral markers for disordered Internet gambling and will aid in the development of behavior-based algorithms capable of predicting the presence and/or the onset of disordered Internet gambling. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Human Factors Evaluation of Conflict Detection Tool for Terminal Area

NASA Technical Reports Server (NTRS)

Verma, Savita Arora; Tang, Huabin; Ballinger, Deborah; Chinn, Fay Cherie; Kozon, Thomas E.

2013-01-01

A conflict detection and resolution tool, Terminal-area Tactical Separation-Assured Flight Environment (T-TSAFE), is being developed to improve the timeliness and accuracy of alerts and reduce the false alert rate observed with the currently deployed technology. The legacy system in use today, Conflict Alert, relies primarily on a dead reckoning algorithm, whereas T-TSAFE uses intent information to augment dead reckoning. In previous experiments, T-TSAFE was found to reduce the rate of false alerts and increase time between the alert to the controller and a loss of separation over the legacy system. In the present study, T-TSAFE was tested under two meteorological conditions, 1) all aircraft operated under instrument flight regimen, and 2) some aircraft operated under mixed operating conditions. The tool was used to visually alert controllers to predicted Losses of separation throughout the terminal airspace, and show compression errors, on final approach. The performance of T-TSAFE on final approach was compared with Automated Terminal Proximity Alert (ATPA), a tool recently deployed by the FAA. Results show that controllers did not report differences in workload or situational awareness between the T-TSAFE and ATPA cones but did prefer T-TSAFE features over ATPA functionality. T-TSAFE will provide one tool that shows alerts in the data blocks and compression errors via cones on the final approach, implementing all tactical conflict detection and alerting via one tool in TRACON airspace.

Environment Agency England flood warning systems

NASA Astrophysics Data System (ADS)

Strong, Chris; Walters, Mark; Haynes, Elizabeth; Dobson, Peter

2015-04-01

Context In England around 5 million homes are at risk of flooding. We invest significantly in flood prevention and management schemes but we can never prevent all flooding. Early alerting systems are fundamental to helping us reduce the impacts of flooding. The Environment Agency has had the responsibility for flood warning since 1996. In 2006 we invested in a new dissemination system that would send direct messages to pre-identified recipients via a range of channels. Since then we have continuously improved the system and service we offer. In 2010 we introduced an 'opt-out' service where we pre-registered landline numbers in flood risk areas, significantly increasing the customer base. The service has performed exceptionally well under intense flood conditions. Over a period of 3 days in December 2013, when England was experiencing an east coast storm surge, the system sent nearly 350,000 telephone messages, 85,000 emails and 70,000 text messages, with a peak call rate of around 37,000 per hour and 100% availability. The Floodline Warnings Direct (FWD) System FWD provides warnings in advance of flooding so that people at risk and responders can take action to minimise the impact of the flood. Warnings are sent via telephone, fax, text message, pager or e-mail to over 1.1 million properties located within flood risk areas in England. Triggers for issuing alerts and warnings include attained and forecast river levels and rainfall in some rapidly responding locations. There are three levels of warning: Flood Alert, Flood Warning and Severe Flood Warning, and a stand down message. The warnings can be updated to include relevant information to help inform those at risk. Working with our current provider Fujitsu, the system is under a programme of continuous improvement including expanding the 'opt-out' service to mobile phone numbers registered to at risk addresses, allowing mobile registration to the system for people 'on the move' and providing access to registration via third parties. The 'Future Flood Warning System' Our research shows that people want more choice on how they access and receive warnings. Many want a service tailored to their own risk, rather than that of their community. They also want more information about the forecast and the situation to that they can make decisions personal to their circumstances. Our future flood warning system will build upon the success of our existing service and will aim to: • provide our customers with a more flexible and personalised self-service approach which caters for the diverse range of user needs • alert people wherever they are, not just in properties • be flexible enough to respond to user feedback to make improvements and utilise new technology as it becomes available • provide real-time visualisation of system performance, to assist our flood response • capture greater levels of information from the recipients of our warnings • be efficient for operators of the system and utilise automation where relevant • take a risk based approach to resilience to provide the highest level of reliability when needed at a reduced cost

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

PubMed

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

2018-06-01

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

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Embedded reference prohibition. 10.440 Section 10.440 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.440 Embedded reference prohibition. A CMAS Alert Message processed by a...

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.420 - Message elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Message elements. 10.420 Section 10.420 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.420 Message elements. A CMAS Alert Message processed by a Participating CMS Provider shall...

47 CFR 10.10 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Definitions. 10.10 Section 10.10 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM General Information § 10.10 Definitions. (a) Alert Message. An Alert Message is a message that is intended to provide the...

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Embedded reference prohibition. 10.440 Section 10.440 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.440 Embedded reference prohibition. A CMAS Alert Message processed by a...

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Embedded reference prohibition. 10.440 Section 10.440 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.440 Embedded reference prohibition. A CMAS Alert Message processed by a...

The Earthquake Early Warning System In Southern Italy: Performance Tests And Next Developments

NASA Astrophysics Data System (ADS)

Zollo, A.; Elia, L.; Martino, C.; Colombelli, S.; Emolo, A.; Festa, G.; Iannaccone, G.

2011-12-01

PRESTo (PRobabilistic and Evolutionary early warning SysTem) is the software platform for Earthquake Early Warning (EEW) in Southern Italy, that integrates recent algorithms for real-time earthquake location, magnitude estimation and damage assessment, into a highly configurable and easily portable package. The system is under active experimentation based on the Irpinia Seismic Network (ISNet). PRESTo processes the live streams of 3C acceleration data for P-wave arrival detection and, while an event is occurring, promptly performs event detection and provides location, magnitude estimations and peak ground shaking predictions at target sites. The earthquake location is obtained by an evolutionary, real-time probabilistic approach based on an equal differential time formulation. At each time step, it uses information from both triggered and not-yet-triggered stations. Magnitude estimation exploits an empirical relationship that correlates it to the filtered Peak Displacement (Pd), measured over the first 2-4 s of P-signal. Peak ground-motion parameters at any distance can be finally estimated by ground motion prediction equations. Alarm messages containing the updated estimates of these parameters can thus reach target sites before the destructive waves, enabling automatic safety procedures. Using the real-time data streaming from the ISNet network, PRESTo has produced a bulletin for about a hundred low-magnitude events occurred during last two years. Meanwhile, the performances of the EEW system were assessed off-line playing-back the records for moderate and large events from Italy, Spain and Japan and synthetic waveforms for large historical events in Italy. These tests have shown that, when a dense seismic network is deployed in the fault area, PRESTo produces reliable estimates of earthquake location and size within 5-6 s from the event origin time (To). Estimates are provided as probability density functions whose uncertainty typically decreases with time, obtaining a stable solution within 10 s from To. The regional approach was recently integrated with a threshold-based early warning method for the definition of alert levels and the estimation of the Potential Damaged Zone (PDZ) in which the highest intensity levels are expected. The dominant period Tau_c and the peak displacement (Pd) are simultaneously measured in a 3s window after the first P-arrival time. Pd and Tau_c are then compared with threshold values, previously established through an empirical regression analysis, that define a decisional table with four alert levels. According to the real-time measured values of Pd and tau_c, each station provides a local alert level that can be used to warn distant sites and to define the extent of the PDZ. The integrated system was validated off-line for the M6.3, 2009 Central Italy earthquake and ten large Japanese events, due to the low-magnitude events currently occurring in Irpinia. The results confirmed the feasibility and the robustness of such an approach, providing reliable predictions of the earthquake damaging effects, that is a relevant information for the efficient planning of the rescue operations in the immediate post-event emergency phase.

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

USGS Publications Warehouse

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

2012-01-01

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

Coordinated Displays to Assist Cyber Defenders

DTIC Science & Technology

2016-09-23

suspicious activity, such as the occurrence of a network event that is similar to a known attack signature, the system generates an alert which is then...presented to a human computer network defense analyst, or more succinctly, a network analyst, who must evaluate the veracity of that alert . To...display and select an alert to investigate further. Though alerts generally include some information about the nature of a potential threat, the

The Zwicky Transient Facility Public Alert Stream

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

MyEEW: A Smartphone App for the ShakeAlert System

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

47 CFR 10.430 - Character limit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Character limit. 10.430 Section 10.430 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Alert Message Requirements § 10.430 Character limit. A CMAS Alert Message processed by a Participating CMS Provider must not...

Alerts Analysis and Visualization in Network-based Intrusion Detection Systems

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

Yang, Dr. Li

2010-08-01

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

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

PubMed

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

2016-01-01

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

Personalized and automated remote monitoring of atrial fibrillation.

PubMed

Rosier, Arnaud; Mabo, Philippe; Temal, Lynda; Van Hille, Pascal; Dameron, Olivier; Deléger, Louise; Grouin, Cyril; Zweigenbaum, Pierre; Jacques, Julie; Chazard, Emmanuel; Laporte, Laure; Henry, Christine; Burgun, Anita

2016-03-01

Remote monitoring of cardiac implantable electronic devices is a growing standard; yet, remote follow-up and management of alerts represents a time-consuming task for physicians or trained staff. This study evaluates an automatic mechanism based on artificial intelligence tools to filter atrial fibrillation (AF) alerts based on their medical significance. We evaluated this method on alerts for AF episodes that occurred in 60 pacemaker recipients. AKENATON prototype workflow includes two steps: natural language-processing algorithms abstract the patient health record to a digital version, then a knowledge-based algorithm based on an applied formal ontology allows to calculate the CHA2DS2-VASc score and evaluate the anticoagulation status of the patient. Each alert is then automatically classified by importance from low to critical, by mimicking medical reasoning. Final classification was compared with human expert analysis by two physicians. A total of 1783 alerts about AF episode >5 min in 60 patients were processed. A 1749 of 1783 alerts (98%) were adequately classified and there were no underestimation of alert importance in the remaining 34 misclassified alerts. This work demonstrates the ability of a pilot system to classify alerts and improves personalized remote monitoring of patients. In particular, our method allows integration of patient medical history with device alert notifications, which is useful both from medical and resource-management perspectives. The system was able to automatically classify the importance of 1783 AF alerts in 60 patients, which resulted in an 84% reduction in notification workload, while preserving patient safety. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed Central

Krall, M. A.; Sittig, D. F.

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use". PMID:11825206

Subjective assessment of usefulness and appropriate presentation mode of alerts and reminders in the outpatient setting.

PubMed

Krall, M A; Sittig, D F

2001-01-01

There is very little known about the limits of alerting in the setting of the outpatient Electronic Medical Record (EMR). We are interested in how users value and prefer such alerts. One hundred Kaiser Permanente primary care clinicians were sent a four-page questionnaire. It contained questions related to the usability and usefulness of different approaches to presenting reminder and alert information. The survey also contained questions about the desirability of six categories of alerts. Forty-three of 100 questionnaires were returned. Users generally preferred an active, more intrusive interaction model for "alerts" and a passive, less intrusive model for order messages and other types of reminders and notifications. Drug related alerts were more highly rated than health maintenance or disease state reminders. Users indicated that more alerts would make the system "more useful" but "less easy to use".

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

PubMed

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

2013-06-01

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

Perceptual evaluation of visual alerts in surveillance videos

NASA Astrophysics Data System (ADS)

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

2015-03-01

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

Machine Learning Seismic Wave Discrimination: Application to Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Li, Zefeng; Meier, Men-Andrin; Hauksson, Egill; Zhan, Zhongwen; Andrews, Jennifer

2018-05-01

Performance of earthquake early warning systems suffers from false alerts caused by local impulsive noise from natural or anthropogenic sources. To mitigate this problem, we train a generative adversarial network (GAN) to learn the characteristics of first-arrival earthquake P waves, using 300,000 waveforms recorded in southern California and Japan. We apply the GAN critic as an automatic feature extractor and train a Random Forest classifier with about 700,000 earthquake and noise waveforms. We show that the discriminator can recognize 99.2% of the earthquake P waves and 98.4% of the noise signals. This state-of-the-art performance is expected to reduce significantly the number of false triggers from local impulsive noise. Our study demonstrates that GANs can discover a compact and effective representation of seismic waves, which has the potential for wide applications in seismology.

Drowsy driver mobile application: Development of a novel scleral-area detection method.

PubMed

Mohammad, Faisal; Mahadas, Kausalendra; Hung, George K

2017-10-01

A reliable and practical app for mobile devices was developed to detect driver drowsiness. It consisted of two main components: a Haar cascade classifier, provided by a computer vision framework called OpenCV, for face/eye detection; and a dedicated JAVA software code for image processing that was applied over a masked region circumscribing the eye. A binary threshold was performed over the masked region to provide a quantitative measure of the number of white pixels in the sclera, which represented the state of eye opening. A continuously low white-pixel count would indicate drowsiness, thereby triggering an alarm to alert the driver. This system was successfully implemented on: (1) a static face image, (2) two subjects under laboratory conditions, and (3) a subject in a vehicle environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sky Event Reporting Metadata (VOEvent) Version 2.0

NASA Technical Reports Server (NTRS)

Seaman, Rob; Williams, Roy; Allan, Alasdair; Barthelmy, Scott; Bloom, Joshua S.; Brewer, John M.; Denny, Robert B.; Fitzpatrick, Mike; Graham, Matthew; Gray, Norman;

An investigation of air transportation technology at the Massachusetts Institute of Technology, 1990-1991

NASA Technical Reports Server (NTRS)

Simpson, Robert W.

1991-01-01

Brief summaries are given of research activities at the Massachusetts Institute of Technology (MIT) under the sponsorship of the FAA/NASA Joint University Program. Topics covered include hazard assessment and cockpit presentation issues for microburst alerting systems; the situational awareness effect of automated air traffic control (ATC) datalink clearance amendments; a graphical simulation system for adaptive, automated approach spacing; an expert system for temporal planning with application to runway configuration management; deterministic multi-zone ice accretion modeling; alert generation and cockpit presentation for an integrated microburst alerting system; and passive infrared ice detection for helicopter applications.

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

Developing, Implementing, and Assessing an Early Alert System

ERIC Educational Resources Information Center

Tampke, Dale R.

2013-01-01

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

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

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

DOT National Transportation Integrated Search

2017-06-01

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

76 FR 11846 - Seventy-second Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Committee 147 meeting: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance... RTCA Special Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision...

76 FR 58077 - Seventy-Third Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance Systems... Committee 147 meeting: Minimum Operational Performance Standards for Traffic Alert and Collision Avoidance... RTCA Special Committee 147: Minimum Operational Performance Standards for Traffic Alert and Collision...

Delivering Alert Messages to Members of a Work Force

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

Solar radiation alert system : final report.

DOT National Transportation Integrated Search

2009-03-01

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

Speech Alarms Pilot Study

NASA Technical Reports Server (NTRS)

Sandor, A.; Moses, H. R.

2016-01-01

Currently on the International Space Station (ISS) and other space vehicles Caution & Warning (C&W) alerts are represented with various auditory tones that correspond to the type of event. This system relies on the crew's ability to remember what each tone represents in a high stress, high workload environment when responding to the alert. Furthermore, crew receive a year or more in advance of the mission that makes remembering the semantic meaning of the alerts more difficult. The current system works for missions conducted close to Earth where ground operators can assist as needed. On long duration missions, however, they will need to work off-nominal events autonomously. There is evidence that speech alarms may be easier and faster to recognize, especially during an off-nominal event. The Information Presentation Directed Research Project (FY07-FY09) funded by the Human Research Program included several studies investigating C&W alerts. The studies evaluated tone alerts currently in use with NASA flight deck displays along with candidate speech alerts. A follow-on study used four types of speech alerts to investigate how quickly various types of auditory alerts with and without a speech component - either at the beginning or at the end of the tone - can be identified. Even though crew were familiar with the tone alert from training or direct mission experience, alerts starting with a speech component were identified faster than alerts starting with a tone. The current study replicated the results from the previous study in a more rigorous experimental design to determine if the candidate speech alarms are ready for transition to operations or if more research is needed. Four types of alarms (caution, warning, fire, and depressurization) were presented to participants in both tone and speech formats in laboratory settings and later in the Human Exploration Research Analog (HERA). In the laboratory study, the alerts were presented by software and participants were asked to identify the alert as quickly and as accurately as possible. Reaction time and accuracy were measured. Participants identified speech alerts significantly faster than tone alerts. The HERA study investigated the performance of participants in a flight-like environment. Participants were instructed to complete items on a task list and respond to C&W alerts as they occurred. Reaction time and accuracy were measured to determine if the benefits of speech alarms are still present in an applied setting.

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

PubMed

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

2016-03-11

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

Benefit Value to the Air Force of the GIDEP (Government Industry Data Exchange Program) Alert

DTIC Science & Technology

1984-06-15

cost avoidance within that organization is not the result of the ALERT system . 3-1 b) Designed Life - This is the expected life of the item as...Analytics1 Phase II efforts under contract F33615-S3- C-5098. The main findings of the report are: (1) The system set up to handle Government...slow to issue ALERTs. (4) There is no formally documented system for determining that the Air Force’s warranty rights are being enforced on items

Pi-EEWS: a low cost prototype for on-site earthquake early warning system

NASA Astrophysics Data System (ADS)

Pazos, Antonio; Vera, Angel; Morgado, Arturo; Rioja, Carlos; Davila, Jose Martin; Cabieces, Roberto

2017-04-01

The Royal Spanish Navy Observatory (ROA), with the participation of the Cadiz University (UCA), have been developed the ALERTES-SC3 EEWS (regional approach) based on the SeisComP3 software package. This development has been done in the frame of the Spanish ALERT-ES (2011-2013) and ALERTES-RIM (2014-2016) projects, and now a days it is being tested in real time for south Iberia. Additionally, the ALERTES-SC3 system integrates an on-site EEWS software, developed by ROA-UCA, which is running for testing in real time in some seismic broad band stations of the WM network. Regional EEWS are not able to provide alerts in the area closet to the epicentre (blind zone), so a dense on-site EEWS is necessary. As it was mentioned, ALERTES-SC3 inludes the on-site software running on several WM stations but a more dense on-site stations are necessary to cover the blind zones. In order to densify this areas, inside of the "blind zones", a low cost on-site prototype "Pi-EEWS", based on a Raspberry Pi card and low cost acelerometers. In this work the main design ideas, the components and its capabilities will be shown.

Safety Alerts: An Observational Study in Portugal.

PubMed

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

2015-09-01

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

Improving the Quality of Alerts and Predicting Intruder's Next Goal with Hidden Colored Petri-Net

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

Yu, Dong; Frincke, Deb A.

2006-06-22

Intrusion detection systems (IDS) often provide poor quality alerts, which are insufficient to support rapid identification of ongoing attacks or predict an intruder’s next likely goal. In this paper, we propose a novel approach to alert post-processing and correlation, the Hidden Colored Petri-Net (HCPN). Different from most other alert correlation methods, our approach treats the alert correlation problem as an inference problem rather than a filter problem. Our approach assumes that the intruder’s actions are unknown to the IDS and can be inferred only from the alerts generated by the IDS sensors. HCPN can describe the relationship between different stepsmore » carried out by intruders, model observations (alerts) and transitions (actions) separately, and associate each token element (system state) with a probability (or confidence). The model is an extension to Colored Petri-Net (CPN) .It is so called “hidden” because the transitions (actions) are not directly observable but can be inferred by looking through the observations (alerts). These features make HCPN especially suitable for discovering intruders’ actions from their partial observations (alerts,) and predicting intruders’ next goal. Our experiments on DARPA evaluation datasets and the attack scenarios from the Grand Challenge Problem (GCP) show that HCPN has promise as a way to reducing false positives and negatives, predicting intruder’s next possible action, uncovering intruders’ intrusion strategies after the attack scenario has happened, and providing confidence scores.« less

The effect of phasic auditory alerting on visual perception.

PubMed

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

2017-08-01

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

Prescription order risk factors for pediatric dosing alerts.

PubMed

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

2015-02-01

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

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

PubMed Central

Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

2012-01-01

Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID:23024254

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

PubMed Central

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

2015-01-01

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

A Secret Support Network

ERIC Educational Resources Information Center

Wasley, Paula

2007-01-01

This article describes Hanover College's Early Alert Team, an early-alert program that seeks to identify students' academic, social, or personal troubles as soon as they surface. The team's five members gather information about students from all corners of the campus and then devise strategies to help them. The early-alert system has not only…

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

Earthquake early Warning ShakeAlert system: West coast wide production prototype

USGS Publications Warehouse

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

2017-01-01

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

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

A prototype system for forecasting landslides in the Seattle, Washington, area

USGS Publications Warehouse

Chleborad, Alan F.; Baum, Rex L.; Godt, Jonathan W.; Powers, Philip S.

2008-01-01

Empirical rainfall thresholds and related information form the basis of a prototype system for forecasting landslides in the Seattle area. The forecasts are tied to four alert levels, and a decision tree guides the use of thresholds to determine the appropriate level. From analysis of historical landslide data, we developed a formula for a cumulative rainfall threshold (CT), P3  =  88.9 − 0.67P15, defined by rainfall amounts in millimeters during consecutive 3 d (72 h) periods, P3, and the 15 d (360 h) period before P3, P15. The variable CT captures more than 90% of historical events of three or more landslides in 1 d and 3 d periods recorded from 1978 to 2003. However, the low probability of landslide occurrence on a day when the CT is exceeded at one or more rain gauges (8.4%) justifies a low-level of alert for possible landslide occurrence, but it does trigger more vigilant monitoring of rainfall and soil wetness. Exceedance of a rainfall intensity-duration threshold I  =  82.73D−1.13, for intensity, I (mm/hr), and duration, D (hr), corresponds to a higher probability of landslide occurrence (30%) and forms the basis for issuing warnings of impending, widespread occurrence of landslides. Information about the area of exceedance and soil wetness can be used to increase the certainty of landslide forecasts (probabilities as great as 71%). Automated analysis of real-time rainfall and subsurface water data and digital quantitative precipitation forecasts are needed to fully implement a warning system based on the two thresholds.

Earthquake Warning Performance in Vallejo for the South Napa Earthquake

NASA Astrophysics Data System (ADS)

Wurman, G.; Price, M.

2014-12-01

In 2002 and 2003, Seismic Warning Systems, Inc. installed first-generation QuakeGuardTM earthquake warning devices at all eight fire stations in Vallejo, CA. These devices are designed to detect the P-wave of an earthquake and initiate predetermined protective actions if the impending shaking is estimated at approximately Modifed Mercalli Intensity V or greater. At the Vallejo fire stations the devices were set up to sound an audio alert over the public address system and to command the equipment bay doors to open. In August 2014, after more than 11 years of operating in the fire stations with no false alarms, the five units that were still in use triggered correctly on the MW 6.0 South Napa earthquake, less than 16 km away. The audio alert sounded in all five stations, providing fire fighters with 1.5 to 2.5 seconds of warning before the arrival of the S-wave, and the equipment bay doors opened in three of the stations. In one station the doors were disconnected from the QuakeGuard device, and another station lost power before the doors opened completely. These problems highlight just a small portion of the complexity associated with realizing actionable earthquake warnings. The issues experienced in this earthquake have already been addressed in subsequent QuakeGuard product generations, with downstream connection monitoring and backup power for critical systems. The fact that the fire fighters in Vallejo were afforded even two seconds of warning at these epicentral distances results from the design of the QuakeGuard devices, which focuses on rapid false positive rejection and ground motion estimates. We discuss the performance of the ground motion estimation algorithms, with an emphasis on the accuracy and timeliness of the estimates at close epicentral distances.

Towards real-time risk mitigation for NPP in Switzerland: the potential role of EEW and OEF.

NASA Astrophysics Data System (ADS)

Cauzzi, Carlo; Wiemer, Stefan; Behr, Yannik; Clinton, John; Renault, Philippe; Le Guenan, Thomas; Douglas, John; Woessner, Jochen; Biro, Yesim; Caprio, Marta; Cua, Georgia

2014-05-01

Spurred by the research activities being carried out within the EC-funded project REAKT (Strategies and Tools for Real Time Earthquake Risk Reduction, FP7, contract no. 282862, 2011-2014, www.reaktproject.eu), we present herein the key elements to understanding the potential benefits of routinely using Earthquake Early Warning and Operational Earthquake Forecasting methods to mitigate the seismic risk at NPP in Switzerland. The advantages of using the aforementioned real-time risk reduction tools are critically discussed based on the limitations of the current scientific knowledge and technology, as well as on the costs associated to both system maintenance and machine- or human-triggered actions following an alert. Basic inputs to this discussion are, amongst others: a) the performances of the Swiss seismic network (http://www.seismo.ethz.ch/monitor, where SeisComP3 is used as earthquake monitoring software) and the selected EEW algorithm (the Virtual Seismologist, VS, http://www.seiscomp3.org/doc/seattle/2013.200/apps/vs.html), in terms of correct detections, false alerts, and missed events; b) the reliability of time-dependent hazard scenarios for the region of interest; c) a careful assessment of the frequency of occurrence of critical warnings based on the local and regional seismicity; d) the identification of the mitigation actions and their benefits and costs for the stakeholders.

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

PubMed

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

2012-01-01

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

Carbamates and ICH M7 classification: Making use of expert knowledge.

PubMed

Hemingway, Rachel; Fowkes, Adrian; Williams, Richard V

2017-06-01

Carbamates are widely used in the chemical industry so understanding their toxicity is important to safety assessment. Carbamates have been associated with certain toxicities resulting in publication of structural alerts, including alerts for mutagenicity. Structural alerts for bacterial mutagenicity can be used in combination with statistical systems to enable ICH M7 classification, which allows assessment of the genotoxic risk posed by pharmaceutical impurities. This study tested a hypothetical bacterial mutagenicity alert for carbamates and examined the impact it would have on ICH M7 classifications using (Q)SAR predictions from the expert rule-based system Derek Nexus and the statistical-based system Sarah Nexus. Public datasets have a low prevalence of mutagenic carbamates, which highlighted that systems containing an alert for carbamates perform poorly for achieving correct ICH M7 classifications. Carbamates are commonly used as protecting groups and proprietary datasets containing such compounds were also found to have a low prevalence of mutagenic compounds. Expert review of the mutagenic compounds established that mutagenicity was often only observed under certain (non-standard) conditions and more generally that the Ames test may be a poor predictor for the risk of carcinogenicity posed by chemicals in this class. Overall a structural alert for the in vitro bacterial mutagenesis of carbamates does not benefit workflows for assigning ICH M7 classification to impurities. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Using Heuristic Evaluation to Improve Sepsis Alert Usability.

PubMed

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

2018-06-01

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

Towards a debris-flow warning system based on hydrological measurements of the triggering conditions. A study of El Rebaixader catchment (Central Pyrenees, Spain)

NASA Astrophysics Data System (ADS)

Abancó, Clàudia; Hürlimann, Marcel; Moya, José

2014-05-01

Debris flows represent a risk to the society due to their high destructive power. Rainfall is the main debris-flow triggering factor. Rainfall thresholds are generally used for warning of debris flow occurrence in susceptible catchments. However, the efficiency of such thresholds for real time hazard assessment is often conditioned by many factors, such as: the location and number of the rain gauges used (both to define the thresholds, and for setting off warnings); the temporal and spatial evolution of rainfall's convective cells or the effect of snow cover melting. These factors affect the length of the warning time, which is of crucial importance for issuing alert messages or alarms to the people and infrastructures at risk. The Rebaixader catchment (Central Pyrenees, Spain) is being monitored since 2009 by six stations recording information on initiation (4 stations) and flow detection and cinematic behaviour (2 stations). Until December 2013, 7 debris flows, 17 debris floods and 4 rockfalls have been recorded. The objectives of this work were: a) the definition of rainfall thresholds at two different rain gauges; b) the analysis of the infiltration patterns in order to define their potential use for warning systems and c) preliminary testing of rainfall thresholds' efficiency in terms of warning time, in this catchment. This last goal consisted in the comparison of the time elapsed between the rainfall threshold was exceeded and the event occurrence was detected by the stations at the channel area. The results suggest that the intensity-duration rainfall thresholds sometimes provide warning times which would be too short for an adequate reaction in the Rebaixader catchment (less than 10 minutes). The combination of such rainfall thresholds with infiltration measurements is useful to increase the warning time. This occurs especially in the events triggered in spring, when the snowmelt plays an important role in the event's triggering conditions. However, the effects of infiltration associated to the summer convective rainfalls are almost imperceptible; therefore their importance in warning systems decreases.

Predictive Information: Status or Alert Information?

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

PubMedAlertMe - Standalone Windows-based PubMed SDI Software Application

PubMed Central

Ma’ayan, Avi

2008-01-01

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

Implementing a Commercial Rule Base as a Medication Order Safety Net

PubMed Central

Reichley, Richard M.; Seaton, Terry L.; Resetar, Ervina; Micek, Scott T.; Scott, Karen L.; Fraser, Victoria J.; Dunagan, W. Claiborne; Bailey, Thomas C.

2005-01-01

A commercial rule base (Cerner Multum) was used to identify medication orders exceeding recommended dosage limits at five hospitals within BJC HealthCare, an integrated health care system. During initial testing, clinical pharmacists determined that there was an excessive number of nuisance and clinically insignificant alerts, with an overall alert rate of 9.2%. A method for customizing the commercial rule base was implemented to increase rule specificity for problematic rules. The system was subsequently deployed at two facilities and achieved alert rates of less than 1%. Pharmacists screened these alerts and contacted ordering physicians in 21% of cases. Physicians made therapeutic changes in response to 38% of alerts presented to them. By applying simple techniques to customize rules, commercial rule bases can be used to rapidly deploy a safety net to screen drug orders for excessive dosages, while preserving the rule architecture for later implementations of more finely tuned clinical decision support. PMID:15802481

The Three-item ALERT-B Questionnaire Provides a Validated Screening Tool to Detect Chronic Gastrointestinal Symptoms after Pelvic Radiotherapy in Cancer Survivors.

PubMed

Taylor, S; Byrne, A; Adams, R; Turner, J; Hanna, L; Staffurth, J; Farnell, D; Sivell, S; Nelson, A; Green, J

2016-10-01

Although pelvic radiotherapy is an effective treatment for various malignancies, around half of patients develop significant gastrointestinal problems. These symptoms often remain undetected, despite the existence of effective treatments. This study developed and refined a simple screening tool to detect common gastrointestinal symptoms in outpatient clinics. These symptoms have a significant effect on quality of life. This tool will increase detection rates and so enable access to specialist gastroenterologists, which will in turn lead to improved symptom control and quality of life after treatment. A literature review and expert consensus meeting identified four items for the ALERT-B (Assessment of Late Effects of RadioTherapy - Bowel) screening tool. ALERT-B was face tested for its usability and acceptability using cognitive interviews with 12 patients experiencing late gastrointestinal symptoms after pelvic radiotherapy. Thematic analysis and probe category were used to analyse interview transcripts. Interview data were presented to a group of experts to agree on the final content and format of the tool. ALERT-B was assessed for reliability and tested for validity against the Gastrointestinal Symptom Rating Scale in a clinical study (EAGLE). Overall, the tool was found to be acceptable in terms of wording, response format and completion time. Participant-reported experiences, including lifestyle modifications and the psychological effect of the symptoms, led to further modifications of the tool. The refined tool includes three questions covering rectal bleeding, incontinence, nocturnal bowel movements and impact on quality of life, including mood, relationships and socialising. ALERT-B was successfully validated against the Gastrointestinal Symptom Rating Scale in the EAGLE study with the tool shown broadly to be internally consistent (Cronbach's α = 0.61 and all item-subscale correlation [Spearman] coefficients are > 0.6). The ALERT-B screening tool can be used in clinical practice to improve post-treatment supportive care by triggering the clinical assessment of patients suitable for referral to a gastroenterologist. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Behavioral Modification of Intraoperative Hyperglycemia Management with a Novel Real-time Audiovisual Monitor.

PubMed

Sathishkumar, Subramanian; Lai, Manda; Picton, Paul; Kheterpal, Sachin; Morris, Michelle; Shanks, Amy; Ramachandran, Satya Krishna

2015-07-01

Hyperglycemia, defined as blood glucose (BG) levels above 200 mg/dl (11.1 mM), is associated with increased postoperative morbidity. Yet, the treatment standard for intraoperative glycemic control is poorly defined for noncardiac surgery. Little is known of the interindividual treatment variability or methods to modify intraoperative glycemic management behaviors. AlertWatch (AlertWatch, USA) is a novel audiovisual alert system that serves as a secondary patient monitor for use in operating rooms. The authors evaluated the influence of use of AlertWatch on intraoperative glycemic management behavior. AlertWatch displays historical patient data (risk factors and laboratory results) from multiple networked information systems, combined with the patient's live physiologic data. The authors extracted intraoperative data for 19 months to evaluate the relationship between AlertWatch usage and initiation of insulin treatment for hyperglycemia. Outcome associations were adjusted for physical status, case duration, procedural complexity, emergent procedure, fasting BG value, home insulin therapy, patient age, and primary anesthetist. Overall, 2,341 patients had documented intraoperative hyperglycemia. Use of AlertWatch (791 of 2,341; 33.5%) was associated with 55% increase in insulin treatment (496 of 791 [62.7%] with and 817 of 1,550 [52.7%] without AlertWatch; adjusted odds ratio [95% CI], 1.55 [1.23 to 1.95]; P < 0.001) and 44% increase in BG recheck after insulin administration (407 of 791 [51.5%] with AlertWatch and 655 of 1,550 [42.3%] in controls; adjusted odds ratio [95% CI], 1.44 [1.14 to 1.81]; P = 0.002). AlertWatch is associated with a significant increase in desirable intraoperative glycemic management behavior and may help achieve tighter intraoperative glycemic control.

Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.

PubMed

Hoste, Eric A J; Kashani, Kianoush; Gibney, Noel; Wilson, F Perry; Ronco, Claudio; Goldstein, Stuart L; Kellum, John A; Bagshaw, Sean M

2016-01-01

Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert. Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts. Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation. This paper reflects the findings of a non-systematic review and expert opinion. We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes.

PubMed

Amland, Robert C; Haley, James M; Lyons, Jason J

2016-11-01

Sepsis is an inflammatory response triggered by infection, with risk of in-hospital mortality fueled by disease progression. Early recognition and intervention by multidisciplinary sepsis programs may reverse the inflammatory response among at-risk patient populations, potentially improving outcomes. This retrospective study of a sepsis program enabled by a 2-stage sepsis Clinical Decision Support (CDS) system sought to evaluate the program's impact, identify early indicators that may influence outcomes, and uncover opportunities for quality improvement. Data encompassed 16 527 adult hospitalizations from 2014 and 2015. Of 2108 non-intensive care unit patients screened-in by sepsis CDS, 97% patients were stratified by 177 providers. Risk of adverse outcome improved 30% from baseline to year end, with gains materializing and stabilizing at month 7 after sepsis program go-live. Early indicators likely to influence outcomes include patient age, recent hospitalization, electrolyte abnormalities, hypovolemic shock, hypoxemia, patient location when sepsis CDS activated, and specific alert patterns. © The Author(s) 2015.

Detecting abandoned objects using interacting multiple models

NASA Astrophysics Data System (ADS)

Becker, Stefan; Münch, David; Kieritz, Hilke; Hübner, Wolfgang; Arens, Michael

2015-10-01

In recent years, the wide use of video surveillance systems has caused an enormous increase in the amount of data that has to be stored, monitored, and processed. As a consequence, it is crucial to support human operators with automated surveillance applications. Towards this end an intelligent video analysis module for real-time alerting in case of abandoned objects in public spaces is proposed. The overall processing pipeline consists of two major parts. First, person motion is modeled using an Interacting Multiple Model (IMM) filter. The IMM filter estimates the state of a person according to a finite-state, discrete-time Markov chain. Second, the location of persons that stay at a fixed position defines a region of interest, in which a nonparametric background model with dynamic per-pixel state variables identifies abandoned objects. In case of a detected abandoned object, an alarm event is triggered. The effectiveness of the proposed system is evaluated on the PETS 2006 dataset and the i-Lids dataset, both reflecting prototypical surveillance scenarios.

Alerts in mobile healthcare applications: requirements and pilot study.

PubMed

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

2004-06-01

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

Evaluation of Helmet Mounted Display Alerting Symbology

NASA Technical Reports Server (NTRS)

DeMaio, Joe; Rutkowski, Michael (Technical Monitor)

2000-01-01

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

Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

NASA Astrophysics Data System (ADS)

Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

75 FR 4760 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

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

An approach for representing sensor data to validate alerts in Ambient Assisted Living.

PubMed

Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A

2012-01-01

The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations--obtained through an argumentation process--of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert.

Results from the Autonomous Triggering of in situ Sensors on Kilauea Volcano, HI, from Eruption Detection by Spacecraft

NASA Astrophysics Data System (ADS)

Doubleday, J.; Behar, A.; Davies, A.; Mora-Vargas, A.; Tran, D.; Abtahi, A.; Pieri, D. C.; Boudreau, K.; Cecava, J.

2008-12-01

Response time in acquiring sensor data in volcanic emergencies can be greatly improved through use of autonomous systems. For instance, ground-based observations and data processing applications of the JPL Volcano Sensor Web have promptly triggered spacecraft observations [e.g., 1]. The reverse command and information flow path can also be useful, using autonomous analysis of spacecraft data to trigger in situ sensors. In this demonstration project, SO2 sensors were incorporated into expendable "Volcano Monitor" capsules and placed downwind of the Pu'u 'O'o vent of Kilauea volcano, Hawai'i. In nominal (low) power conservation mode, data from these sensors were collected and transmitted every hour to the Volcano Sensor Web through the Iridium Satellite Network. When SO2 readings exceeded a predetermined threshold, the modem within the Volcano Monitor sent an alert to the Sensor Web, and triggered a request for prompt Earth Observing-1 (EO-1) spacecraft data acquisition. The Volcano Monitors were also triggered by the Sensor Web in response to an eruption detection by the MODIS instrument on Terra. During these pre- defined "critical events" the Sensor Web ordered the SO2 sensors within the Volcano Monitor to increase their sampling frequency to every 5 minutes (high power "burst mode"). Autonomous control of the sensors' sampling frequency enabled the Sensor Web to monitor and respond to rapidly evolving conditions, and allowed rapid compilation and dissemination of these data to the scientific community. Reference: [1] Davies et al., (2006) Eos, 87, (1), 1 and 5. This work was performed at the Jet Propulsion Laboratory-California Institute of Technology, under contract to NASA. Support was provided by the NASA AIST program, the Idaho Space Grant Consortium, and the New Mexico Space Grant Program. We also especially thank the personnel of the USGS Hawaiian Volcano Observatory for their invaluable scientific guidance and logistical assistance.

Automated critical test result notification system: architecture, design, and assessment of provider satisfaction.

PubMed

Lacson, Ronilda; O'Connor, Stacy D; Andriole, Katherine P; Prevedello, Luciano M; Khorasani, Ramin

2014-11-01

Communicating critical results of diagnostic imaging procedures is a national patient safety goal. The purposes of this study were to describe the system architecture and design of Alert Notification of Critical Results (ANCR), an automated system designed to facilitate communication of critical imaging results between care providers; to report providers' satisfaction with ANCR; and to compare radiologists' and ordering providers' attitudes toward ANCR. The design decisions made for each step in the alert communication process, which includes user authentication, alert creation, alert communication, alert acknowledgment and management, alert reminder and escalation, and alert documentation, are described. To assess attitudes toward ANCR, internally developed and validated surveys were administered to all radiologists (n = 320) and ordering providers (n = 4323) who sent or received alerts 3 years after ANCR implementation. The survey response rates were 50.4% for radiologists and 36.1% for ordering providers. Ordering providers were generally dissatisfied with the training received for use of ANCR and with access to technical support. Radiologists were more satisfied with documenting critical result communication (61.1% vs 43.2%; p = 0.0001) and tracking critical results (51.6% vs 35.1%; p = 0.0003) than were ordering providers. Both groups agreed use of ANCR reduces medical errors and improves the quality of patient care. Use of ANCR enables automated communication of critical test results. The survey results confirm overall provider satisfaction with ANCR but highlight the need for improved training strategies for large numbers of geographically dispersed ordering providers. Future enhancements beyond acknowledging receipt of critical results are needed to help ensure timely and appropriate follow-up of critical results to improve quality and patient safety.

Automated Critical Test Result Notification System: Architecture, Design, and Assessment of Provider Satisfaction

PubMed Central

Lacson, Ronilda; O'Connor, Stacy D.; Andriole, Katherine P.; Prevedello, Luciano M.; Khorasani, Ramin

2015-01-01

OBJECTIVE Communicating critical results of diagnostic imaging procedures is a national patient safety goal. The purposes of this study were to describe the system architecture and design of Alert Notification of Critical Results (ANCR), an automated system designed to facilitate communication of critical imaging results between care providers; to report providers’ satisfaction with ANCR; and to compare radiologists’ and ordering providers’ attitudes toward ANCR. MATERIALS AND METHODS The design decisions made for each step in the alert communication process, which includes user authentication, alert creation, alert communication, alert acknowledgment and management, alert reminder and escalation, and alert documentation, are described. To assess attitudes toward ANCR, internally developed and validated surveys were administered to all radiologists (n = 320) and ordering providers (n = 4323) who sent or received alerts 3 years after ANCR implementation. RESULTS The survey response rates were 50.4% for radiologists and 36.1% for ordering providers. Ordering providers were generally dissatisfied with the training received for use of ANCR and with access to technical support. Radiologists were more satisfied with documenting critical result communication (61.1% vs 43.2%; p = 0.0001) and tracking critical results (51.6% vs 35.1%; p = 0.0003) than were ordering providers. Both groups agreed use of ANCR reduces medical errors and improves the quality of patient care. CONCLUSION Use of ANCR enables automated communication of critical test results. The survey results confirm overall provider satisfaction with ANCR but highlight the need for improved training strategies for large numbers of geographically dispersed ordering providers. Future enhancements beyond acknowledging receipt of critical results are needed to help ensure timely and appropriate follow-up of critical results to improve quality and patient safety. PMID:25341163

Combining Surveillance Systems: Effective Merging of U.S. Veteran and Military Health Data

DTIC Science & Technology

2016-08-04

respectively, and better in VA data for 34% and 15%. The VA system tended to alert earlier with a typical H3N2 seasonal influenza affecting older...manageable effect on customary alert rates. Citation: Pavlin JA, Burkom HS, Elbert Y, Lucero-Obusan C, Winston CA, et al. (2013) Combining...facilities within the CBSA. We applied ESSENCE alerting algorithms [11] to weekly CBSA-level outpatient data and analyzed the two data streams (DoD and VA

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2016-12-01

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

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

PubMed

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

2010-01-01

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

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

PubMed Central

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

2010-01-01

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

Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

PubMed Central

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

2008-01-01

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

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

DOT National Transportation Integrated Search

2001-04-01

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

Engine monitoring display study

NASA Technical Reports Server (NTRS)

Hornsby, Mary E.

1992-01-01

The current study is part of a larger NASA effort to develop displays for an engine-monitoring system to enable the crew to monitor engine parameter trends more effectively. The objective was to evaluate the operational utility of adding three types of information to the basic Boeing Engine Indicating and Crew Alerting System (EICAS) display formats: alphanumeric alerting messages for engine parameters whose values exceed caution or warning limits; alphanumeric messages to monitor engine parameters that deviate from expected values; and a graphic depiction of the range of expected values for current conditions. Ten training and line pilots each flew 15 simulated flight scenarios with five variants of the basic EICAS format; these variants included different combinations of the added information. The pilots detected engine problems more quickly when engine alerting messages were included in the display; adding a graphic depiction of the range of expected values did not affect detection speed. The pilots rated both types of alphanumeric messages (alert and monitor parameter) as more useful and easier to interpret than the graphic depiction. Integrating engine parameter messages into the EICAS alerting system appears to be both useful and preferred.

[Health alert management and emerging risk].

PubMed

Pillonel, J

2010-12-01

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

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

DTIC Science & Technology

2017-09-01

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

Incidence of potential drug interactions in a transplant centre setting and relevance of electronic alerts for clinical practice support.

PubMed

Polidori, Piera; Di Giorgio, Concetta; Provenzani, Alessio

2012-01-01

Adverse drug events may occur as a result of drug-drug interactions (DDIs). Information technology (IT) systems can be an important decision-making tool for healthcare workers to identify DDIs. The aim of the study is to analyse drug prescriptions in our main hospital units, in order to measure the incidence and severity of potential DDIs. The utility of clinical decision-support systems (CDSSs) and computerised physician order entry (CPOE) in term of alerts adherence was also assessed. DDIs were assessed using a Micromedex® healthcare series database. The system, adopted by the hospital, generates alerts for prescriptions with negative interactions and thanks to an 'acknowledgement function' it is possible to verify physician adherence to alerts. This function, although used previously, became mandatory from September 2010. Physician adherence to alerts and mean monthly incidence of potential DDIs in analysed units, before and after the mandatory 'acknowledgement function', were calculated. The intensive care unit (ICU) registered the greatest incidence of potential DDIs (49.0%), followed by the abdominal surgery unit and dialysis (43.4 and 42.0%, respectively). The cardiothoracic surgery unit (41.6%), step-down unit (38.3%) and post-anaesthesia care unit (30.0%) were comparable. The operating theatre and endoscopy registered the fewest potential DDIs (28.2 and 22.7%, respectively). Adherence to alerts after the 'acknowledgement function' increased by 25.0% in the ICU, 54.0% in the cardiothoracic surgery unit, 52.5% in the abdominal surgery unit, 58.0% in the stepdown unit, 67.0% in dialysis, 51.0% in endoscopy and 48.0% in the post-anaesthesia care unit. In the operating theatre, adherence to alerts decreased from 34.0 to 30.0%. The incidence of potential DDIs after mandatory use of the 'acknowledgement function' decreased slightly in endoscopy (-2.9%), the abdominal surgery unit (-2.7%), dialysis (-1.9%) and the step-down unit (-1.4%). Improving DDI alerts will improved patient safety by more appropriately alerting clinicians.

Providing accurate near real-time fire alerts for Protected Areas through NASA FIRMS: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Wong, M.; Murphy, K. J.

2013-12-01

The NASA Fire Information for Resource Management System (FIRMS) is at the forefront of providing global near real-time (NRT) MODIS thermal anomalies / hotspot location data to end-users . FIRMS serves the data via an interactive Web GIS named Web Fire Mapper, downloads of NRT active fire, archive data downloads for MODIS hotspots dating back to 1999 and a hotspot email alert system The FIRMS Email Alerts system has been successfully alerting users of fires in their area of interest in near real-time and/or via daily and weekly email summaries, with an option to receive MODIS hotspot data as a text file (CSV) attachment. Currently, there are more than 7000 email alert subscriptions from more than 100 countries. Specifically, the email alerts system is designed to generate and send an email alert for any region or area on the globe, with a special focus on providing alerts for protected areas worldwide. For many protected areas, email alerts are particularly useful for early fire detection, monitoring on going fires, as well as allocating resources to protect wildlife and natural resources of particular value. For protected areas, FIRMS uses the World Database on Protected Areas (WDPA) supplied by United Nations Environment Program - World Conservation Monitoring Centre (UNEP-WCMC). Maintaining the most up-to-date, accurate boundary geometry for the protected areas for the email alerts is a challenge as the WDPA is continuously updated due to changing boundaries, merging or delisting of certain protected areas. Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database. To maintain the most up-to-date boundary information for protected areas and to be in compliance with the WDPA terms and conditions, FIRMS needs to constantly update its database of protected areas. Currently, FIRMS strives to keep its database up to date by downloading the most recent WDPA database at regular intervals, processing it, and ingesting it into the FIRMS spatial database. However, due to the large size of database, the process to download, process and ingest the database is quite time consuming. The FIRMS team is currently working on developing a method to update the protected areas database via web at regular intervals or on-demand. Using such a solution, FIRMS will be able access the most up-to-date extents of any protected area and the corresponding spatial geometries in real time. As such, FIRMS can utilize such a service to access the protected areas and their associated geometries to keep users' protected area boundaries in sync with those of the most recent WDPA database, and thus serve a more accurate email alert to the users. Furthermore, any client accessing the WDPA protected areas database could potentially use the solution of real-time access to the protected areas database. This talk primarily focuses on the challenges for FIRMS in sending accurate email alerts for protected areas, along with the solution the FIRMS team is developing. This talk also introduces the FIRMS fire information system and its components, with a special emphasis on the FIRMS email alerts system.

Wearable Smart System for Visually Impaired People

PubMed Central

2018-01-01

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs. PMID:29533970

Wearable Smart System for Visually Impaired People.

PubMed

Ramadhan, Ali Jasim

2018-03-13

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs.

Experimental Study of Collision Detection Schema Used by Pilots During Closely Spaced Parallel Approaches

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1996-01-01

An experimental flight simulator study was conducted to examine the mental alerting logic and thresholds used by subjects to issue an alert and execute an avoidance maneuver. Subjects flew a series of autopilot landing approaches with traffic on a closely-spaced parallel approach; during some runs, the traffic would deviate towards the subject and the subject was to indicate the point when they recognized the potential traffic conflict, and then indicate a direction of flight for an avoidance maneuver. A variety of subjects, including graduate students, general aviation pilots and airline pilots, were tested. Five traffic displays were evaluated, with a moving map TCAS-type traffic display as a baseline. A side-task created both high and low workload situations. Subjects appeared to use the lateral deviation of the intruder aircraft from its approach path as the criteria for an alert regardless of the display available. However, with displays showing heading and/or trend information, their alerting thresholds were significantly lowered. This type of range-only schema still resulted in many near misses, as a high convergence rate was often established by the time of the subject's alert. Therefore, the properties of the intruder's trajectory had the greatest effect on the resultant near miss rate; no display system reliably caused alerts timely enough for certain collision avoidance. Subjects' performance dropped significantly on a side-task while they analyzed the need for an alert, showing alert generation can be a high workload situation at critical times. No variation was found between subjects with and with out piloting experience. These results suggest the design of automatic alerting systems should take into account the range-type alerting schema used by the human, such that the rationale for the automatic alert should be obvious to, and trusted by, the operator. Although careful display design may help generate pilot/automation trust, issues such as user non-conformance to automatically generated commands can remain a possibility.

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

NASA Astrophysics Data System (ADS)

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

2002-05-01

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

Demonstration of the Cascadia G‐FAST geodetic earthquake early warning system for the Nisqually, Washington, earthquake

USGS Publications Warehouse

Crowell, Brendan; Schmidt, David; Bodin, Paul; Vidale, John; Gomberg, Joan S.; Hartog, Renate; Kress, Victor; Melbourne, Tim; Santillian, Marcelo; Minson, Sarah E.; Jamison, Dylan

2016-01-01

A prototype earthquake early warning (EEW) system is currently in development in the Pacific Northwest. We have taken a two‐stage approach to EEW: (1) detection and initial characterization using strong‐motion data with the Earthquake Alarm Systems (ElarmS) seismic early warning package and (2) the triggering of geodetic modeling modules using Global Navigation Satellite Systems data that help provide robust estimates of large‐magnitude earthquakes. In this article we demonstrate the performance of the latter, the Geodetic First Approximation of Size and Time (G‐FAST) geodetic early warning system, using simulated displacements for the 2001Mw 6.8 Nisqually earthquake. We test the timing and performance of the two G‐FAST source characterization modules, peak ground displacement scaling, and Centroid Moment Tensor‐driven finite‐fault‐slip modeling under ideal, latent, noisy, and incomplete data conditions. We show good agreement between source parameters computed by G‐FAST with previously published and postprocessed seismic and geodetic results for all test cases and modeling modules, and we discuss the challenges with integration into the U.S. Geological Survey’s ShakeAlert EEW system.

The Zadko Telescope: Exploring the Transient Universe

NASA Astrophysics Data System (ADS)

Coward, D. M.; Gendre, B.; Tanga, P.; Turpin, D.; Zadko, J.; Dodson, R.; Devogéle, M.; Howell, E. J.; Kennewell, J. A.; Boër, M.; Klotz, A.; Dornic, D.; Moore, J. A.; Heary, A.

2017-01-01

The Zadko telescope is a 1 m f/4 Cassegrain telescope, situated in the state of Western Australia about 80-km north of Perth. The facility plays a niche role in Australian astronomy, as it is the only meter class facility in Australia dedicated to automated follow-up imaging of alerts or triggers received from different external instruments/detectors spanning the entire electromagnetic spectrum. Furthermore, the location of the facility at a longitude not covered by other meter class facilities provides an important resource for time critical projects. This paper reviews the status of the Zadko facility and science projects since it began robotic operations in March 2010. We report on major upgrades to the infrastructure and equipment (2012-2014) that has resulted in significantly improved robotic operations. Second, we review the core science projects, which include automated rapid follow-up of gamma ray burst (GRB) optical afterglows, imaging of neutrino counterpart candidates from the ANTARES neutrino observatory, photometry of rare (Barbarian) asteroids, supernovae searches in nearby galaxies. Finally, we discuss participation in newly commencing international projects, including the optical follow-up of gravitational wave (GW) candidates from the United States and European GW observatory network and present first tests for very low latency follow-up of fast radio bursts. In the context of these projects, we outline plans for a future upgrade that will optimise the facility for alert triggered imaging from the radio, optical, high-energy, neutrino, and GW bands.

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

PubMed Central

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

2012-01-01

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

47 CFR 10.210 - CMAS participation election procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false CMAS participation election procedures. 10.210 Section 10.210 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.210 CMAS participation election procedures...

Intrusion Detection System Visualization of Network Alerts

DTIC Science & Technology

2010-07-01

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

Implementation of a computer-assisted monitoring system for the detection of adverse drug reactions in gastroenterology.

PubMed

Dormann, H; Criegee-Rieck, M; Neubert, A; Egger, T; Levy, M; Hahn, E G; Brune, K

2004-02-01

To investigate the effectiveness of a computer monitoring system that detects adverse drug reactions (ADRs) by laboratory signals in gastroenterology. A prospective, 6-month, pharmaco-epidemiological survey was carried out on a gastroenterological ward at the University Hospital Erlangen-Nuremberg. Two methods were used to identify ADRs. (i) All charts were reviewed daily by physicians and clinical pharmacists. (ii) A computer monitoring system generated a daily list of automatic laboratory signals and alerts of ADRs, including patient data and dates of events. One hundred and nine ADRs were detected in 474 admissions (377 patients). The computer monitoring system generated 4454 automatic laboratory signals from 39 819 laboratory parameters tested, and issued 2328 alerts, 914 (39%) of which were associated with ADRs; 574 (25%) were associated with ADR-positive admissions. Of all the alerts generated, signals of hepatotoxicity (1255), followed by coagulation disorders (407) and haematological toxicity (207), were prevalent. Correspondingly, the prevailing ADRs were concerned with the metabolic and hepato-gastrointestinal system (61). The sensitivity was 91%: 69 of 76 ADR-positive patients were indicated by an alert. The specificity of alerts was increased from 23% to 76% after implementation of an automatic laboratory signal trend monitoring algorithm. This study shows that a computer monitoring system is a useful tool for the systematic and automated detection of ADRs in gastroenterological patients.

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

DTIC Science & Technology

1982-06-01

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

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

FT4 Data Analysis Summary (SSI-ARC)

NASA Technical Reports Server (NTRS)

Isaacson, Douglas R.; Gong, Chester; Reardon, Scott Edward; Santiago, Confesor

2016-01-01

Standards for Unmanned Aircraft System (UAS) Detect-and-Avoid (DAA) systems are currently being developed under the auspices of the RTCA Special Committee 228 (SC-228). To support the development of these standards, a series of flight tests has been conducted at NASAs Armstrong Flight Research Center (NASA-AFRC). The fourth in this series of flight test activities (Flight Test 4, or simply FT4) was conducted during the Spring and Summer of 2016. FT4 supported the objectives of numerous organizations working toward UAS DAA Minimum Operational Performance Standards (MOPS) and UAS DAA Radar MOPS. The summary provided herein is limited to the objectives, analysis and conclusions of the NASA Ames Research Center (NASA-ARC) SSI team toward the refinement of UAS DAA MOPS. This document provides a high-level overview of FT4 and the SSI-ARC objectives, a summary of the data analysis methodology and recommendations for UAS DAA MOPS refinements based on the data analysis results. A total of 72 encounters were flown to support SSI-ARC objectives. Test results were generally consistent with acceptable UAS DAA system performance and will be considered in broader SC-228 requirements validation efforts. Observed alert lead times indicated acceptable UAS DAA alerting performance. Effective interoperability between the UAS DAA system and the Traffic Alert and Collision Avoidance System (TCAS) was observed with one notable exception: TCAS Resolutions Advisories (RA) were observed in the absence of any DAA alert on two occasions, indicating the need for alert parameter refinement. Findings further indicated the need for continued work in the areas of DAA Well Clear Recovery logic and alert stability for Mode-C-only intruders. Finally, results demonstrated a high level of compliance with a set of evaluation criteria designed to provide anecdotal evidence of acceptable UAS DAA system performance.

An Approach for Representing Sensor Data to Validate Alerts in Ambient Assisted Living

PubMed Central

Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A.

2012-01-01

The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations—obtained through an argumentation process—of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert. PMID:22778642

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

PubMed

Epstein, Richard H; Dexter, Franklin

2012-10-01

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

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

PubMed

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

2015-06-01

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

47 CFR 10.270 - Subscribers' right to terminate subscription.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Subscribers' right to terminate subscription. 10.270 Section 10.270 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.270 Subscribers' right to...

47 CFR 10.260 - Timing of subscriber notification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Timing of subscriber notification. 10.260 Section 10.260 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.260 Timing of subscriber notification. A CMS...

Evaluation of BacT/Alert 3D Liquid Culture System for Recovery of Mycobacteria from Clinical Specimens Using Sodium Dodecyl (Lauryl) Sulfate-NaOH Decontamination

PubMed Central

Carricajo, A.; Fonsale, N.; Vautrin, A. C.; Aubert, G.

2001-01-01

A total of 52 mycobacterial isolates were recovered from 1,197 clinical specimens decontaminated by a sodium dodecyl (lauryl) sulfate (SDS)-NaOH protocol. Of these, 94% were recovered with the BacT/Alert 3D system (Organon Teknika, Durham, N.C.) and 79% were recovered on Löwenstein-Jensen (LJ) medium. Mean times to detection of organisms of the Mycobacterium tuberculosis complex (n = 47) were 22.8 days with LJ medium and 16.2 days with the system. The BacT/Alert 3D system is a rapid and efficient detection system which can be used with an SDS-NaOH decontamination procedure. PMID:11574623

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

PubMed

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

2015-08-01

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

Quality-improvement analytics for intravenous infusion pumps.

PubMed

Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

2013-04-15

The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

Conditional Outlier Detection for Clinical Alerting

PubMed Central

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

2010-01-01

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

Conditional outlier detection for clinical alerting.

PubMed

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

2010-11-13

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

From diagnosis to case investigation for malaria elimination in Swaziland: is reporting and response timely?

PubMed

Dlamini, N; Zulu, Z; Kunene, S; Geoffroy, E; Ntshalintshali, N; Owiti, P; Sikhondze, W; Makadzange, K; Zachariah, R

2018-04-25

Background: Swaziland is one of the southern African countries that aim to eliminate malaria by 2020. In 2010, the country introduced an Immediate Disease Notification System (IDNS) for immediate reporting of notifiable diseases, including malaria. Health facilities are to report malaria cases within 24 h through a toll-free telephone number (977), triggering an alert for case investigation at the patient's household within 48 h. We assessed the completeness of reporting in the IDNS, the subsequent case investigation, and whether it was done within the stipulated timelines. Methods: A cross-sectional study using routine country-wide data. Results: Of 1991 malaria cases notified between July 2011 and June 2015, 76% were reported in the IDNS, of which 68% were investigated-a shortfall of 24% in reporting and 32% in case investigations. Of the 76% of cases reported through the IDNS, 62% were reported within 24 h and 20% were investigated within 48 h. These shortcomings were most pronounced in hospitals and private facilities. Investigated cases ( n = 1346) were classified as follows: 60% imported, 35% local and 5% undetermined. Conclusion: The utilisation of the IDNS for case reporting to trigger investigation is crucial for active surveillance. There is a need to address the reporting and investigation gaps identified to ensure that malaria cases receive appropriate interventions.

The Impact of Alerting Designs on Air Traffic Controller's Eye Movement Patterns and Situation Awareness.

PubMed

Kearney, Peter; Li, Wen-Chin; Yu, Chung-San; Braithwaite, Graham

2018-06-26

This research investigated controller' situation awareness by comparing COOPANS's acoustic alerts with newly designed semantic alerts. The results demonstrate that ATCOs' visual scan patterns had significant differences between acoustic and semantic designs. ATCOs established different eye movement patterns on fixations number, fixation duration and saccade velocity. Effective decision support systems require human-centred design with effective stimuli to direct ATCO's attention to critical events. It is necessary to provide ATCOs with specific alerting information to reflect the nature of of the critical situation in order to minimize the side-effects of startle and inattentional deafness. Consequently, the design of a semantic alert can significantly reduce ATCOs' response time, therefore providing valuable extra time in a time-limited situation to formulate and execute resolution strategies in critical air safety events. The findings of this research indicate that the context-specified design of semantic alerts could improve ATCO's situational awareness and significantly reduce response time in the event of Short Term Conflict Alert activation which alerts to two aircraft having less than the required lateral or vertical separation.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Advanced Collision Avoidance System for UAS (ACAS Xu) Interoperability White Paper Presentation

NASA Technical Reports Server (NTRS)

Fern, Lisa

2017-01-01

The Phase 1 DAA Minimum Operational Performance Standards (MOPS) provided requirements for two classes of DAA equipment: equipment Class 1 contains the basic DAA equipment required to assist a pilot in remaining well clear, while equipment Class 2 integrates the Traffic Alert and Collision Avoidance (TCAS) II system. Thus, the Class 1 system provides RWC functionality only, while the Class 2 system is intended to provide both RWC and Collision Avoidance (CA) functionality, in compliance with the Minimum Aviation System Performance (MASPS) for the Interoperability of Airborne Collision Avoidance Systems. The FAAs TCAS Program Office is currently developing Airborne Collision Avoidance System X (ACAS X) to support the objectives of the Federal Aviation Administrations (FAA) Next Generation Air Transportation System Program (NextGen). ACAS X has a suite of variants with a common underlying design that are intended to be optimized for their intended airframes and operations. ACAS Xu being is designed for UAS and allows for new surveillance technologies and tailored logic for platforms with different performance characteristics. In addition to Collision Avoidance (CA) alerting and guidance, ACAS Xu is being tuned to provide RWC alerting and guidance in compliance with the SC 228 DAA MOPS. With a single logic performing both RWC and CA functions, ACAS Xu will provide industry with an integrated DAA solution that addresses many of the interoperability shortcomings of Phase I systems. While the MOPS for ACAS Xu will specify an integrated DAA system, it will need to show compliance with the RWC alerting thresholds and alerting requirements defined in the DAA Phase 2 MOPS. Further, some functional components of the ACAS Xu system such as the remote pilots displayed guidance might be mostly references to the corresponding requirements in the DAA MOPS. To provide a seamless, integrated, RWC-CA system to assist the pilot in remaining well clear and avoiding collisions, several issues need to be addressed within the Phase 2 SC-228 DAA efforts. Interoperability of the RWC and CA alerting and guidance, and ensuring pilot comprehension, compliance and performance, will be a primary research area.

78 FR 44931 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... disseminate emergency alerts and notification information to DLA installation personnel. DATES: This proposed... effectively disseminate emergency alerts and notification information to DLA installation personnel. Routine...

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

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Changes in Pilot Behavior with Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1998-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, changes in pilot behavior associated with using this predictive information have not been ascertained. The study described here quantified these changes using three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and three initial time intervals until a parameter alert range was reached (ITIs) (1 minute, 5 minutes, and 15 minutes). With predictive information, subjects accomplished most of their tasks before an alert occurred. Subjects organized the time they did their tasks by locus-of-control with no predictive information and for the 1-minute ITI, and by aviatenavigate-communicate for the time for a parameter to reach an alert range and the 15-minute conditions. Overall, predictive information and the longer ITIs moved subjects to performing tasks before the alert actually occurred and had them more mission oriented as indicated by their tasks grouping of aviate-navigate-communicate.

Pilot Mental Workload with Predictive System Status Information

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1998-01-01

Research has shown a strong pilot preference for predictive information of aircraft system status in the flight deck. However, the mental workload associated with using this predictive information has not been ascertained. The study described here attempted to measure mental workload. In this simulator experiment, three types of predictive information (none, whether a parameter was changing abnormally, and the time for a parameter to reach an alert range) and four initial times to a parameter alert range (1 minute, 5 minutes, 15 minutes, and ETA+45 minutes) were tested to determine their effects on subjects mental workload. Subjective workload ratings increased with increasing predictive information (whether a parameter was changing abnormally or the time for a parameter to reach an alert range). Subjective situation awareness decreased with more predictive information but it became greater with increasing initial times to a parameter alert range. Also, subjective focus changed depending on the type of predictive information. Lastly, skin temperature fluctuated less as the initial time to a parameter alert range increased.

76 FR 24875 - Notice of Public Information Collection(s) Being Submitted for Review and Approval to the Office...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

...: 3060-1113. Title: Commercial Mobile Alert System (CMAS). Form No.: N/A. Type of Review: Revision of a..., Alert and Response Network (``WARN'') Act, including inter alia, a requirement that within 30 days of... the Commission indicating whether or not it intends to transmit emergency alerts as part of the...

Case-Based Multi-Sensor Intrusion Detection

NASA Astrophysics Data System (ADS)

Schwartz, Daniel G.; Long, Jidong

2009-08-01

Multi-sensor intrusion detection systems (IDSs) combine the alerts raised by individual IDSs and possibly other kinds of devices such as firewalls and antivirus software. A critical issue in building a multi-sensor IDS is alert-correlation, i.e., determining which alerts are caused by the same attack. This paper explores a novel approach to alert correlation using case-based reasoning (CBR). Each case in the CBR system's library contains a pattern of alerts raised by some known attack type, together with the identity of the attack. Then during run time, the alert streams gleaned from the sensors are compared with the patterns in the cases, and a match indicates that the attack described by that case has occurred. For this purpose the design of a fast and accurate matching algorithm is imperative. Two such algorithms were explored: (i) the well-known Hungarian algorithm, and (ii) an order-preserving matching of our own device. Tests were conducted using the DARPA Grand Challenge Problem attack simulator. These showed that the both matching algorithms are effective in detecting attacks; but the Hungarian algorithm is inefficient; whereas the order-preserving one is very efficient, in fact runs in linear time.

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

PubMed

Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions. The borderline significant improvement of short-term renal outcome in the RIFLE class risk patients needs to be confirmed in a large multicenter trial.

Real-time Seismic Alert System of NIED

NASA Astrophysics Data System (ADS)

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

2001-12-01

An extensive seismic network has been constructed nationwide composed of hi-sensitivity seismographic network, broadband seismographic network and strong motion seismographic network. All these data from some 3,000 sites belonging to NIED, JMA and universities are to be accumulated and distributed through NIED to any scientists and engineering through INTERNET under the coordination of the National Seismic Research Committee of MEXT. As a practical application of those data we are now developing a real-time seismic alert information system for the purpose of providing short-term warning of imminent strong grounds motions from major earthquakes from several seconds to a few days. The contents of information are seismic focal parameters (several seconds), seismic fault plane solutions (some 10 seconds), after-shock activities (several minutes-a few days ). The fundamental fault parameters are used to build specific information at sites for particular users for use of triggering automated and /or half-automated responses. The most important application is an immediate estimate of expected shaking distribution and damages in a district using synthetic database and site effects for local governments to initial proper measures of hazard mitigation. Another application is estimation of arrival time and shaking strength at any individual site for human lives to be safeguarded. The system could also start an automatic electrical isolation and protection of computer systems, protection of hazardous chronic systems, transportation systems and so on. The information are corrected successively as seismic ground motion are received at a larger number of sites in time with the result that more accurate and more sophisticated earthquake information is transmitted to any user. Besides the rapid determination of seismic parameters, one of essential items in this alert system is the data transmission means. The data transmission is chosen to assure negligibly small delay of data transmission and inexpensive cost under the condition of very small data quantity. For the imminent information transmission the leased line is the most suitable because of short time delay of less than 0.1 second without any interference from other sources. But it is very expensive because of much infrequent occasions of hazardous earthquakes for particular users. Another means is to use the modified packet transfer communication. It is characterized by reasonable costs and small time delay of order in 1 second. For information transmission to several hundreds thousand of users, the satellite data broadcast would be one of practical solutions. Data are expected to reach with time loss of some 2 seconds including one-hop time delay of some 0.5 second to the satellite. The system will start to be experimented in 2002 for evaluation of the whole system including rapid seismic parameter calculations, data transmissions, automated processes and particular safeguard actions for several chosen users.

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

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

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

NASA Astrophysics Data System (ADS)

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

2009-03-01

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

47 CFR 10.230 - New CMS providers participation in CMAS.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false New CMS providers participation in CMAS. 10.230 Section 10.230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.230 New CMS providers participation in CMAS...

47 CFR 10.250 - Notification to existing subscribers of non-participation in CMAS.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Notification to existing subscribers of non-participation in CMAS. 10.250 Section 10.250 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.250...

47 CFR 10.220 - Withdrawal of election to participate in CMAS.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 10.220 Section 10.220 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.220 Withdrawal of election... subscribers as well as the Federal Communications Commission at least sixty (60) days prior to the withdrawal...

47 CFR 10.280 - Subscribers' right to opt out of CMAS notifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Subscribers' right to opt out of CMAS notifications. 10.280 Section 10.280 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.280 Subscribers' right...

For Emergency Alerts, Some Colleges Try Sirens

ERIC Educational Resources Information Center

Young, Jeffrey R.

2008-01-01

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

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

DOT National Transportation Integrated Search

1989-01-01

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

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

DOT National Transportation Integrated Search

1989-09-01

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

Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology, ICSH, survey and recommendations.

PubMed

Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R

2016-10-01

These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.

Request to monitor 2035-01 AE Aqr for multiwavelength campaign AND Reminder to monitor HT Cas, Z Cha, and OY Car

NASA Astrophysics Data System (ADS)

Waagen, Elizabeth O.

2005-08-01

AAVSO Alert Notice 326 contains two topics. First: Dr. Christopher Mauche (Lawrence Livermore National Laboratory) has requested our assistance in monitoring the novalike intermediate polar AE Aqr in support of multiwavelength (gamma-ray, X-ray, UV, optical, and radio) observations scheduled for August-September 2005. AAVSO observations, particularly CCD ones, are requested to correlate with these multiwavelength observations; visual observations are also encouraged. Second: as announced in Alert Notice 317, Drs. Christopher Mauche, Peter Wheatley, and Koji Mukai have obtained time on XMM-Newton to observe HT Cas, Z Cha, or OY Car in outburst, and they have requested our assistance in monitoring these stars closely so we can inform them promptly when any of them go into outburst. Very prompt notification is essential because of the time required to trigger the satellite and the shortness of the outbursts of the target stars. Please monitor HT Cas, OY Car, and Z Cha closely from now through at least a month after the last observing window closes, and notify Headquarters immediately if any of the target stars goes into outburst. Both visual and CCD observations are encouraged. Finder charts with sequence may be created using the AAVSO Variable Star Plotter (https://www.aavso.org/vsp). Observations should be submitted to the AAVSO International Database. See full Alert Notice for more details.

Validation of the CME Geomagnetic forecast alerts under COMESEP alert system

NASA Astrophysics Data System (ADS)

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

2017-04-01

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

Development of a standardized, citywide process for managing smart-pump drug libraries.

PubMed

Walroth, Todd A; Smallwood, Shannon; Arthur, Karen; Vance, Betsy; Washington, Alana; Staublin, Therese; Haslar, Tammy; Reddan, Jennifer G; Fuller, James

2018-06-15

Development and implementation of an interprofessional consensus-driven process for review and optimization of smart-pump drug libraries and dosing limits are described. The Indianapolis Coalition for Patient Safety (ICPS), which represents 6 Indianapolis-area health systems, identified an opportunity to reduce clinically insignificant alerts that smart infusion pumps present to end users. Through a consensus-driven process, ICPS aimed to identify best practices to implement at individual hospitals in order to establish specific action items for smart-pump drug library optimization. A work group of pharmacists, nurses, and industrial engineers met to evaluate variability within and lack of scrutiny of smart-pump drug libraries. The work group used Lean Six Sigma methodologies to generate a list of key needs and barriers to be addressed in process standardization. The group reviewed targets for smart-pump drug library optimization, including dosing limits, types of alerts reviewed, policies, and safety best practices. The work group also analyzed existing processes at each site to develop a final consensus statement outlining a model process for reviewing alerts and managing smart-pump data. Analysis of the total number of alerts per device across ICPS-affiliated health systems over a 4-year period indicated a 50% decrease (from 7.2 to 3.6 alerts per device per month) after implementation of the model by ICPS member organizations. Through implementation of a standardized, consensus-driven process for smart-pump drug library optimization, ICPS member health systems reduced clinically insignificant smart-pump alerts. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers.

PubMed

Gregory, Megan E; Russo, Elise; Singh, Hardeep

2017-07-05

Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied. To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload. A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States. Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system. Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

Development and preliminary evidence for the validity of an instrument assessing implementation of human-factors principles in medication-related decision-support systems—I-MeDeSA

PubMed Central

Zachariah, Marianne; Seidling, Hanna M; Neri, Pamela M; Cresswell, Kathrin M; Duke, Jon; Bloomrosen, Meryl; Volk, Lynn A; Bates, David W

2011-01-01

Background Medication-related decision support can reduce the frequency of preventable adverse drug events. However, the design of current medication alerts often results in alert fatigue and high over-ride rates, thus reducing any potential benefits. Methods The authors previously reviewed human-factors principles for relevance to medication-related decision support alerts. In this study, instrument items were developed for assessing the appropriate implementation of these human-factors principles in drug–drug interaction (DDI) alerts. User feedback regarding nine electronic medical records was considered during the development process. Content validity, construct validity through correlation analysis, and inter-rater reliability were assessed. Results The final version of the instrument included 26 items associated with nine human-factors principles. Content validation on three systems resulted in the addition of one principle (Corrective Actions) to the instrument and the elimination of eight items. Additionally, the wording of eight items was altered. Correlation analysis suggests a direct relationship between system age and performance of DDI alerts (p=0.0016). Inter-rater reliability indicated substantial agreement between raters (κ=0.764). Conclusion The authors developed and gathered preliminary evidence for the validity of an instrument that measures the appropriate use of human-factors principles in the design and display of DDI alerts. Designers of DDI alerts may use the instrument to improve usability and increase user acceptance of medication alerts, and organizations selecting an electronic medical record may find the instrument helpful in meeting their clinicians' usability needs. PMID:21946241

Rapid deployable global sensing hazard alert system

DOEpatents

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

2015-04-28

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

Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

PubMed

Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

2017-11-01

Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

PubMed

Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

2011-12-01

Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

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

PubMed

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

2015-06-01

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

Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing.

PubMed

Tora, Hammar; Bo, Hovstadius; Bodil, Lidström; Göran, Petersson; Birgit, Eiermann

2014-10-01

Background Drug related problems (DRPs) are frequent and cause suffering for patients and substantial costs for society. Multi-dose drug dispensing (MDDD) is a service by which patients receive their medication packed in bags with one unit for each dose occasion. The clinical decision support system (CDSS) electronic expert support (EES) analyses patients' prescriptions in the Swedish national e-prescription repository and provides alerts if potential DRPs are detected, i.e. drug-drug interactions, duplicate therapy, drug-disease contraindications, high dose, gender warnings, geriatric, and paediatric alerts. Objective To analyse potential DRPs in patients with MDDD, detected by means of EES. Setting A register study of all electronically stored prescriptions for patients with MDDD in Sweden (n = 180,059) March 5-June 5, 2013. Method Drug use and potential DRPs detected in the study population during the 3 month study period by EES were analysed. The potential DRPs were analysed in relation to patients' age, gender, number of drugs, and type of medication. Main outcome measure Prevalence of potential DRPs measured as EES alerts. Results The study population was on average 75.8 years of age (± 17.5, range 1-110) and had 10.0 different medications (± 4.7, range 1-53). EES alerted for potential DRPs in 76 % of the population with a mean of 2.2 alerts per patient (± 2.4, range 0-27). The older patients received a lower number of alerts compared to younger patients despite having a higher number of drugs. The most frequent alert categories were drug-drug interactions (37 % of all alerts), duplicate therapy (30 %), and geriatric warnings for high dose or inappropriate drugs (23 %). Psycholeptics, psychoanaleptics, antithrombotic agents, anti-epileptics, renin-angiotensin system agents, and analgesics represented 71 % of all drugs involved in alerts. Conclusions EES detected potential DRPs in the majority of patients with MDDD. The number of potential DRPs was associated with the number of drugs, age, gender, and type of medication. A CDSS such as EES might be a useful tool for physicians and pharmacists to assist in the important task of monitoring patients with MDDD for potential DRPs.

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

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1997-01-01

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

Novel online monitoring and alert system for anaerobic digestion reactors.

PubMed

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

2011-10-15

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

The agile alert system for gamma-ray transients

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

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

2014-01-20

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

The AGILE Alert System for Gamma-Ray Transients

NASA Astrophysics Data System (ADS)

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

2014-01-01

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

The OGC Sensor Web Enablement framework

NASA Astrophysics Data System (ADS)

Cox, S. J.; Botts, M.

2006-12-01

Sensor observations are at the core of natural sciences. Improvements in data-sharing technologies offer the promise of much greater utilisation of observational data. A key to this is interoperable data standards. The Open Geospatial Consortium's (OGC) Sensor Web Enablement initiative (SWE) is developing open standards for web interfaces for the discovery, exchange and processing of sensor observations, and tasking of sensor systems. The goal is to support the construction of complex sensor applications through real-time composition of service chains from standard components. The framework is based around a suite of standard interfaces, and standard encodings for the message transferred between services. The SWE interfaces include: Sensor Observation Service (SOS)-parameterized observation requests (by observation time, feature of interest, property, sensor); Sensor Planning Service (SPS)-tasking a sensor- system to undertake future observations; Sensor Alert Service (SAS)-subscription to an alert, usually triggered by a sensor result exceeding some value. The interface design generally follows the pattern established in the OGC Web Map Service (WMS) and Web Feature Service (WFS) interfaces, where the interaction between a client and service follows a standard sequence of requests and responses. The first obtains a general description of the service capabilities, followed by obtaining detail required to formulate a data request, and finally a request for a data instance or stream. These may be implemented in a stateless "REST" idiom, or using conventional "web-services" (SOAP) messaging. In a deployed system, the SWE interfaces are supplemented by Catalogue, data (WFS) and portrayal (WMS) services, as well as authentication and rights management. The standard SWE data formats are Observations and Measurements (O&M) which encodes observation metadata and results, Sensor Model Language (SensorML) which describes sensor-systems, Transducer Model Language (TML) which covers low-level data streams, and domain-specific GML Application Schemas for definitions of the target feature types. The SWE framework has been demonstrated in several interoperability testbeds. These were based around emergency management, security, contamination and environmental monitoring scenarios.

Exploring transient X-ray sky with Einstein Probe

NASA Astrophysics Data System (ADS)

Yuan, W.; Zhang, C.; Ling, Z.; Zhao, D.; Chen, Y.; Lu, F.; Zhang, S.

2017-10-01

The Einstein Probe is a small satellite in time-domain astronomy to monitor the soft X-ray sky. It is a small mission in the space science programme of the Chinese Academy of Sciences. It will carry out systematic survey and characterisation of high-energy transients at unprecedented sensitivity, spatial resolution, Grasp and monitoring cadence. Its wide-field imaging capability is achieved by using established technology of micro-pore lobster-eye X-ray focusing optics. Complementary to this is X-ray follow-up capability enabled by a narrow-field X-ray telescope. It is capable of on-board triggering and real time downlink of transient alerts, in order to trigger fast follow-up observations at multi-wavelengths. Its scientific goals are concerned with discovering and characterising diverse types of X-ray transients, including tidal disruption events, supernova shock breakouts, high-redshift GRBs, and of particular interest, X-ray counterparts of gravitational wave events.

Development of a wearable wireless body area network for health monitoring of the elderly and disabled

NASA Astrophysics Data System (ADS)

Rushambwa, Munyaradzi C.; Gezimati, Mavis; Jeeva, J. B.

2017-11-01

Novel advancements in systems miniaturization, electronics in health care and communication technologies are enabling the integration of both patients and doctors involvement in health care system. A Wearable Wireless Body Area Network (WWBAN) provides continuous, unobtrusive ambulatory, ubiquitous health monitoring, and provide real time patient’s status to the physician without any constraint on their normal daily life activities. In this project we developed a wearable wireless body area network system that continuously monitor the health of the elderly and the disabled and provide them with independent, safe and secure living. The WWBAN system monitors the following parameters; blood oxygen saturation using a pulse oximeter sensor (SpO2), heart rate (HR) pulse sensor, Temperature, hydration, glucose level and fall detection. When the wearable system is put on, the sensor values are processed and analysed. If any of the monitored parameter values falls below or exceeds the normal range, there is trigger of remote alert by which an SMS is send to a doctor or physician via GSM module and network. The developed system offers flexibility and mobility to the user; it is a real time system and has significance in revolutionizing health care system by enabling non-invasive, inexpensive, continuous health monitoring.