Exploring Online Asynchronous Counseling With Tobacco Treatment Specialists in the QUIT-PRIMO and National Dental PBRN HI-QUIT Studies: Who Uses It and What Do They Say?

PubMed

Williams, Jessica H; DeLaughter, Kathryn; Volkman, Julie E; Sadasivam, Rajani S; Ray, Midge N; Gilbert, Gregg H; Houston, Thomas K

2018-06-01

To describe the content of messages sent by smokers through asynchronous counseling within a Web-based smoking cessation intervention. Qualitative. National community-based setting of patients who had been engaged by the medical or dental practices at which they attended or via Google advertisements. Adults older than 19 years who were current smokers and interested in quitting. Participants throughout the United States referred to a Web-based cessation intervention by their medical or dental provider or by clicking on a Google advertisement. We conducted a qualitative review of 742 asynchronous counseling messages sent by 270 Web site users. Messages were reviewed, analyzed, and organized into qualitative themes by the investigative team. The asynchronous counseling feature of the intervention was used most frequently by smokers who were white (87%), female (67%), aged 45 to 54 (32%), and who had at least some college-level education (70%). Qualitative analysis yielded 7 basic themes-Talk about the Process of Quitting, Barriers to Quitting, Reasons to Quit, Quit History, Support and Strategies for Quitting, Quitting with Medication, and Quit Progress. The most common theme was Support and Strategies for Quitting with 255 references among all messages. We found rich communication across the spectrum of the quit process, from persons preparing to quit to those who had successfully quit. Asynchronous smoking cessation counseling provides a promising means of social support for smokers during the quit process.

Seahawk: telemedicine project in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Kim, Yongmin; Cabral, James E., Jr.; Parsons, David M.; Lipski, Gregory L.; Kirchdoerfer, Richard G.; Sado, Anthony; Bender, Gregory N.; Goeringer, Fred

1995-05-01

Telemedicine is becoming increasingly possible due to the confluence of ongoing technical advances in such areas as telecommunications, imaging, multimedia, computers, and information systems. Project Seahawk is a regional telemedicine program in the Pacific Northwest with Madigan Army Medical Center (MAMC) as the hub connecting various military and other federal hospitals and clinics utilizing the state-of-the-art technologies. The first phase of Project Seahawk successfully connected MAMC in Tacoma, Wash. to the University of Washington in Seattle, Wash. through the Western Washington Local Access Transport Area (LATA) Integrated Optical Network (LION) Sonet Ring using asynchronous transfer mode (ATM) and two MediaStation 5000s as a feasibility demonstration. Several telemedicine scenarios were demonstrated including synchronized image manipulation, real- time transmission of ultrasound and medical images, and video and audio teleconferencing, and remote consultation. The second phase implementation will consist of increasing the number of hospitals and clinics with telemedicine capability, e.g., Bremerton Naval Hospital, Oak Harbor Naval Hospital, Seattle VA, and American Lake VA.

Web-based continuing medical education. (II): Evaluation study of computer-mediated continuing medical education.

PubMed

Curran, V R; Hoekman, T; Gulliver, W; Landells, I; Hatcher, L

2000-01-01

Over the years, various distance learning technologies and methods have been applied to the continuing medical education needs of rural and remote physicians. They have included audio teleconferencing, slow scan imaging, correspondence study, and compressed videoconferencing. The recent emergence and growth of Internet, World Wide Web (Web), and compact disk read-only-memory (CD-ROM) technologies have introduced new opportunities for providing continuing education to the rural medical practitioner. This evaluation study assessed the instructional effectiveness of a hybrid computer-mediated courseware delivery system on dermatologic office procedures. A hybrid delivery system merges Web documents, multimedia, computer-mediated communications, and CD-ROMs to enable self-paced instruction and collaborative learning. Using a modified pretest to post-test control group study design, several evaluative criteria (participant reaction, learning achievement, self-reported performance change, and instructional transactions) were assessed by various qualitative and quantitative data collection methods. This evaluation revealed that a hybrid computer-mediated courseware system was an effective means for increasing knowledge (p < .05) and improving self-reported competency (p < .05) in dermatologic office procedures, and that participants were very satisfied with the self-paced instruction and use of asynchronous computer conferencing for collaborative information sharing among colleagues.

Cost-analysis of teledentistry in residential aged care facilities.

PubMed

Mariño, Rodrigo; Tonmukayakul, Utsana; Manton, David; Stranieri, Andrew; Clarke, Ken

2016-09-01

The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident. Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination. © The Author(s) 2015.

A telehealth approach to conducting clinical swallowing evaluations in children with cerebral palsy.

PubMed

Kantarcigil, Cagla; Sheppard, Justine Joan; Gordon, Andrew M; Friel, Kathleen M; Malandraki, Georgia A

2016-08-01

Accurate and timely evaluation of dysphagia in children with cerebral palsy (CP) is critical. For children with limited access to quality healthcare, telehealth is an option; however, its reliability needs to be investigated. To test the reliability of an asynchronous telehealth model for evaluating dysphagia in children with CP using a standardized clinical assessment. Nineteen children (age range 6.9-17.5) were assessed at three mealtimes via the Dysphagia Disorder Survey (DDS) by three clinicians (face-to-face evaluations). Mealtimes were video-recorded to allow asynchronous evaluations by a remote clinician who also completed approximately 1/3 of face-to-face evaluations. Agreement was tested on DDS variables and dysphagia severity. Results revealed substantial to excellent agreement between face-to-face and remote assessments by the same rater (78-100%, KW=0.64-1) on all, but two variables (oral transport and oral pharyngeal swallow) and by different raters (69-89%, KW=0.6-0.86) on all but one variable (orienting). For dysphagia severity, intrarater agreement was excellent (100%, KW=1); interrater agreement was substantial (85%; KW=0.76). Asynchronous clinical swallowing evaluations using standardized tools have acceptable levels of agreement with face-to-face evaluations, and can be an alternative for children with limited access to expert swallowing care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Facilitating preemptive hardware system design using partial reconfiguration techniques.

PubMed

Dondo Gazzano, Julio; Rincon, Fernando; Vaderrama, Carlos; Villanueva, Felix; Caba, Julian; Lopez, Juan Carlos

2014-01-01

In FPGA-based control system design, partial reconfiguration is especially well suited to implement preemptive systems. In real-time systems, the deadline for critical task can compel the preemption of noncritical one. Besides, an asynchronous event can demand immediate attention and, then, force launching a reconfiguration process for high-priority task implementation. If the asynchronous event is previously scheduled, an explicit activation of the reconfiguration process is performed. If the event cannot be previously programmed, such as in dynamically scheduled systems, an implicit activation to the reconfiguration process is demanded. This paper provides a hardware-based approach to explicit and implicit activation of the partial reconfiguration process in dynamically reconfigurable SoCs and includes all the necessary tasks to cope with this issue. Furthermore, the reconfiguration service introduced in this work allows remote invocation of the reconfiguration process and then the remote integration of off-chip components. A model that offers component location transparency is also presented to enhance and facilitate system integration.

Facilitating Preemptive Hardware System Design Using Partial Reconfiguration Techniques

PubMed Central

Rincon, Fernando; Vaderrama, Carlos; Villanueva, Felix; Caba, Julian; Lopez, Juan Carlos

2014-01-01

In FPGA-based control system design, partial reconfiguration is especially well suited to implement preemptive systems. In real-time systems, the deadline for critical task can compel the preemption of noncritical one. Besides, an asynchronous event can demand immediate attention and, then, force launching a reconfiguration process for high-priority task implementation. If the asynchronous event is previously scheduled, an explicit activation of the reconfiguration process is performed. If the event cannot be previously programmed, such as in dynamically scheduled systems, an implicit activation to the reconfiguration process is demanded. This paper provides a hardware-based approach to explicit and implicit activation of the partial reconfiguration process in dynamically reconfigurable SoCs and includes all the necessary tasks to cope with this issue. Furthermore, the reconfiguration service introduced in this work allows remote invocation of the reconfiguration process and then the remote integration of off-chip components. A model that offers component location transparency is also presented to enhance and facilitate system integration. PMID:24672292

Internet-based remote consultations - general practitioner experience and attitudes in Norway and Germany.

PubMed

Kampik, Timotheus; Larsen, Frank; Bellika, Johan Gustav

2015-01-01

The objective of the study was to identify experiences and attitudes of German and Norwegian general practitioners (GPs) towards Internet-based remote consultation solutions supporting communication between GPs and patients in the context of the German and Norwegian healthcare systems. Interviews with four German and five Norwegian GPs were conducted. The results were qualitatively analyzed. All interviewed GPs stated they would like to make use of Internet-based remote consultations in the future. Current experiences with remote consultations are existent to a limited degree. No GP reported to use a comprehensive remote consultation solution. The main features GPs would like to see in a remote consultation solution include asynchronous exchange of text messages, video conferencing with text chat, scheduling of remote consultation appointments, secure login and data transfer and the integration of the remote consultation solution into the GP's EHR system.

Remote Classroom Observations with Preservice Teachers

ERIC Educational Resources Information Center

Wash, Pamela D.; Bradley, Gary; Beck, Judy

2014-01-01

According to O'Brien, Aguinaga, Hines, and Hartsborne (2011), "Delivery of course content via various distance education technologies (e.g., interactive video, asynchronous and/or synchronous online delivery) is becoming an accepted and expected component of many teacher preparation programs" (p. 3). With the infusion of technology in…

Enhancing Expressivity of Document-Centered Collaboration with Multimodal Annotations

ERIC Educational Resources Information Center

Yoon, Dongwook

2017-01-01

As knowledge work moves online, digital documents have become a staple of human collaboration. To communicate beyond the constraints of time and space, remote and asynchronous collaborators create digital annotations over documents, substituting face-to-face meetings with online conversations. However, existing document annotation interfaces…

Analysis of Asynchronous Online Discussion Using the SOLO Taxonomy

ERIC Educational Resources Information Center

Holmes, Kathryn

2005-01-01

The online learning environment provides the opportunity for remote groups of students to interact with instructors and each other. Most web based learning platforms facilitate synchronous online discussions between participants. These discussion forums are designed to replicate the face to face tutorial setting and provide a medium for the…

Distributed Training for the Reserve Component: Instructor Handbook for Computer Conferencing.

ERIC Educational Resources Information Center

Harbour, J.; And Others

The purpose of this handbook is to provide background and teaching recommendations for instructors who will be remotely conducting Reserve Component training using asynchronous computer conferencing techniques. The recommendations in this handbook are based on an international review of the literature in distance learning and experience gained…

Networking Labs in the Online Environment: Indicators for Success

ERIC Educational Resources Information Center

Lahoud, Hilmi A.; Krichen, Jack P.

2010-01-01

Several techniques have been used to provide hands-on educational experiences to online learners, including remote labs, simulation software, and virtual labs, which offer a more structured environment, including simulations and scheduled asynchronous access to physical resources. This exploratory study investigated how these methods can be used…

Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

PubMed

Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

2016-10-01

Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

A Cloud Architecture for Teleradiology-as-a-Service.

PubMed

Melício Monteiro, Eriksson J; Costa, Carlos; Oliveira, José L

2016-05-17

Telemedicine has been promoted by healthcare professionals as an efficient way to obtain remote assistance from specialised centres, to get a second opinion about complex diagnosis or even to share knowledge among practitioners. The current economic restrictions in many countries are increasing the demand for these solutions even more, in order to optimize processes and reduce costs. However, despite some technological solutions already in place, their adoption has been hindered by the lack of usability, especially in the set-up process. In this article we propose a telemedicine platform that relies on a cloud computing infrastructure and social media principles to simplify the creation of dynamic user-based groups, opening up opportunities for the establishment of teleradiology trust domains. The collaborative platform is provided as a Software-as-a-Service solution, supporting real time and asynchronous collaboration between users. To evaluate the solution, we have deployed the platform in a private cloud infrastructure. The system is made up of three main components - the collaborative framework, the Medical Management Information System (MMIS) and the HTML5 (Hyper Text Markup Language) Web client application - connected by a message-oriented middleware. The solution allows physicians to create easily dynamic network groups for synchronous or asynchronous cooperation. The network created improves dataflow between colleagues and also knowledge sharing and cooperation through social media tools. The platform was implemented and it has already been used in two distinct scenarios: teaching of radiology and tele-reporting. Collaborative systems can simplify the establishment of telemedicine expert groups with tools that enable physicians to improve their clinical practice. Streamlining the usage of this kind of systems through the adoption of Web technologies that are common in social media will increase the quality of current solutions, facilitating the sharing of clinical information, medical imaging studies and patient diagnostics among collaborators.

System architecture for asynchronous multi-processor robotic control system

NASA Technical Reports Server (NTRS)

Steele, Robert D.; Long, Mark; Backes, Paul

1993-01-01

The architecture for the Modular Telerobot Task Execution System (MOTES) as implemented in the Supervisory Telerobotics (STELER) Laboratory is described. MOTES is the software component of the remote site of a local-remote telerobotic system which is being developed for NASA for space applications, in particular Space Station Freedom applications. The system is being developed to provide control and supervised autonomous control to support both space based operation and ground-remote control with time delay. The local-remote architecture places task planning responsibilities at the local site and task execution responsibilities at the remote site. This separation allows the remote site to be designed to optimize task execution capability within a limited computational environment such as is expected in flight systems. The local site task planning system could be placed on the ground where few computational limitations are expected. MOTES is written in the Ada programming language for a multiprocessor environment.

Comparing face-to-face, synchronous, and asynchronous learning: postgraduate dental resident preferences.

PubMed

Kunin, Marc; Julliard, Kell N; Rodriguez, Tobias E

2014-06-01

The Department of Dental Medicine of Lutheran Medical Center has developed an asynchronous online curriculum consisting of prerecorded PowerPoint presentations with audio explanations. The focus of this study was to evaluate if the new asynchronous format satisfied the educational needs of the residents compared to traditional lecture (face-to-face) and synchronous (distance learning) formats. Lectures were delivered to 219 dental residents employing face-to-face and synchronous formats, as well as the new asynchronous format; 169 (77 percent) participated in the study. Outcomes were assessed with pretests, posttests, and individual lecture surveys. Results found the residents preferred face-to-face and asynchronous formats to the synchronous format in terms of effectiveness and clarity of presentations. This preference was directly related to the residents' perception of how well the technology worked in each format. The residents also rated the quality of student-instructor and student-student interactions in the synchronous and asynchronous formats significantly higher after taking the lecture series than they did before taking it. However, they rated the face-to-face format as significantly more conducive to student-instructor and student-student interaction. While the study found technology had a major impact on the efficacy of this curricular model, the results suggest that the asynchronous format can be an effective way to teach a postgraduate course.

A Web-Free Prototype for Distance Learning.

ERIC Educational Resources Information Center

Molinari, Andrea; Colazzo, Luigi

This paper presents a prototype for the construction of interactive educational hypermedia that can be used on the Internet without being bound to typical World Wide Web protocols and tools. Its most innovative aspect is interactivity: it allows teachers and learners to remotely interact in real time in both a synchronous and asynchronous manner.…

Effectiveness of Asynchronous Reference Services for Distance Learning Students within Florida's Community College System

ERIC Educational Resources Information Center

Profeta, Patricia C.

2007-01-01

The provision of equitable library services to distance learning students emerged as a critical area during the 1990s. Library services available to distance learning students included digital reference and instructional services, remote access to online research tools, database and research tutorials, interlibrary loan, and document delivery.…

ScienceDesk Project Overview

NASA Technical Reports Server (NTRS)

Keller, Richard M.; Norvig, Peter (Technical Monitor)

2000-01-01

NASA's ScienceDesk Project at the Ames Research Center is responsible for scientific knowledge management which includes ensuring the capture, preservation, and traceability of scientific knowledge. Other responsibilities include: 1) Maintaining uniform information access which is achieved through intelligent indexing and visualization, 2) Collaborating both asynchronous and synchronous science teamwork, 3) Monitoring and controlling semi-autonomous remote experimentation.

Developing a Five-Stage Model of Learning in "Second Life"

ERIC Educational Resources Information Center

Salmon, Gilly; Nie, Ming; Edirisingha, Palitha

2010-01-01

Background: In the 1990s, Salmon developed a five-stage model for enabling and scaffolding remote groups to work and learn together using asynchronous bulletin boards. The model has informed online learning and development practice across different levels and education for online and blended learning. Purpose: This paper reports our testing of the…

Design Improvements and Analysis of Innovative High-Level Waste Pipeline Unplugging Technologies - 12171

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

Pribanic, Tomas; Awwad, Amer; Crespo, Jairo

2012-07-01

Transferring high-level waste (HLW) between storage tanks or to treatment facilities is a common practice performed at the Department of Energy (DoE) sites. Changes in the chemical and/or physical properties of the HLW slurry during the transfer process may lead to the formation of blockages inside the pipelines resulting in schedule delays and increased costs. To improve DoE's capabilities in the event of a pipeline plugging incident, FIU has continued to develop two novel unplugging technologies: an asynchronous pulsing system and a peristaltic crawler. The asynchronous pulsing system uses a hydraulic pulse generator to create pressure disturbances at two oppositemore » inlet locations of the pipeline to dislodge blockages by attacking the plug from both sides remotely. The peristaltic crawler is a pneumatic/hydraulic operated crawler that propels itself by a sequence of pressurization/depressurization of cavities (inner tubes). The crawler includes a frontal attachment that has a hydraulically powered unplugging tool. In this paper, details of the asynchronous pulsing system's ability to unplug a pipeline on a small-scale test-bed and results from the experimental testing of the second generation peristaltic crawler are provided. The paper concludes with future improvements for the third generation crawler and a recommended path forward for the asynchronous pulsing testing. (authors)« less

Remote Observing with the Keck Telescope Using the ACTS Satellite

NASA Technical Reports Server (NTRS)

Cohen, Judy; Shopbell, Patrick; Bergman, Larry

1998-01-01

As a technical demonstration project for the NASA Advanced Communications Technology Satellite (ACTS), we have implemented remote observing on the 10-meter Keck II telescope on Mauna Kea in Hawaii from the California Institute of Technology campus in Pasadena. The data connection consists of optical fiber networks in Hawaii and California, connecting the end-points to high data rate (HDR) ACTS satellite antennae at JPL in Pasadena and at the Tripler Army Medical Center in Honolulu. The terrestrial fiber networks run the asynchronous transfer mode (ATM) protocol at DS-3 (45 Mbit/sec) speeds, providing ample bandwidth to enable remote observing with a software environment identical to that used for on-site observing in Hawaii. This experiment has explored the data requirements of remote observing with a modern research telescope and large-format detector arrays. While the maximum burst data rates are lower than those required for many other applications (e.g., HDTV), the network reliability and data integrity requirements are critical. As we show in this report, the former issue particularly may be the greatest challenge for satellite networks for this class of application. We have also experimented with the portability of standard TCP/IP applications to satellite networks, demonstrating the need for alternative TCP congestion algorithms and minimization of bit error rates (BER). Reliability issues aside, we have demonstrated that true remote observing over high-speed networks provides several important advantages over standard observing paradigms. Technical advantages of the high-speed network access include more rapid download of data to a user's home institution and the opportunity for alternative communication facilities between members of an observing team, such as audio- and videoconferencing.

Design Issues Related to the Creation and Delivery of Asynchronous Multimedia Presentations

ERIC Educational Resources Information Center

Lightfoot, Jay M.

2003-01-01

Technology has advanced to the point where it is now possible to create and distribute digital multimedia recordings of class lectures over the Internet to remote learners. More importantly, the price of this technology has decreased to the point where it is also affordable to most instructional institutions. The main factor limiting its…

Evaluation of Distance Education Components of e-MBA Program--A Case Study

ERIC Educational Resources Information Center

Gunes, Ali; Altintas, Tugba

2013-01-01

By 2008-2009 educational year, distance education e-MBA Program have been added to Graduate School of Social Sciences of Istanbul Aydin University. The distance education components that were used included asynchronous education, synchronous education, exams, the learning management system-web site and a remote live-support desk. At the end of the…

Ontology-Based Adaptive Dynamic e-Learning Map Planning Method for Conceptual Knowledge Learning

ERIC Educational Resources Information Center

Chen, Tsung-Yi; Chu, Hui-Chuan; Chen, Yuh-Min; Su, Kuan-Chun

2016-01-01

E-learning improves the shareability and reusability of knowledge, and surpasses the constraints of time and space to achieve remote asynchronous learning. Since the depth of learning content often varies, it is thus often difficult to adjust materials based on the individual levels of learners. Therefore, this study develops an ontology-based…

Asynchronous Amazon forest canopy phenology indicates adaptation to both water and light availability

NASA Astrophysics Data System (ADS)

Jones, Matthew O.; Kimball, John S.; Nemani, Ramakrishna R.

2014-12-01

Amazon forests represent nearly half of all tropical vegetation biomass and, through photosynthesis and respiration, annually process more than twice the amount of estimated carbon (CO2) from fossil fuel emissions. Yet the seasonality of Amazon canopy cover, and the extent to which seasonal fluctuations in water availability and photosynthetically available radiation influence these processes, is still poorly understood. Implementing six remotely sensed data sets spanning nine years (2003-2011), with reported field and flux tower data, we show that southern equatorial Amazon forests exhibit a distinctive seasonal signal. Seasonal timing of water availability, canopy biomass growth and net leaf flush are asynchronous in regions with short dry seasons and become more synchronous across a west-to-east longitudinal moisture gradient of increasing dry season. Forest cover is responsive to seasonal disparities in both water and solar radiation availability, temporally adjusting net leaf flush to maximize use of these generally abundant resources, while reducing drought susceptibility. An accurate characterization of this asynchronous behavior allows for improved understanding of canopy phenology across contiguous tropical forests and their sensitivity to climate variability and drought.

Asynchronous web-based learning, a practical method to enhance teaching in emergency medicine.

PubMed

Pourmand, Ali; Lucas, Raymond; Nouraie, Mehdi

2013-03-01

Abstract Objective: To compare medical knowledge acquisition among emergency medicine (EM) residents who attend weekly core content lectures with those absent but asynchronously viewing the same lectures in a Web-based electronic platform. During the study period all EM residents attending or absent from weekly educational conferences were given a quiz on the covered material. During Phase 1, absentees were not given supplemental educational content for missed lectures. During Phase 2, absentees were sent a link to an online multimedia module containing an audiovisual recording of the actual missed lecture with presentation slides. Scores between attendees and absentees during both phases were compared using a repeated-measures analysis to evaluate the effect of the supplemental online module on knowledge acquisition. Thirty-nine EM residents (equally distributed in postgraduate years 1-4) were studied during a 15-week period. Overall and after adjusting for sex and postgraduate year level, both lecture attendance (b=27; 95% confidence interval, 22-32; p<0.0001) and Web-based learning (b=32; 95% confidence interval, 26-37; p<0.0001) were associated with significant increases in test scores compared with residents who were absent and not receiving supplemental Web-based learning. Neither the self-perceived level of mastery with the lecture topic nor the amount of reported reading was found to be a predictor of test scores. In an EM residency program, asynchronous Web-based learning may result in medical knowledge acquisition similar to or better than attending traditional core content lectures. The percentage of curriculum delivery by asynchronous learning that may be used to achieve overall terminal learning objectives in medical knowledge acquisition requires further study.

Pediatric emergency medicine asynchronous e-learning: a multicenter randomized controlled Solomon four-group study.

PubMed

Chang, Todd P; Pham, Phung K; Sobolewski, Brad; Doughty, Cara B; Jamal, Nazreen; Kwan, Karen Y; Little, Kim; Brenkert, Timothy E; Mathison, David J

2014-08-01

Asynchronous e-learning allows for targeted teaching, particularly advantageous when bedside and didactic education is insufficient. An asynchronous e-learning curriculum has not been studied across multiple centers in the context of a clinical rotation. We hypothesize that an asynchronous e-learning curriculum during the pediatric emergency medicine (EM) rotation improves medical knowledge among residents and students across multiple participating centers. Trainees on pediatric EM rotations at four large pediatric centers from 2012 to 2013 were randomized in a Solomon four-group design. The experimental arms received an asynchronous e-learning curriculum consisting of nine Web-based, interactive, peer-reviewed Flash/HTML5 modules. Postrotation testing and in-training examination (ITE) scores quantified improvements in knowledge. A 2 × 2 analysis of covariance (ANCOVA) tested interaction and main effects, and Pearson's correlation tested associations between module usage, scores, and ITE scores. A total of 256 of 458 participants completed all study elements; 104 had access to asynchronous e-learning modules, and 152 were controls who used the current education standards. No pretest sensitization was found (p = 0.75). Use of asynchronous e-learning modules was associated with an improvement in posttest scores (p < 0.001), from a mean score of 18.45 (95% confidence interval [CI] = 17.92 to 18.98) to 21.30 (95% CI = 20.69 to 21.91), a large effect (partial η(2) = 0.19). Posttest scores correlated with ITE scores (r(2) = 0.14, p < 0.001) among pediatric residents. Asynchronous e-learning is an effective educational tool to improve knowledge in a clinical rotation. Web-based asynchronous e-learning is a promising modality to standardize education among multiple institutions with common curricula, particularly in clinical rotations where scheduling difficulties, seasonality, and variable experiences limit in-hospital learning. © 2014 by the Society for Academic Emergency Medicine.

24-channel dual microcontroller-based voltage controller for ion optics remote control

NASA Astrophysics Data System (ADS)

Bengtsson, L.

2018-05-01

The design of a 24-channel voltage control instrument for Wenzel Elektronik N1130 NIM modules is described. This instrument is remote controlled from a LabVIEW GUI on a host Windows computer and is intended for ion optics control in electron affinity measurements on negative ions at the CERN-ISOLDE facility. Each channel has a resolution of 12 bits and has a normally distributed noise with a standard deviation of <1 mV. The instrument is designed as a standard 2-unit NIM module where the electronic hardware consists of a printed circuit board with two asynchronously operating microcontrollers.

Working Together for Better Student Learning: A Multi-University, Multi-Federal Partner Program for Asynchronous Learning Module Development for Radar-Based Remote Sensing Systems

ERIC Educational Resources Information Center

Yeary, M. B.; Yu, T.; Palmer, R. D.; Monroy, H.; Ruin, I.; Zhang, G.; Chilson, P. B.; Biggerstaff, M. I.; Weiss, C.; Mitchell, K. A.; Fink, L. D.

2010-01-01

Students are not exposed to enough real-life data. This paper describes how a community of scholars seeks to remedy this deficiency and gives the pedagogical details of an ongoing project that commenced in the Fall 2004 semester. Fostering deep learning, this multiyear project offers a new active-learning, hands-on interdisciplinary laboratory…

Asynchronous Replica Exchange Software for Grid and Heterogeneous Computing.

PubMed

Gallicchio, Emilio; Xia, Junchao; Flynn, William F; Zhang, Baofeng; Samlalsingh, Sade; Mentes, Ahmet; Levy, Ronald M

2015-11-01

Parallel replica exchange sampling is an extended ensemble technique often used to accelerate the exploration of the conformational ensemble of atomistic molecular simulations of chemical systems. Inter-process communication and coordination requirements have historically discouraged the deployment of replica exchange on distributed and heterogeneous resources. Here we describe the architecture of a software (named ASyncRE) for performing asynchronous replica exchange molecular simulations on volunteered computing grids and heterogeneous high performance clusters. The asynchronous replica exchange algorithm on which the software is based avoids centralized synchronization steps and the need for direct communication between remote processes. It allows molecular dynamics threads to progress at different rates and enables parameter exchanges among arbitrary sets of replicas independently from other replicas. ASyncRE is written in Python following a modular design conducive to extensions to various replica exchange schemes and molecular dynamics engines. Applications of the software for the modeling of association equilibria of supramolecular and macromolecular complexes on BOINC campus computational grids and on the CPU/MIC heterogeneous hardware of the XSEDE Stampede supercomputer are illustrated. They show the ability of ASyncRE to utilize large grids of desktop computers running the Windows, MacOS, and/or Linux operating systems as well as collections of high performance heterogeneous hardware devices.

Asynchronous Amazon Forest Canopy Phenology Indicates Adaptation to Both Water and Light Availability

NASA Astrophysics Data System (ADS)

Jones, M. O.; Kimball, J. S.; Nemani, R. R.

2015-12-01

Amazon forests represent nearly half of all tropical vegetation biomass and, through photosynthesis and respiration, annually process more than twice the amount of estimated carbon (CO2) from fossil fuel emissions. Yet the seasonality of Amazon canopy cover, and the extent to which seasonal fluctuations in water availability and photosynthetically active radiation influence these processes, is still poorly understood. Implementing six remotely sensed data sets spanning nine years (2003-2011), with reported field and flux tower data, we show that southern equatorial Amazon forests exhibit a distinctive seasonal signal. Seasonal timing of water availability, canopy biomass growth and net leaf flush are asynchronous in regions with short dry seasons and become more synchronous across a west-to-east longitudinal moisture gradient of increasing dry season length. Forest cover is responsive to seasonal disparities in both water and solar radiation availability, temporally adjusting net leaf flush to maximize use of these generally abundant resources, while reducing drought susceptibility. An accurate characterization of this asynchronous behavior allows for improved understanding of canopy phenology across contiguous tropical forests and their sensitivity to climate variability and drought. These insights can also inform land surface models to provide a more accurate representation of seasonal forest carbon allocation strategies responsive to environmental drivers.

Educational technology improves ECG interpretation of acute myocardial infarction among medical students and emergency medicine residents.

PubMed

Pourmand, Ali; Tanski, Mary; Davis, Steven; Shokoohi, Hamid; Lucas, Raymond; Zaver, Fareen

2015-01-01

Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI). We developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation. 148 students and 35 EM residents participated in this training in the 2012-2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7-6.1]) to 7.3 (95% CI [7.1-7.5]), with a mean difference of 1.4 (95% CI [1.12-1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2-6.9]) to 7.8 (95% CI [7.4-8.2]) (p<0.0001). An online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.

Demonstrating NaradaBrokering as a Middleware Fabric for Grid-based Remote Visualization Services

NASA Astrophysics Data System (ADS)

Pallickara, S.; Erlebacher, G.; Yuen, D.; Fox, G.; Pierce, M.

2003-12-01

Remote Visualization Services (RVS) have tended to rely on approaches based on the client server paradigm. Here we demonstrate our approach - based on a distributed brokering infrastructure, NaradaBrokering [1] - that relies on distributed, asynchronous and loosely coupled interactions to meet the requirements and constraints of RVS. In our approach to RVS, services advertise their capabilities to the broker network that manages these service advertisements. Among the services considered within our system are those that perform graphic transformations, mediate access to specialized datasets and finally those that manage the execution of specified tasks. There could be multiple instances of each of these services and the system ensures that load for a given service is distributed efficiently over these service instances. We will demonstrate implementation of concepts that we outlined in the oral presentation. This would involve two or more visualization servers interacting asynchronously with multiple clients through NaradaBrokering. The communicating entities may exchange SOAP [2] (Simple Object Access Protocol) messages. SOAP is a lightweight protocol for exchange of information in a decentralized, distributed environment. It is an XML based protocol that consists of three parts: an envelope that describes what is in a message and how to process it, rules for expressing instances of application-defined data types, and a convention for representing remote invocation related operations. Furthermore, we will also demonstrate how clients can retrieve their results after prolonged disconnects or after any failures that might have taken place. The entities, services and clients alike, are not limited by the geographical distances that separate them. We are planning to test this system in the context of trans-Atlantic links separating interacting entities. {[1]} The NaradaBrokering Project: http://www.naradabrokering.org {[2]} Newcomer, E., 2002, Understanding web services: XML, WSDL, SOAP, and UDDI, Addison Wesley Professional.

Proceedings of the Systems Reengineering Technology Workshop (4th) held in Monterey, California on February 8 - 10, 1994

DTIC Science & Technology

1994-09-01

report for the Properties of User Interface Software Architetures ", draft DISCUS Working Group, Programmers Tutorial, MITRE paper, SEI. Carnegie...execution that we have defined called asynchronous remote procedure call (ARPC) [15], which allows concurrency in amounts proportional to the amount of...demonstration project to use STARS DoD software budget and the proportion concepts. IBM is one of the prime is expected to be increased during the contractors

A cryptologic based trust center for medical images.

PubMed

Wong, S T

1996-01-01

To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment.

A cryptologic based trust center for medical images.

PubMed Central

Wong, S T

1996-01-01

OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment. PMID:8930857

The Ottawa telehealth project.

PubMed

Cheung, S T; Davies, R F; Smith, K; Marsh, R; Sherrard, H; Keon, W J

1998-01-01

To examine the telehealth system as a means of improving access to cardiac consultations and specialized health services in remote areas of Ontario. The University of Ottawa Heart Institute has set up a telehealth test program, Healthcare and Education Access for Remote Residents by Telecommunications (HEARRT), in collaboration with industry and the provincial and federal government, as well as several remote clinical test sites. The program makes off-site cardiology consultations possible. History taking and physical examinations are conducted by video and electronic stethoscope. Laboratory results and echocardiograms are transmitted by document camera and VCR. The technology is being tested in both stable outpatient and emergency situations. Various telecommunications bandwidths and encoding systems are being evaluated, including satellite and terrestrial-based asynchronous transfer-mode circuits. Patient satisfaction and cost-effectiveness are also being assessed. Bandwidths from as low as 384 kbps using H.320 encoders to 40 Mbps using digital transport of NTSC video signals have been evaluated. Although lower bandwidths are sufficient for sending echocardiographic and electrocardiogram data, bandwidths with transport speeds of 4 to 6 Mbps appear necessary to capture the nuances of the cardiac physical examination. A preliminary satisfaction survey of 19 patients noted that all felt that they could communicate effectively with the cardiologist by video, and each had confidence in the advice offered. None reported that he or she would rather have traveled to the doctor in person. Initial and projected examination of the costs suggested that telehealth will effectively reduce overall health care spending while decreasing travel expenses for rural patients. Telehealth technology is sufficiently sophisticated to allow off-site cardiology assessments. Preliminary results suggest there is a sound business case for the implementation of telehealth technology to meet the needs of remote residents in northern Ontario. Working closely with government and industry, we will develop a marketing and commercialization plan to support the use of this technology throughout Ontario and expand application to patient education and continuing medical education.

European project RETAIN: new approach for IBC in teleradiology and PACS based on full ATM network

NASA Astrophysics Data System (ADS)

Cordonnier, Emmanuel; Jensch, Peter F.; Piqueras, Joachim; Gandon, Yves

1995-05-01

This paper describes the RETAIN project (radiological examination transfer on ATM Integrated Network), which is supported by the European Community, in the frame of the TEN-IBC program (trans-European networks integrated broad band communication). It links together three European sites in France (Rennes), Spain (Barcelona), and Germany (Oldenburg) and involves a partnership between the public national operators France Telecom, Telefonica, and Telekom. One important reason to explicitly consider asynchronous transfer mode (ATM) for medical imaging is that multimedia applications on such networks allow integration of digital data and person-to-person communication. The RETAIN project includes trials of teleworking sessions between radiologists of Rennes and Barcelona within a clinical and/or scientific context based on ATM equipments performing DICOM transfer on examination, digital remote manipulation within a comprehensive dialogue, and high quality visiophony on ATM adaptation layer (AAL) type 1. The project includes also visiophony trials with Oldenburg and preparation of harmonized regional experimentation within an emergency context. The network used is a full 10 Mbits/s ATM network directly connected to local PACSs.

Telemedicine for children with developmental disabilities: a more effective clinical process than office-based care.

PubMed

Langkamp, Diane L; McManus, Mark D; Blakemore, Susan D

2015-02-01

The literature on the use of telemedicine for children with developmental disabilities (DD) is limited and mostly describes telemedicine being used to link patients with distant subspecialty multidisciplinary care. Parents generally have reported satisfaction with such care and have perceived it to be equally effective as in-person care. Here we report on the use of school-based asynchronous telemedicine to connect children with DD with primary care providers. We developed Tele-Health-Kids, a school-based program using asynchronous telemedicine to connect children with DD with their primary care physician for the care of minor illnesses. We surveyed parents at enrollment and after the child's first telemedicine visit to assess satisfaction. We describe 4 cases that illustrate benefits, particularly for children with DD and challenging behaviors, suggesting that asynchronous telemedicine may actually be superior to traditional in-office visits in some circumstances. Most parents expressed a high level of satisfaction with the program. Benefits identified include decreased stress to the child and the parents as well as increasing the likelihood of a successful medical examination due to greater cooperation by the child. Visits using asynchronous or "store and forward" telemedicine technology may be superior in some situations by allowing the visit to be performed at a pace that can be adjusted to the needs of the child with DD. More research in the use of asynchronous telemedicine for children and youth with DD, particularly for children with DD and challenging behaviors, is needed.

Aspects of the Patient-centered Medical Home currently in place: initial findings from preparing the personal physician for practice.

PubMed

Carney, Patricia A; Eiff, M Patrice; Saultz, John W; Douglass, Alan B; Tillotson, Carrie J; Crane, Steven D; Jones, Samuel M; Green, Larry A

2009-10-01

The Patient-centered Medical Home (PCMH) is a central concept in the evolving debate about American health care reform. We studied family medicine residency training programs' continuity clinics to assess baseline status of implementing PCMH components and to compare implementation status between community-based and university training programs. We conducted a survey 24 continuity clinics in 14 residency programs that are part of the Preparing the Personal Physicians for Practice (P(4)) program. We asked questions about aspects of P(4) that had been already implemented at the beginning of the P(4) program. We defined high implementation as aspects that were present in >50% of clinics and low implementation as those present in <50% of clinics. We compared features at university-based and community-based clinics. High areas of implementation were having an electronic health record (EHR), fully secured remote access, electronic patient notes/scheduling/billing, chronic disease management registries, and open-access scheduling. Low areas of implementation included hospital EHR with computerized physician order entry, asynchronous communication with patients, ongoing population-based QA using EHR, use of preventive registries, and practice-based research using EHR. Few differences were noted between university- and community-based residency programs. Many features of the PCMH were already established at baseline in programs participating in P(4).

[System of telesonography with synchronous teleconsultations and asynchronous telediagnoses (Togo)].

PubMed

Adambounou, K; Farin, F; Boucher, A; Adjenou, K V; Gbeassor, M; N'dakena, K; Vincent, N; Arbeille, P

2012-01-01

Ultrasonography is an important nonirradiating diagnostic medical imaging procedure, frequently used, especially in urgent circumstances. This relatively inexpensive noninvasive examination makes it possible to diagnose disorders in various parts of the human body, by examining, for example, the abdomen and pelvis, the cardiovascular system, and the muscles and joints. Ultrasound is also an operator-dependent examination, in that the quality of the result depends on precision in the manipulation of the probe. Unfortunately, many small medical centers and isolated sites do not have an appropriate well-trained sonographer to perform initial evaluations, and an untrained operator cannot capture the appropriate echographic views required for a safe diagnosis of current patients, even with realtime vocal guidance (personal data). The lack of experienced physicians or qualified technicians means that diagnostic ultrasound is not always accessible to patients for rapid examination worldwide, especially in Africa, Amazonia or near the North or South Poles. This situation has led to the development of a new concept of telemedicine: telesonography, with a remote ultrasound diagnosis either in real time (synchronous) or delayed (asynchronous; store-and-forward). These systems of real-time telesonography and data transmission require expensive and complex technology with sophisticated equipment not available in many developing countries. The purpose of this study is to design a low-cost real-time system of telesonography for teleconsultations with experts and a delayed telediagnostic mode between isolated peripheral hospitals and a University Hospital center (UHC). An IP camera and an internet video server were installed in a geographically isolated site equipped with an ultrasound machine and an operator with basic training in its use. Synchronous teleconsultation (second-opinion diagnosis) is possible via internet with a UHC expert. If no ultrasound operator is available at the isolated center, volume capture-and-store software is used. Later on, the UHC expert uses Echo-Cnes 3D software to reconstruct the organs scanned. The expert can then navigate within the reconstructed volume and display any plane. Volume capture is performed by tilting (± 40°) to both sides vertically to the skin. To locate the probe on the organ acoustic window, the novice operator uses acoustic window mapping designed by our laboratory (UMPS-Tours). The system was tested between the Tsévié regional hospital in Togo (40 km from Lomé, Togo, and 4500 km from Tours, France) and the UHC at Lomé and the Trousseau UHC in Tours. With an average internet connection of 2 Mbps, the quality of transmission of the background video and ultrasound sequence videos from Tsévié towards Lomé was satisfactory (16 images/s) with a maximal transmission delay of 1.5 s (almost in real time). A video conference between the Trousseau UHC in Tours, the UHC Campus in Lomé and the Tsévié Hospital was possible and the bandwidth allowed the Lomé experts (radiologists) to perform real-time telesonography with very satisfactory results (ultrasound diagnoses obtained) for abdominal (n = 5), pelvic (n = 3), obstetric (n = 2), prostate (n = 2) and mammary (n = 2) ultrasound, both normal and pathological. Because the doctors at Tsévié had minimal experience with ultrasound, complete ultrasound diagnoses were obtained by combining remote voice instruction for image capture and full diagnosis by Echo-Cnes. Asynchronous telediagnosis was also performed with Tsévié operators who lacked ultrasound expertise but could perform the required tilt movements (after 3 training sessions). The expert at Trousseau UHC performed real-time telesonography with the Tsévié Hospital for two cases requiring abdominal images and another viewing of the prostate. He also performed asynchronous reconstruction of the abdominal organs with Echo-Cnes. A demonstration seminar of our platform was organized successfully for 2 days during the 9(th) Congress of the French-speaking Black Africa Society of Radiology (SRANF in French) held from 4 till 6 May 2011 at the hotel EDA OBA. During this seminar, 4 ultrasound teleconsultations were performed from the hotel by eminent African radiologists. This preliminary study, although limited in the number of patients, allowed us to assess the technical features of our telesonography system. Togo, a developing country with a very modest infrastructure for information and communication, was an ideal site for a first test of this platform. Our system of remote ultrasound requires the local patient center to be equipped simply with a 2D ultrasound machine. The cost is quite low, in comparison to the asynchronous techniques requiring 3D devices. The high cost of 3D or 4D ultrasound machines and their fragility make it difficult to install them at the isolated sites and was a serious obstacle in the development of this system. If the center already has a 2D device and a computer, the cost to equip it with the remaining communications materials is 1,500 €. The experience in Togo clearly highlighted the possibility of teletraining and complete teleradiology with our system. The next stage of this work will seek to validate the results of this preliminary experience on a larger sample with more precise assessment criteria in 2012. The results will allow the widespread dissemination and routine use of this system in developing countries.

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

PubMed Central

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

2015-01-01

Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff. PMID:26618034

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

PubMed

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun; Cha, Hyo Soung

2015-10-01

Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

21 CFR 880.6315 - Remote Medication Management System.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication...

Marionette

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

Sullivan, M.; Anderson, D.P.

1988-01-01

Marionette is a system for distributed parallel programming in an environment of networked heterogeneous computer systems. It is based on a master/slave model. The master process can invoke worker operations (asynchronous remote procedure calls to single slaves) and context operations (updates to the state of all slaves). The master and slaves also interact through shared data structures that can be modified only by the master. The master and slave processes are programmed in a sequential language. The Marionette runtime system manages slave process creation, propagates shared data structures to slaves as needed, queues and dispatches worker and context operations, andmore » manages recovery from slave processor failures. The Marionette system also includes tools for automated compilation of program binaries for multiple architectures, and for distributing binaries to remote fuel systems. A UNIX-based implementation of Marionette is described.« less

The Pacific Asynchronous TeleHealth (PATH) system: review of 1,000 pediatric teleconsultations.

PubMed

Mahnke, Christopher Becket; Jordan, Christopher P; Bergvall, Ethan; Person, Donald A; Pinsker, Jordan E

2011-01-01

The aim of this study was to evaluate the impact on pediatric care of the Pacific Asynchronous TeleHealth (PATH) system, a provider-to-provider teleconsultation platform utilized by military medical facilities throughout the Pacific Region. This review focuses on access to care, quality of care, and cost savings for the Department of Defense as a result of ongoing development of the PATH system from 2006 to 2009. This is a retrospective review of 1,000 consecutive teleconsultations occurring from January 2006 to March 2009. Three pediatric subspecialists reviewed the characteristics of each teleconsultation and the ultimate outcome. The PATH system processed > 300 pediatric teleconsultations in 2009 from 20 hospitals and clinics throughout the Pacific Region. The number of teleconsultations has grown significantly since 2006. Median teleconsultation response time was 14.5 h with 97% of teleconsultations answered within 1 week. The majority (75%) of teleconsultations came from areas without host nation pediatric subspecialty resources. Most teleconsultations (72%) involved diagnostic questions, whereas 21% were primarily for treatment issues. Teleconsultations originated predominantly from outpatient clinics (90%), with question resolution in 60% of cases without a face-to-face subspecialty evaluation. Fifteen percent of teleconsultations resulted in patient transfer to our center for definitive diagnosis and treatment. The diagnostic and/or treatment plan was modified in 74% of teleconsultations. PATH precluded patient transfer in 12%-43% of teleconsultations (annual savings: $208,283-$746,348 per year) and generated an average of 1.7 relative value units per teleconsultation. PATH provided patient access to pediatric subspecialty expertise via provider-to-provider asynchronous teleconsultation. Internet-based pediatric subspecialty teleconsultation provides fast, convenient, cost-effective, quality pediatric care to populations of patients who might otherwise require transfer to a distant medical facility for more advanced care. PATH serves as a model for future asynchronous teleconsultation platforms in both the military and civilian healthcare arenas.

Uniform instruction using web-based, asynchronous technology in a geographically distributed clinical clerkship: analysis of osteopathic medical student participation and satisfaction.

PubMed

Peska, Don N; Lewis, Kadriye O

2010-03-01

As medical schools in the United States increase their class sizes, many institutions are forced to extend their teaching affiliations outside of their immediate communities. Geographic distribution threatens the ability to provide the uniform learning opportunities that students need and accrediting bodies require. To determine if a Web-based, asynchronous learning module can provide an effective, uniform learning opportunity for osteopathic medical students enrolled in clinical clerkship. Third-year osteopathic medical students enrolled in an 8-week core clinical clerkship in surgery were required to participate in a Web-based, asynchronous, interactive instructional module designed to provide opportunities for higher-order thinking through analysis, synthesis, and reflective learning. The quantity and content of students' online course interactions were analyzed to determine quantitative and qualitative features of their course participation. At the completion of the clerkship, students completed a 10-item Likert-type survey of their experience to determine the most helpful attributes of the Web-based learning module. Responses were assigned numerical values from 1 (strongly disagree) to 5 (strongly agree) to obtain a mean score for each question. Sixty-three students completed the Web-based module. The content of their discussions, as determined by message coding, identified the critical thinking needed to acquire abstract conceptualization of the problems presented in a typical surgery clerkship. Students found the content of the module relevant to the clerkship (mean score, 4.18) and valued facilitator feedback (4.00). Although they did not prefer Web-based instruction of classroom lecture (2.66), students indicated that the Web-based module enhanced their overall learning experience in the clerkship (3.30). Web-based technology in the clinical education of third-year osteopathic medical students appears to afford an acceptable teaching alternative when face-to-face instruction cannot be provided. Further study of the impact of instructional design on the quality of higher-order thinking in this domain is needed, as is an appreciation for the dynamics of group learning in a virtual environment.

Information and informatics literacies of first-year medical students

PubMed Central

Bouquin, Daina R.; Tmanova, Lyubov L.; Wright, Drew

2015-01-01

Purpose The study evaluated medical students' familiarity with information literacy and informatics during the health sciences library orientation. Methods A survey was fielded at the start of the 2013 school year. Results Seventy-two of 77 students (94%) completed the survey. Over one-half (57%) expected to use library research materials and services. About half (43%) expected to use library physical space. Students preferred accessing biomedical research on laptops and learning via online-asynchronous modes. Conclusions The library identified areas for service development and outreach to medical students and academic departments. PMID:26512221

Remote Asynchronous Message Service Gateway

NASA Technical Reports Server (NTRS)

Wang, Shin-Ywan; Burleigh, Scott C.

2011-01-01

The Remote Asynchronous Message Service (RAMS) gateway is a special-purpose AMS application node that enables exchange of AMS messages between nodes residing in different AMS "continua," notionally in different geographical locations. JPL s implementation of RAMS gateway functionality is integrated with the ION (Interplanetary Overlay Network) implementation of the DTN (Delay-Tolerant Networking) bundle protocol, and with JPL s implementation of AMS itself. RAMS protocol data units are encapsulated in ION bundles and are forwarded to the neighboring RAMS gateways identified in the source gateway s AMS management information base. Each RAMS gateway has interfaces in two communication environments: the AMS message space it serves, and the RAMS network - the grid or tree of mutually aware RAMS gateways - that enables AMS messages produced in one message space to be forwarded to other message spaces of the same venture. Each gateway opens persistent, private RAMS network communication channels to the RAMS gateways of other message spaces for the same venture, in other continua. The interconnected RAMS gateways use these communication channels to forward message petition assertions and cancellations among themselves. Each RAMS gateway subscribes locally to all subjects that are of interest in any of the linked message spaces. On receiving its copy of a message on any of these subjects, the RAMS gateway node uses the RAMS network to forward the message to every other RAMS gateway whose message space contains at least one node that has subscribed to messages on that subject. On receiving a message via the RAMS network from some other RAMS gateway, the RAMS gateway node forwards the message to all subscribers in its own message space.

Web-based asynchronous teleconsulting for consumers in Colombia: a case study.

PubMed

Valenzuela, José Ignacio; Arguello, Arturo; Cendales, Juan Gabriel; Rizo, Carlos A

2007-10-22

Fourteen years after the reform to Colombia's health system, the promises of universality, improved equity, efficiency, and better quality of care have not materialized. Remote areas remain underserved and access to care very limited. Recognizing teleconsultation as an effective way to improve access to health care and health information, a noncommercial open-access Web-based application for teleconsultation called Doctor Chat was developed. The objective was to report the experience of the Center for Virtual Education and Simulation eHealth (Centro de Educación Virtual y Simulación e-Salud) with open-access Web-based asynchronous teleconsultation for consumers in Colombia. A teleconsultation service in Spanish was developed and implemented in 2006. Teleconsultation requests were classified on three axes: (1) the purpose of the query, (2) the specialty, and (3) the geographic area of the query. Content analysis was performed on the free-text queries submitted to Doctor Chat, and descriptive statistics were gathered for each of the data categories (name, email, city, country, age, and gender). From September 2006 to March 2007, there were 270 asynchronous teleconsultations documented from 102 (37.8%) men and 168 (62.2%) women. On average, 1.4 requests were received per day. By age group, the largest number of requests (n = 80; 30%) were from users 24-29 years, followed by users (n = 66; 24%) 18-23 years. Requests were mainly from Colombia (n = 204; 75.6%) but also from Spain (n = 17; 6.3%), Mexico (n = 11; 4.1%), and other countries. In Colombia, 137 requests (67.2%) originated in Bogotá, the nation's capital, 25 (12.4%) from other main cities of the country, 40 (19.7%) from intermediate cities, and 2 (0.7%) from remote areas. The purpose of the majority of requests was for information about symptoms, health-related problems, or diseases (n = 149; 55.2%) and medications/treatments (n = 70; 25.9%). By specialty, information was most requested for gynecology and obstetrics (n = 71; 26%), dermatology (n = 28; 10%), urology (n = 22; 8%), and gastroenterology (n = 18; 7%), with anesthesiology, critical care, physical medicine and rehabilitation, and pathology being the least requested (n = 0; 0%). Overall, sexual and reproductive health (n = 93; 34%) issues constituted the main query subject. The average time to deliver a response was 120 hours in 2006 and 59 hours in 2007. Only 19 out of 270 users (7%) completed a survey with comments and perceptions about the system, of which 18 out of 19 (95%) corresponded to positive perceptions and 1 out of 19 (5%) expressed dissatisfaction with the service. The implementation of a Web-based teleconsulting service in Colombia appeared to be an innovative way to improve access to health care and information in the community and encouraged open and explicit discussion. Extending the service to underserved areas could improve access to health services and health information and could potentially improve economic indicators such as waiting times for consultations and the rate of pregnancy among teenagers; however, cultural, infrastructural, and Internet connectivity barriers are to be solved before successful implementation can derive population-wide positive impacts.

Web-Based Asynchronous Teleconsulting for Consumers in Colombia: A Case Study

PubMed Central

Valenzuela, José Ignacio; Arguello, Arturo; Cendales, Juan Gabriel

2007-01-01

Background Fourteen years after the reform to Colombia’s health system, the promises of universality, improved equity, efficiency, and better quality of care have not materialized. Remote areas remain underserved and access to care very limited. Recognizing teleconsultation as an effective way to improve access to health care and health information, a noncommercial open-access Web-based application for teleconsultation called Doctor Chat was developed. Objective The objective was to report the experience of the Center for Virtual Education and Simulation eHealth (Centro de Educación Virtual y Simulación e-Salud) with open-access Web-based asynchronous teleconsultation for consumers in Colombia. Methods A teleconsultation service in Spanish was developed and implemented in 2006. Teleconsultation requests were classified on three axes: (1) the purpose of the query, (2) the specialty, and (3) the geographic area of the query. Content analysis was performed on the free-text queries submitted to Doctor Chat, and descriptive statistics were gathered for each of the data categories (name, email, city, country, age, and gender). Results From September 2006 to March 2007, there were 270 asynchronous teleconsultations documented from 102 (37.8%) men and 168 (62.2%) women. On average, 1.4 requests were received per day. By age group, the largest number of requests (n = 80; 30%) were from users 24-29 years, followed by users (n = 66; 24%) 18-23 years. Requests were mainly from Colombia (n = 204; 75.6%) but also from Spain (n = 17; 6.3%), Mexico (n = 11; 4.1%), and other countries. In Colombia, 137 requests (67.2%) originated in Bogotá, the nation’s capital, 25 (12.4%) from other main cities of the country, 40 (19.7%) from intermediate cities, and 2 (0.7%) from remote areas. The purpose of the majority of requests was for information about symptoms, health-related problems, or diseases (n = 149; 55.2%) and medications/treatments (n = 70; 25.9%). By specialty, information was most requested for gynecology and obstetrics (n = 71; 26%), dermatology (n = 28; 10%), urology (n = 22; 8%), and gastroenterology (n = 18; 7%), with anesthesiology, critical care, physical medicine and rehabilitation, and pathology being the least requested (n = 0; 0%). Overall, sexual and reproductive health (n = 93; 34%) issues constituted the main query subject. The average time to deliver a response was 120 hours in 2006 and 59 hours in 2007. Only 19 out of 270 users (7%) completed a survey with comments and perceptions about the system, of which 18 out of 19 (95%) corresponded to positive perceptions and 1 out of 19 (5%) expressed dissatisfaction with the service. Conclusion The implementation of a Web-based teleconsulting service in Colombia appeared to be an innovative way to improve access to health care and information in the community and encouraged open and explicit discussion. Extending the service to underserved areas could improve access to health services and health information and could potentially improve economic indicators such as waiting times for consultations and the rate of pregnancy among teenagers; however, cultural, infrastructural, and Internet connectivity barriers are to be solved before successful implementation can derive population-wide positive impacts. PMID:17954469

UPC++ Programmer’s Guide, v1.0-2018.3.0

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

Bachan, J.; Baden, S.; Bonachea, Dan

UPC++ is a C++11 library that provides Partitioned Global Address Space (PGAS) programming. It is designed for writing parallel programs that run efficiently and scale well on distributed-memory parallel computers. The PGAS model is single program, multiple-data (SPMD), with each separate thread of execution (referred to as a rank, a term borrowed from MPI) having access to local memory as it would in C++. However, PGAS also provides access to a global address space, which is allocated in shared segments that are distributed over the ranks. UPC++ provides numerous methods for accessing and using global memory. In UPC++, all operationsmore » that access remote memory are explicit, which encourages programmers to be aware of the cost of communication and data movement. Moreover, all remote-memory access operations are by default asynchronous, to enable programmers to write code that scales well even on hundreds of thousands of cores.« less

Center for Plasma Edge Simulation (CPES) -- Rutgers University Final Report

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

Parashar, Manish

2014-03-06

The CPES scientific simulations run at scale on leadership class machines, collaborate at runtime and produce and exchange large data sizes, which present multiple I/O and data management challenges. During the CPES project, the Rutgers team worked with the rest of the CPES team to address these challenges at different levels, and specifically (1) at the data transport and communication level through the DART (Decoupled and Asynchronous Remote Data Transfers) framework, and (2) at the data management and services level through the DataSpaces and ActiveSpaces frameworks. These frameworks and their impact are briefly described.

Expanding the Traditional Physiology Class with Asynchronous Online Discussions and Collaborative Projects

ERIC Educational Resources Information Center

Taradi, Suncana Kukolja; Taradi, Milan

2004-01-01

Discussion and writing are very powerful ways to support learning. This article describes the use of a free, synchronous online forum to expand student-teacher discussions beyond the time/place constraints of the physical physiology classroom. The main participants were medical students enrolled in physiology class at the University of Zagreb…

Elements of Problem-Based Learning: Suggestions for Implementation in the Asynchronous Environment

ERIC Educational Resources Information Center

Nelson, Erik

2010-01-01

Problem-based learning, or PBL, is a student-centered instructional approach that is derived from constructivist epistemology. It is based upon ill-structured real-world problems with the goal of strengthening and developing critical thinking and problem-solving skills in learners. Initially utilized in medical schools to strengthen diagnostic…

Performance of asynchronous transfer mode (ATM) local area and wide area networks for medical imaging transmission in clinical environment.

PubMed

Huang, H K; Wong, A W; Zhu, X

1997-01-01

Asynchronous transfer mode (ATM) technology emerges as a leading candidate for medical image transmission in both local area network (LAN) and wide area network (WAN) applications. This paper describes the performance of an ATM LAN and WAN network at the University of California, San Francisco. The measurements were obtained using an intensive care unit (ICU) server connecting to four image workstations (WS) at four different locations of a hospital-integrated picture archiving and communication system (HI-PACS) in a daily regular clinical environment. Four types of performance were evaluated: magnetic disk-to-disk, disk-to-redundant array of inexpensive disks (RAID), RAID-to-memory, and memory-to-memory. Results demonstrate that the transmission rate between two workstations can reach 5-6 Mbytes/s from RAID-to-memory, and 8-10 Mbytes/s from memory-to-memory. When the server has to send images to all four workstations simultaneously, the transmission rate to each WS is about 4 Mbytes/s. Both situations are adequate for radiologic image communications for picture archiving and communication systems (PACS) and teleradiology applications.

Asynchronous learning: student utilization out of sync with their preference.

PubMed

Lew, Edward K; Nordquist, Erik K

2016-01-01

Asynchronous learning is gaining popularity. Data are limited regarding this learning method in medical students rotating in emergency medicine (EM). In EM, faculty time is limited to give in-person lectures. The authors sought to create an online curriculum that students could utilize as an additional learning modality. The goal was to evaluate effectiveness, participation, and preference for this mode of learning. We developed five online, narrated PowerPoint presentations. After orientation, access to the online curriculum was provided to the students, which they could review at their leisure. One hundred and seven fourth-year medical students participated. They reported the curriculum to be of high quality. Pretest scores were similar for those that viewed all lectures - compliant group (CG) (9.5 [CI 4.8-14.1]) and those that did not view any - non-compliant group (NCG) (9.6 [CI 5.9-13.4]). There was no statistical significant difference in posttest scores between the groups although there was improvement overall: CG 14.6 (CI 6.9-22.1); NCG 11.4 (CI 5.7-17.1). A majority (69.2%) favored inclusion of asynchronous learning, but less than a quarter (22.4%) reported viewing all five modules and more than a third (36.4%) viewed none. Despite student-expressed preference for an online curriculum, they used the online resource less than expected. This should give pause to educators looking to convert core EM topics to an online format. However, when high-quality online lectures are utilized as a learning tool, this study demonstrates that they had neither a positive nor a negative impact on test scores.

Space Flight Middleware: Remote AMS over DTN for Delay-Tolerant Messaging

NASA Technical Reports Server (NTRS)

Burleigh, Scott

2011-01-01

This paper describes a technique for implementing scalable, reliable, multi-source multipoint data distribution in space flight communications -- Delay-Tolerant Reliable Multicast (DTRM) -- that is fully supported by the "Remote AMS" (RAMS) protocol of the Asynchronous Message Service (AMS) proposed for standardization within the Consultative Committee for Space Data Systems (CCSDS). The DTRM architecture enables applications to easily "publish" messages that will be reliably and efficiently delivered to an arbitrary number of "subscribing" applications residing anywhere in the space network, whether in the same subnet or in a subnet on a remote planet or vehicle separated by many light minutes of interplanetary space. The architecture comprises multiple levels of protocol, each included for a specific purpose and allocated specific responsibilities: "application AMS" traffic performs end-system data introduction and delivery subject to access control; underlying "remote AMS" directs this application traffic to populations of recipients at remote locations in a multicast distribution tree, enabling the architecture to scale up to large networks; further underlying Delay-Tolerant Networking (DTN) Bundle Protocol (BP) advances RAMS protocol data units through the distribution tree using delay-tolerant storeand- forward methods; and further underlying reliable "convergence-layer" protocols ensure successful data transfer over each segment of the end-to-end route. The result is scalable, reliable, delay-tolerant multi-source multicast that is largely self-configuring.

Design of a secure remote management module for a software-operated medical device.

PubMed

Burnik, Urban; Dobravec, Štefan; Meža, Marko

2017-12-09

Software-based medical devices need to be maintained throughout their entire life cycle. The efficiency of after-sales maintenance can be improved by managing medical systems remotely. This paper presents how to design the remote access function extensions in order to prevent risks imposed by uncontrolled remote access. A thorough analysis of standards and legislation requirements regarding safe operation and risk management of medical devices is presented. Based on the formal requirements, a multi-layer machine design solution is proposed that eliminates remote connectivity risks by strict separation of regular device functionalities from remote management service, deploys encrypted communication links and uses digital signatures to prevent mishandling of software images. The proposed system may also be used as an efficient version update of the existing medical device designs.

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care.

PubMed

Ferrante, Jeanne M; Friedman, Asia; Shaw, Eric K; Howard, Jenna; Cohen, Deborah J; Shahidi, Laleh

2015-10-18

While an increasing number of researchers are using online discussion forums for qualitative research, few authors have documented their experiences and lessons learned to demonstrate this method's viability and validity in health services research. We comprehensively describe our experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. Our lessons learned from each phase, including planning, designing, implementing, using, and ending this private online discussion forum, provide some recommendations for other health services researchers considering this method. An asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals. © The Author(s) 2015.

Lessons Learned Designing and Using an Online Discussion Forum for Care Coordinators in Primary Care

PubMed Central

Ferrante, Jeanne M.; Friedman, Asia; Shaw, Eric K.; Howard, Jenna; Cohen, Deborah J.; Shahidi, Laleh

2016-01-01

While an increasing number of researchers are using online discussion forums for qualitative research, few authors have documented their experiences and lessons learned to demonstrate this method’s viability and validity in health services research. We comprehensively describe our experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. Our lessons learned from each phase, including planning, designing, implementing, using, and ending this private online discussion forum, provide some recommendations for other health services researchers considering this method. An asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals. PMID:26481942

Mobile Diabetes Management for USAF Active and Retired Military Spouses: Lessons Learned in the Integration of Mobile Integrated Therapies (MIT) into Electronic Medical Records (EMR)

DTIC Science & Technology

2013-09-24

episodic testing, activity, nutrition , etc.) asynchronously throughout any given day, and to recall the correct (and often complex) medication and/or...instructions as much as 50% of the time13. In a dynamic world, patients need dynamic access to relevant and timely education outside of their healthcare...which provides adults with type 2 diabetes real-time, contextually relevant coaching and education . This automated feedback is tailored to the

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

Sadowski, Greg

In one form, a logic circuit includes an asynchronous logic circuit, a synchronous logic circuit, and an interface circuit coupled between the asynchronous logic circuit and the synchronous logic circuit. The asynchronous logic circuit has a plurality of asynchronous outputs for providing a corresponding plurality of asynchronous signals. The synchronous logic circuit has a plurality of synchronous inputs corresponding to the plurality of asynchronous outputs, a stretch input for receiving a stretch signal, and a clock output for providing a clock signal. The synchronous logic circuit provides the clock signal as a periodic signal but prolongs a predetermined state ofmore » the clock signal while the stretch signal is active. The asynchronous interface detects whether metastability could occur when latching any of the plurality of the asynchronous outputs of the asynchronous logic circuit using said clock signal, and activates the stretch signal while the metastability could occur.« less

Performance and function of a high-speed multiple star topology image management system at Mayo Clinic Scottsdale.

PubMed

Pavlicek, W; Zavalkovskiy, B; Eversman, W G

1999-05-01

Mayo Clinic Scottsdale (MCS) is a busy outpatient facility (150,000 examinations per year) connected via asynchronous transfer mode (ATM; OC-3 155 MB/s) to a new Mayo Clinic Hospital (178 beds) located more than 12 miles distant. A primary care facility staffed by radiology lies roughly halfway between the hospital and clinic connected to both. Installed at each of the three locations is a high-speed star topology image network providing direct fiber connection (160 MB/s) from the local image storage unit (ISU) to the local radiology and clinical workstations. The clinic has 22 workstations in its star, the hospital has 13, and the primary care practice has two. In response to Mayo's request for a seamless service among the three locations, the vendor (GE Medical Systems, Milwaukee, WI) provided enhanced connectivity capability in a two-step process. First, a transfer gateway (TGW) was installed, tested, and implemented to provide the needed communication of the examinations generated at the three sites. Any examinations generated at either the hospital or the primary care facility (specified as the remote stars) automatically transfer their images to the ISU at the clinic. Permanent storage (Kodak optical jukebox, Rochester, NY) is only connected to the hub (Clinic) star. Thus, the hub ISU is provided with a copy of all examinations, while the two remote ISUs maintain local exams. Prefetching from the archive is intelligently accomplished during the off hours only to the hub star, thus providing the remote stars with network dependent access to comparison images. Image transfer is possible via remote log-on. The second step was the installation of an image transfer server (ITS) to replace the slower Digital Imaging and Communications in Medicine (DICOM)-based TGW, and a central higher performance database to replace the multiple database environment. This topology provides an enterprise view of the images at the three locations, while maintaining the high-speed performance of the local star connection to what is now called the short-term storage (STS). Performance was measured and 25 chest examinations (17 MB each) transferred in just over 4 minutes. Integration of the radiology information management system (RIMS) was modified to provide location-specific report and examination interfaces, thereby allowing local filtering of the worklist to remote and near real-time consultation, and remote examination monitoring of modalities are addressed with this technologic approach. The installation of the single database ITS environment has occurred for testing prior to implementation.

77 FR 37573 - Effective Date of Requirement for Premarket Approval for an Implantable Pacemaker Pulse Generator

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... triggered, inhibited, and asynchronous modes and is implanted in the human body. * * * * * (c) Date PMA or... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 870 [Docket No..., established a comprehensive system for the regulation of medical devices intended for human use. Section 513...

[Implementation of telemedicine services in the earthquake disaster relief: the best medical experts provide direct medical service to the affected people].

PubMed

Li, Tan-shi; Chai, Jia-ke

2013-05-01

To sum up the experience and significance of the remote medical consultation system used by the PLA General Hospital in 4/20 Sichuan Lushan earthquake medical rescue in 2013. After the Lushan earthquake in April 20, 2013, the expert medical rescue team of the PLA General Hospital immediately took the wireless portable telemedicine system to the converge hospital which had received many wounds in earthquake and had been connected with other hospitals, medical rescue teams and rescue ambulances to open the remote medical consultation system for disaster services including intensive care, emergency treatment, orthopedics, cerebral surgery, hepatobiliary surgery, obstetrics, gynecology and other related professional remote assistance services. The experts put forward the diagnosis and treatment for victims and had a benign interaction between the experts in disaster site and rear experts, as a result improved the ability of treatment of the disaster expert medical team. The PLA General Hospital treated more than 110 patients by remote medical consultation system in the Lushan earthquake and achieved real-time HD consultation and on-site operation guide. The using of remote medical consultation system achieved the connection between multimedia communication system and medical information system of the hospital and the interconnection of video, audio, data and medical services among each united hospitals, which can provide the significant experience of using remote medical consultation system in our disaster medical rescue activities.

Maintaining High Assurance in Asynchronous Messaging

DTIC Science & Technology

2015-10-24

Assurance in Asynchronous Messaging Kevin E. Foltz and William R. Simpson Abstract—Asynchronous messaging is the delivery of a message without... integrity , and confidentiality guarantees. End-to-end security for asynchronous messaging must be provided by the asynchronous messaging layer itself... continuing its processing. At the completion of message transmission, the sender does not know when or whether the receiver received it. The message

Highly Scalable Asynchronous Computing Method for Partial Differential Equations: A Path Towards Exascale

NASA Astrophysics Data System (ADS)

Konduri, Aditya

Many natural and engineering systems are governed by nonlinear partial differential equations (PDEs) which result in a multiscale phenomena, e.g. turbulent flows. Numerical simulations of these problems are computationally very expensive and demand for extreme levels of parallelism. At realistic conditions, simulations are being carried out on massively parallel computers with hundreds of thousands of processing elements (PEs). It has been observed that communication between PEs as well as their synchronization at these extreme scales take up a significant portion of the total simulation time and result in poor scalability of codes. This issue is likely to pose a bottleneck in scalability of codes on future Exascale systems. In this work, we propose an asynchronous computing algorithm based on widely used finite difference methods to solve PDEs in which synchronization between PEs due to communication is relaxed at a mathematical level. We show that while stability is conserved when schemes are used asynchronously, accuracy is greatly degraded. Since message arrivals at PEs are random processes, so is the behavior of the error. We propose a new statistical framework in which we show that average errors drop always to first-order regardless of the original scheme. We propose new asynchrony-tolerant schemes that maintain accuracy when synchronization is relaxed. The quality of the solution is shown to depend, not only on the physical phenomena and numerical schemes, but also on the characteristics of the computing machine. A novel algorithm using remote memory access communications has been developed to demonstrate excellent scalability of the method for large-scale computing. Finally, we present a path to extend this method in solving complex multi-scale problems on Exascale machines.

Synchronous distance interactive classroom conferencing.

PubMed

Oz, Halit Hami

2005-01-01

New medical schools have been opened in the eastern and southeastern regions of the country. They are also in great need of basic medical science teachers. However, due to security reasons over the past two decades, teachers from the established universities do not desire to travel to these medical schools for lectures. The objective of this study was to develop a synchronous classroom conferencing system to teach basic science courses between two general purpose technology enhanced classrooms of two different universities--Istanbul University (IU) and Istanbul and Harran University (HU), Urfa--located 1,500 miles apart in Turkey. I videostreamed the instructor, content from document camera, Power Point presentations at IU, and the students at both places, IU and HU. In addition, I synchronously broadcast two whiteboards by attaching two mimio devices to the two blackboards in the IU classroom to capture and convert everything written or drawn on them into broadcasting over the intranet. This technique is called "boardcasting," which allows users to stream ink and audio together over the Internet or intranet live. A total of 260 students at IU and 150 students at HU were involved. Off-campus HU students also have asynchronous access to the stored lecture video materials at any time. Midterm and final examinations were administered simultaneously using the same questions at both sites in two universities under the observation of the teaching faculty using the very same system. This system permitted interaction between the students in the class at IU and remote-campus students at HU and the instructor in real time. The instructors at IU were able to maintain a significant level of spontaneity in using their multimedia materials and electronic whiteboards. The mean midterm and final exam scores of students at both universities were similar. The system developed in this study can be used by the medical faculty at the main teaching hospitals to deliver their lectures in real time to the medical students when they are on placement in general practices, ambulatory clinics, and district hospitals in rural areas or to the students of other medical schools. This is an efficacious system in developing countries where availability of high-speed networks and cost of communication are major concerns.

Asynchronous automated electronic laboratory result notifications: a systematic review.

PubMed

Slovis, Benjamin H; Nahass, Thomas A; Salmasian, Hojjat; Kuperman, Gilad; Vawdrey, David K

2017-11-01

To systematically review the literature pertaining to asynchronous automated electronic notifications of laboratory results to clinicians. PubMed, Web of Science, and the Cochrane Collaboration were queried for studies pertaining to automated electronic notifications of laboratory results. A title review was performed on the primary results, with a further abstract review and full review to produce the final set of included articles. The full review included 34 articles, representing 19 institutions. Of these, 19 reported implementation and design of systems, 11 reported quasi-experimental studies, 3 reported a randomized controlled trial, and 1 was a meta-analysis. Twenty-seven articles included alerts of critical results, while 5 focused on urgent notifications and 2 on elective notifications. There was considerable variability in clinical setting, system implementation, and results presented. Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from >10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes. © 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

Medical Applications of Remote Electronic Browsing.

ERIC Educational Resources Information Center

Chadwick, Joseph

The purposes of this study are to identify and define viable remote browsing techniques and the requirements for an interactive medical information system that would permit the use of such techniques. The main emphasis is in the areas of: (1) remote viewing of page material; and (2) remote interrogation of fact banks with question-answering…

An 'electronic' extramural course in epidemiology and medical statistics.

PubMed

Ostbye, T

1989-03-01

This article describes an extramural university course in epidemiology and medical statistics taught using a computer conferencing system, microcomputers and data communications. Computer conferencing was shown to be a powerful, yet quite easily mastered, vehicle for distance education. It allows health personnel unable to attend regular classes due to geographical or time constraints, to take part in an interactive learning environment at low cost. This overcomes part of the intellectual and social isolation associated with traditional correspondence courses. Teaching of epidemiology and medical statistics is well suited to computer conferencing, even if the asynchronicity of the medium makes discussion of the most complex statistical concepts a little cumbersome. Computer conferencing may also prove to be a useful tool for teaching other medical and health related subjects.

Acceptability of an Asynchronous Learning Forum on Mobile Devices

ERIC Educational Resources Information Center

Chang, Chih-Kai

2010-01-01

Mobile learning has recently become noteworthy because mobile devices have become popular. To construct an asynchronous learning forum on mobile devices is important because an asynchronous learning forum is always an essential part of networked asynchronous distance learning. However, the input interface in handheld learning devices, which is…

The Influence of Asynchronous Video Communication on Learner Social Presence: A Narrative Analysis of Four Cases

ERIC Educational Resources Information Center

Borup, Jered; West, Richard E.; Graham, Charles R.

2013-01-01

Online courses are increasingly using asynchronous video communication. However, little is known about how asynchronous video communication influences students' communication patterns. This study presents four narratives of students with varying characteristics who engaged in asynchronous video communication. The extrovert valued the efficiency of…

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients.

PubMed

Moreno, Gerardo; Lin, Elizabeth H; Chang, Eva; Johnson, Ron L; Berthoud, Heidi; Solomon, Cam C; Morales, Leo S

2016-03-01

Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems. To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions. Cross-sectional survey in six languages/dialects (English, Cantonese, Mandarin, Korean, Vietnamese, and Spanish) of 509 adults with diabetes, hypertension, or hyperlipidemia. Primary study outcomes were self-reported use of 1) Internet refills, 2) telephone refills, and 3) any remote refill system. LEP was measured by patient self-identification of a primary language other than English and a claims record of use of an interpreter. Other measures were age, gender, education, years in the U.S., insurance, health status, chronic conditions, and number of prescribed medications. Analyses included multivariable logistic regression weighted for survey non-response. Overall, 33.1 % of patients refilled their medications by telephone and 31.6 % by Internet. Among LEP patients (n = 328), 31.5 % refilled by telephone and 21.2 % by Internet, compared with 36.7 % by telephone and 52.7 % by Internet among EP patients (n = 181). Internet refill by language groups were as follows: English (52.7 %), Cantonese (34.9 %), Mandarin (17.4 %), Korean (16.7 %), Vietnamese (24.4 %), and Spanish (12.6 %). Compared to EP patients, LEP patients had lower use of any remote refill system (adjusted odds ratio [AOR] 0.18; p < 0.001), CONCLUSIONS: LEP patients are significantly less likely than EP patients to use any remote medication refill system. Increased reliance on current systems for remote medication refills may increase disparities in health outcomes affecting LEP patients with poor access to telephone and Internet medication refills.

Pharmacists' perception of synchronous versus asynchronous distance learning for continuing education programs.

PubMed

Buxton, Eric C

2014-02-12

To evaluate and compare pharmacists' satisfaction with the content and learning environment of a continuing education program series offered as either synchronous or asynchronous webinars. An 8-lecture series of online presentations on the topic of new drug therapies was offered to pharmacists in synchronous and asynchronous webinar formats. Participants completed a 50-question online survey at the end of the program series to evaluate their perceptions of the distance learning experience. Eighty-two participants completed the survey instrument (41 participants from the live webinar series and 41 participants from the asynchronous webinar series.) Responses indicated that while both groups were satisfied with the program content, the asynchronous group showed greater satisfaction with many aspects of the learning environment. The synchronous and asynchronous webinar participants responded positively regarding the quality of the programming and the method of delivery, but asynchronous participants rated their experience more positively overall.

Pharmacists’ Perception of Synchronous Versus Asynchronous Distance Learning for Continuing Education Programs

PubMed Central

2014-01-01

Objective. To evaluate and compare pharmacists’ satisfaction with the content and learning environment of a continuing education program series offered as either synchronous or asynchronous webinars. Methods. An 8-lecture series of online presentations on the topic of new drug therapies was offered to pharmacists in synchronous and asynchronous webinar formats. Participants completed a 50-question online survey at the end of the program series to evaluate their perceptions of the distance learning experience. Results. Eighty-two participants completed the survey instrument (41 participants from the live webinar series and 41 participants from the asynchronous webinar series.) Responses indicated that while both groups were satisfied with the program content, the asynchronous group showed greater satisfaction with many aspects of the learning environment. Conclusion. The synchronous and asynchronous webinar participants responded positively regarding the quality of the programming and the method of delivery, but asynchronous participants rated their experience more positively overall. PMID:24558276

Comparing the force ripple during asynchronous and conventional stimulation.

PubMed

Downey, Ryan J; Tate, Mark; Kawai, Hiroyuki; Dixon, Warren E

2014-10-01

Asynchronous stimulation has been shown to reduce fatigue during electrical stimulation; however, it may also exhibit a force ripple. We quantified the ripple during asynchronous and conventional single-channel transcutaneous stimulation across a range of stimulation frequencies. The ripple was measured during 5 asynchronous stimulation protocols, 2 conventional stimulation protocols, and 3 volitional contractions in 12 healthy individuals. Conventional 40 Hz and asynchronous 16 Hz stimulation were found to induce contractions that were as smooth as volitional contractions. Asynchronous 8, 10, and 12 Hz stimulation induced contractions with significant ripple. Lower stimulation frequencies can reduce fatigue; however, they may also lead to increased ripple. Future efforts should study the relationship between force ripple and the smoothness of the evoked movements in addition to the relationship between stimulation frequency and NMES-induced fatigue to elucidate an optimal stimulation frequency for asynchronous stimulation. © 2014 Wiley Periodicals, Inc.

Synchronous Office Hours in an Asynchronous Course: Making the Connection

ERIC Educational Resources Information Center

Gibbons-Kunka, Beatrice

2017-01-01

The notion of synchronous office hours in an asynchronous course seems counterintuitive. After all, one of the tenets of asynchronous education is to not require students to be online and participating at any time during the course. Having taught higher education online asynchronous courses for twenty years, the researcher experimented with online…

Fiber optic cable-based high-resolution, long-distance VGA extenders

NASA Astrophysics Data System (ADS)

Rhee, Jin-Geun; Lee, Iksoo; Kim, Heejoon; Kim, Sungjoon; Koh, Yeon-Wan; Kim, Hoik; Lim, Jiseok; Kim, Chur; Kim, Jungwon

2013-02-01

Remote transfer of high-resolution video information finds more applications in detached display applications for large facilities such as theaters, sports complex, airports, and security facilities. Active optical cables (AOCs) provide a promising approach for enhancing both the transmittable resolution and distance that standard copper-based cables cannot reach. In addition to the standard digital formats such as HDMI, the high-resolution, long-distance transfer of VGA format signals is important for applications where high-resolution analog video ports should be also supported, such as military/defense applications and high-resolution video camera links. In this presentation we present the development of a compressionless, high-resolution (up to WUXGA, 1920x1200), long-distance (up to 2 km) VGA extenders based on serialized technique. We employed asynchronous serial transmission and clock regeneration techniques, which enables lower cost implementation of VGA extenders by removing the necessity for clock transmission and large memory at the receiver. Two 3.125-Gbps transceivers are used in parallel to meet the required maximum video data rate of 6.25 Gbps. As the data are transmitted asynchronously, 24-bit pixel clock time stamp is employed to regenerate video pixel clock accurately at the receiver side. In parallel to the video information, stereo audio and RS-232 control signals are transmitted as well.

An epigenetic state associated with areas of gene duplication

PubMed Central

Gimelbrant, Alexander A.; Chess, Andrew

2006-01-01

Asynchronous DNA replication is an epigenetically determined feature found in all cases of monoallelic expression, including genomic imprinting, X-inactivation, and random monoallelic expression of autosomal genes such as immunoglobulins and olfactory receptor genes. Most genes of the latter class were identified in experiments focused on genes functioning in the chemosensory and immune systems. We performed an unbiased survey of asynchronous replication in the mouse genome, excluding known asynchronously replicated genes. Fully 10% (eight of 80) of the genes tested exhibited asynchronous replication. A common feature of the newly identified asynchronously replicated areas is their proximity to areas of tandem gene duplication. Testing of other clustered areas supported the idea that such regions are enriched with asynchronously replicated genes. PMID:16687731

JSC Pharmacy Services for Remote Operations

NASA Technical Reports Server (NTRS)

Stoner, Paul S.; Bayuse, Tina

2005-01-01

The Johnson Space Center Pharmacy began operating in March of 2003. The pharmacy serves in two main capacities: to directly provide medications and services in support of the medical clinics at the Johnson Space Center, physician travel kits for NASA flight surgeon staff, and remote operations, such as the clinics in Devon Island, Star City and Moscow; and indirectly provide medications and services for the International Space Station and Space Shuttle medical kits. Process changes that occurred and continued to evolve in the advent of the installation of the new JSC Pharmacy, and the process of stocking medications for each of these aforementioned areas will be discussed. Methods: The incorporation of pharmacy involvement to provide services for remote operations and supplying medical kits was evaluated. The first step was to review the current processes and work the JSC Pharmacy into the existing system. The second step was to provide medications to these areas. Considerations for the timeline of expiring medications for shipment are reviewed with each request. The third step was the development of a process to provide accountability for the medications. Results: The JSC Pharmacy utilizes a pharmacy management system to document all medications leaving the pharmacy. Challenges inherent to providing medications to remote areas were encountered. A process has been designed to incorporate usage into the electronic medical record upon return of the information from these remote areas. This is an evolving program and several areas have been identified for further improvement.

Research and Development for Advanced Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices

DTIC Science & Technology

2009-09-01

Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices PRINCIPAL INVESTIGATOR...Remote Serial Console Access and Proactive Monitoring of Medical Devices 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...ORGANIZATION REPORT NUMBER Concepteers LLC 880 Bergen Avenue, Suite 403 Jersey City, NJ 07306 9. SPONSORING / MONITORING

3D web based learning of medical equipment employed in intensive care units.

PubMed

Cetin, Aydın

2012-02-01

In this paper, both synchronous and asynchronous web based learning of 3D medical equipment models used in hospital intensive care unit have been described over the moodle course management system. 3D medical equipment models were designed with 3ds Max 2008, then converted to ASE format and added interactivity displayed with Viewpoint-Enliven. 3D models embedded in a web page in html format with dynamic interactivity-rotating, panning and zooming by dragging a mouse over images-and descriptive information is embedded to 3D model by using xml format. A pilot test course having 15 h was applied to technicians who is responsible for intensive care unit at Medical Devices Repairing and Maintenance Center (TABOM) of Turkish High Specialized Hospital.

A Phenomenological Synapse Model for Asynchronous Neurotransmitter Release

PubMed Central

Wang, Tao; Yin, Luping; Zou, Xiaolong; Shu, Yousheng; Rasch, Malte J.; Wu, Si

2016-01-01

Neurons communicate with each other via synapses. Action potentials cause release of neurotransmitters at the axon terminal. Typically, this neurotransmitter release is tightly time-locked to the arrival of an action potential and is thus called synchronous release. However, neurotransmitter release is stochastic and the rate of release of small quanta of neurotransmitters can be considerably elevated even long after the ceasing of spiking activity, leading to asynchronous release of neurotransmitters. Such asynchronous release varies for tissue and neuron types and has been shown recently to be pronounced in fast-spiking neurons. Notably, it was found that asynchronous release is enhanced in human epileptic tissue implicating a possibly important role in generating abnormal neural activity. Current neural network models for simulating and studying neural activity virtually only consider synchronous release and ignore asynchronous transmitter release. Here, we develop a phenomenological model for asynchronous neurotransmitter release, which, on one hand, captures the fundamental features of the asynchronous release process, and, on the other hand, is simple enough to be incorporated in large-size network simulations. Our proposed model is based on the well-known equations for short-term dynamical synaptic interactions and includes an additional stochastic term for modeling asynchronous release. We use experimental data obtained from inhibitory fast-spiking synapses of human epileptic tissue to fit the model parameters, and demonstrate that our model reproduces the characteristics of realistic asynchronous transmitter release. PMID:26834617

Medical care delivery in the US space program

NASA Technical Reports Server (NTRS)

Stewart, Donald F.

1991-01-01

The stated goal of this meeting is to examine the use of telemedicine in disaster management, public health, and remote health care. NASA has a vested interest in providing health care to crews in remote environments. NASA has unique requirements for telemedicine support, in that our flight crews conduct their job in the most remote of all work environments. Compounding the degree of remoteness are other environmental concerns, including confinement, lack of atmosphere, spaceflight physiological deconditioning, and radiation exposure, to name a few. In-flight medical care is a key component in the overall support for missions, which also includes extensive medical screening during selection, preventive medical programs for astronauts, and in-flight medical monitoring and consultation. This latter element constitutes the telemedicine aspect of crew health care. The level of in-flight resources dedicated to medical care is determined by the perceived risk of a given mission, which in turn is related to mission duration, planned crew activities, and length of time required for return to definitive medical care facilities.

Patterns of computer usage among medical practitioners in rural and remote Queensland.

PubMed

White, Col; Sheedy, Vicki; Lawrence, Nicola

2002-06-01

As part of a more detailed needs analysis, patterns of computer usage among medical practitioners in rural and remote Queensland were investigated. Utilising a questionnaire approach, a response rate of 23.82% (n = 131) was obtained. Results suggest that medical practitioners in rural and remote Queensland are relatively sophisticated in their use of computer and information technologies and have embraced computerisation to a substantially higher extent compared with their urban counterparts and previously published estimates. Findings also indicate that a substantial number of rural and remote practitioners are utilising computer and information technologies for clinical purposes such as pathology, patient information sheets, prescribing, education, patient records and patient recalls. Despite barriers such as bandwidth limitations, cost and the sometimes unreliable quality of Internet service providers, a majority of rural and remote respondents rated an Internet site with continuing medical education information and services as being important or very important. Suggestions that "rural doctors are slow to adapt to new technologies" are questioned, with findings indicating that rural and remote medical practitioners in Queensland have adapted to, and utilise, information technology to a far higher extent than has been previously documented.

Medical student evaluations of lectures attended in person or from rural sites via interactive videoconferencing.

PubMed

Callas, Peter W; Bertsch, Tania F; Caputo, Michael P; Flynn, Brian S; Doheny-Farina, Stephen; Ricci, Michael A

2004-01-01

Interactive videoconferencing may be an effective way for medical students on remote rotations to attend teaching sessions at the main campus. To compare medical student evaluations of lectures for those attending in person and those attending through interactive videoconferencing. Lecture evaluations were completed by medical students on University of Vermont College of Medicine clinical clerkship rotations. Students on clerkships at rural sites attended lectures using our telemedicine network. Responses from in-person and remote attendees were compared. Evaluation forms for 110 lectures were received from 648 in-person and 255 remote attendees. All evaluation items were rated "good" or "excellent" by at least 95% of in-person attendees. Over 90% of remote attendees rated nontelemedicine evaluation items, such as appropriateness of lecture topic for students, as good or excellent. Ratings of telemedicine-specific questions, such as ability to hear the lecturer, were lower. Level of satisfaction was high for most aspects of remote lecture attendance, although not quite as high as for in-person attendance. Improved technical reliability would likely increase remote attendee satisfaction. Overall, lecture attendance using videoconferencing was found to be an acceptable alternative to travel for medical students in rural clerkships.

Construction of a smart medication dispenser with high degree of scalability and remote manageability.

PubMed

Pak, JuGeon; Park, KeeHyun

2012-01-01

We propose a smart medication dispenser having a high degree of scalability and remote manageability. We construct the dispenser to have extensible hardware architecture for achieving scalability, and we install an agent program in it for achieving remote manageability. The dispenser operates as follows: when the real-time clock reaches the predetermined medication time and the user presses the dispense button at that time, the predetermined medication is dispensed from the medication dispensing tray (MDT). In the proposed dispenser, the medication for each patient is stored in an MDT. One smart medication dispenser contains mainly one MDT; however, the dispenser can be extended to include more MDTs in order to support multiple users using one dispenser. For remote management, the proposed dispenser transmits the medication status and the system configurations to the monitoring server. In the case of a specific event such as a shortage of medication, memory overload, software error, or non-adherence, the event is transmitted immediately. All these operations are performed automatically without the intervention of patients, through the agent program installed in the dispenser. Results of implementation and verification show that the proposed dispenser operates normally and performs the management operations from the medication monitoring server suitably.

How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study

PubMed Central

Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

2017-01-01

Objectives Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. Design A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. Setting 4 DAPs at 2 teaching and 2 community hospitals in Canada. Participants 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Results Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural–remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. Conclusions This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. PMID:28235969

Asynchronous Video Streaming vs. Synchronous Videoconferencing for Teaching a Pharmacogenetic Pharmacotherapy Course

PubMed Central

2007-01-01

Objectives To compare students' performance and course evaluations for a pharmacogenetic pharmacotherapy course taught by synchronous videoconferencing method via the Internet and for the same course taught via asynchronous video streaming via the Internet. Methods In spring 2005, a pharmacogenetic therapy course was taught to 73 students located on Amarillo, Lubbock, and Dallas campuses using synchronous videoconferencing, and in spring 2006, to 78 students located on the same 3 campuses using asynchronous video streaming. A course evaluation was administered to each group at the end of the courses. Results Students in the asynchronous setting had final course grades of 89% ± 7% compared to the mean final course grade of 87% ± 7% in the synchronous group (p = 0.05). Regardless of which technology was used, average course grades did not differ significantly among the 3 campus sites. Significantly more of the students in the asynchronous setting agreed (57%) with the statement that they could read the lecture notes and absorb the content on their own without attending the class than students in the synchronous class (23%; chi-square test; p < 0.001). Conclusions Students in both asynchronous and synchronous settings performed well. However, students taught using asynchronous videotaped lectures had lower satisfaction with the method of content delivery, and preferred live interactive sessions or a mix of interactive sessions and asynchronous videos over delivery of content using the synchronous or asynchronous method alone. PMID:17429516

Medics as a channel for worksite health promotion in remote global locations.

PubMed

Bisits Bullen, Piroska A

2012-01-01

In the energy and mining sectors, it is common for employees to work in geographically remote locations, often with a medic for emergency response. This study evaluated an intervention to increase the number of medics conducting health promotion in remote worksites. Interviews were conducted to gather data for informing intervention and survey development. The intervention was evaluated in a quasiexperimental posttest-only comparison group design using survey data collected at baseline and again after 12 months. The intervention was implemented in remote worksites (N  =  201). There were 96 worksites in the intervention condition and 105 sites in the control condition. The target population was medics, including nurses, doctors, and paramedics, operating in remote worksites in 44 countries. The intervention was a series of campaign tool kits. The tool kits were adapted to the remote environment and could be customized for culture, language, and education level. The survey assessed frequency of health promotion activities, satisfaction with the intervention, and barriers to implementation. Survey data were analyzed using descriptive statistics and χ(2) tests. Interview results were coded to identify themes. Most medics (88%) in the intervention group reported running "tool box talks" (short education sessions) on at least a monthly basis, compared with 78% in the comparison group (p  =  .056). The trend was similar for displaying posters (71% vs. 55%; p  =  .021) and advocating for policy changes (84% vs. 71%; p  =  .027). Medic satisfaction was high. Difficulty distributing tool kits was the main barrier to implementation. When provided with appropriate tools, medics may be an ideal channel for health promotion in remote worksites.

Building asynchronous geospatial processing workflows with web services

NASA Astrophysics Data System (ADS)

Zhao, Peisheng; Di, Liping; Yu, Genong

2012-02-01

Geoscience research and applications often involve a geospatial processing workflow. This workflow includes a sequence of operations that use a variety of tools to collect, translate, and analyze distributed heterogeneous geospatial data. Asynchronous mechanisms, by which clients initiate a request and then resume their processing without waiting for a response, are very useful for complicated workflows that take a long time to run. Geospatial contents and capabilities are increasingly becoming available online as interoperable Web services. This online availability significantly enhances the ability to use Web service chains to build distributed geospatial processing workflows. This paper focuses on how to orchestrate Web services for implementing asynchronous geospatial processing workflows. The theoretical bases for asynchronous Web services and workflows, including asynchrony patterns and message transmission, are examined to explore different asynchronous approaches to and architecture of workflow code for the support of asynchronous behavior. A sample geospatial processing workflow, issued by the Open Geospatial Consortium (OGC) Web Service, Phase 6 (OWS-6), is provided to illustrate the implementation of asynchronous geospatial processing workflows and the challenges in using Web Services Business Process Execution Language (WS-BPEL) to develop them.

Social accountability in medical education--an Australian rural and remote perspective.

PubMed

Worley, Paul; Murray, Richard

2011-01-01

Australia's medical education system is undergoing a socially motivated transformation focused on improving access to medical care for rural and remote communities. A rural and remote backbone of Rural Clinical Schools (RCS), University Departments of Rural Health, regional medical schools, and the postgraduate college, ACRRM, have enabled community responsive innovation and partnerships with rural health services that once would have been difficult to imagine. This article argues that this transformation is succeeding because of the passionate leadership of rural medical and community leaders, government seed funding to encourage rural medicine as an academic discipline, rigorous research and consultation that underpinned each step of the innovation pathway, and a political campaign to invest in rural medical education as a form of rural social capital.

PubMed Interact: an Interactive Search Application for MEDLINE/PubMed

PubMed Central

Muin, Michael; Fontelo, Paul; Ackerman, Michael

2006-01-01

Online search and retrieval systems are important resources for medical literature research. Progressive Web 2.0 technologies provide opportunities to improve search strategies and user experience. Using PHP, Document Object Model (DOM) manipulation and Asynchronous JavaScript and XML (Ajax), PubMed Interact allows greater functionality so users can refine search parameters with ease and interact with the search results to retrieve and display relevant information and related articles. PMID:17238658

A Retrospective Evaluation of Remote Pharmacist Interventions in a Telepharmacy Service Model Using a Conceptual Framework

PubMed Central

Murante, Lori J.; Moffett, Lisa M.

2014-01-01

Abstract Objectives: This retrospective cross-sectional study evaluated a telepharmacy service model using a conceptual framework to compare documented remote pharmacist interventions by year, hospital, and remote pharmacist and across rural hospitals with or without an on-site rural hospital pharmacist. Materials and Methods: Documented remote pharmacist interventions for patients at eight rural hospitals in the Midwestern United States during prospective prescription order review/entry from 2008 to 2011 were extracted from RxFusion® database (a home-grown system, i.e., internally developed program at The Nebraska Medical Center (TNMC) for capturing remote pharmacist-documented intervention data). The study authors conceptualized an analytical framework, mapping the 37 classes of remote pharmacist interventions to three broader-level definitions: (a) intervention, eight categories (interaction/potential interaction, contraindication, adverse effects, anticoagulation monitoring, drug product selection, drug regimen, summary, and recommendation), (b) patient medication management, two categories (therapy review and action), and (c) health system-centered medication use process, four categories (prescribing, transcribing and documenting, administering, and monitoring). Frequencies of intervention levels were compared by year, hospital, remote pharmacist, and hospital pharmacy status (with a remote pharmacist and on-site pharmacist or with a remote pharmacist only) using chi-squared test and univariate logistic regression analyses, as appropriate. Results: For 450,000 prescription orders 19,222 remote pharmacist interventions were documented. Frequency of interventions significantly increased each year (36% in 2009, 55% in 2010, and 7% in 2011) versus the baseline year (2008, 3%) when service started. The frequency of interventions also differed significantly across the eight hospitals and 16 remote pharmacists for the three defined intervention levels and categories. Remote pharmacist interventions at hospitals with an on-site and remote pharmacist (n=12,141) versus those with a remote pharmacist alone (n=7,081) were significantly more likely to be (1) patient-centered, (2) related to “actionable” medication management recommendations (unadjusted odds ratio [OR]=1.12), and (3) related to the “transcribing” (OR=1.47) and “prescribing” (OR=1.40) steps of the health system-centered medication use process level (all p<0.01). Conclusions: This is one of the first studies to demonstrate the patient- and health system-centered nature of pharmaceutical care delivered via a telepharmacy service model by evaluating documented remote pharmacist interventions with an analytical framework. PMID:24611489

Free open access medical education can help rural clinicians deliver 'quality care, out there'.

PubMed

Leeuwenburg, Tim J; Parker, Casey

2015-01-01

Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessible crowd-sourced adjunct, providing inline (contextual) and offline (asynchronous) content to augment traditional educational principles and the availability of relevant resources for life-long learning. This markedly reduces knowledge translation (the delay from inception of a new idea to bedside implementation) and allows rural clinicians to further expertise by engaging in discussion of cutting edge concepts with peers worldwide.

Issues in ATM Support of High-Performance, Geographically Distributed Computing

NASA Technical Reports Server (NTRS)

Claus, Russell W.; Dowd, Patrick W.; Srinidhi, Saragur M.; Blade, Eric D.G

1995-01-01

This report experimentally assesses the effect of the underlying network in a cluster-based computing environment. The assessment is quantified by application-level benchmarking, process-level communication, and network file input/output. Two testbeds were considered, one small cluster of Sun workstations and another large cluster composed of 32 high-end IBM RS/6000 platforms. The clusters had Ethernet, fiber distributed data interface (FDDI), Fibre Channel, and asynchronous transfer mode (ATM) network interface cards installed, providing the same processors and operating system for the entire suite of experiments. The primary goal of this report is to assess the suitability of an ATM-based, local-area network to support interprocess communication and remote file input/output systems for distributed computing.

Extreme Tele-Echocardiography: Methodology for Remote Guidance of In-Flight Echocardiography Aboard the International Space Station

NASA Technical Reports Server (NTRS)

Martin, David S.; Borowski, Allan; Bungo, Michael W.; Gladding, Patrick; Greenberg, Neil; Hamilton, Doug; Levine, Benjamin D.; Lee, Stuart M.; Norwood, Kelly; Platts, Steven H.;

Wearable technologies for soldier first responder assessment and remote monitoring (Conference Presentation)

NASA Astrophysics Data System (ADS)

Lee, Stephen

2017-05-01

Embedded combat medical personnel require accurate and timely biometric data to ensure appropriate life saving measures. Injured warfighter's operating in remote environments require both assessment and monitoring often while still engaged with enemy forces. Small wearable devices that can be placed on injured personnel capable of collecting essential biometric data, including the capacity to remotely deliver collected data in real-time, would allow additional medical monitoring and triage that will greatly help the medic in the battlefield. These new capabilities will provide a force multiplier through remote assessment, increased survivability, and in freeing engaged warfighter's from direct monitoring thus improving combat effectiveness and increasing situational awareness. Key questions around what information does the medic require and how effective it can be relayed to support personnel are at their early stages of development. A low power biometric wearable device capable of reliable electrocardiogram (EKG) rhythm, temperature, pulse, and other vital data collection which can provide real-time remote monitoring are in development for the Soldier.

How do general practice residents use social networking sites in asynchronous distance learning?

PubMed

Maisonneuve, Hubert; Chambe, Juliette; Lorenzo, Mathieu; Pelaccia, Thierry

2015-09-21

Blended learning environments - involving both face-to-face and remote interactions - make it easier to adapt learning programs to constraints such as residents' location and low teacher-student ratio. Social networking sites (SNS) such as Facebook®, while not originally intended to be used as learning environments, may be adapted for the distance-learning part of training programs. The purpose of our study was to explore the use of SNS for asynchronous distance learning in a blended learning environment as well as its influence on learners' face-to-face interactions. We conducted a qualitative study and carried out semi-structured interviews. We performed purposeful sampling for maximal variation to include eight general practice residents in 2(nd) and 3(rd) year training. A thematic analysis was performed. The social integration of SNS facilitates the engagement of users in their learning tasks. This may also stimulate students' interactions and group cohesion when members meet up in person. Most of the general practice residents who work in the blended learning environment we studied had a positive appraisal on their use of SNS. In particular, we report a positive impact on their engagement in learning and their participation in discussions during face-to-face instruction. Further studies are needed in order to evaluate the effectiveness of SNS in blended learning environments and the appropriation of SNS by teachers.

The Role of Audio-Visual Feedback in a Thought-Based Control of a Humanoid Robot: A BCI Study in Healthy and Spinal Cord Injured People.

PubMed

Tidoni, Emmanuele; Gergondet, Pierre; Fusco, Gabriele; Kheddar, Abderrahmane; Aglioti, Salvatore M

2017-06-01

The efficient control of our body and successful interaction with the environment are possible through the integration of multisensory information. Brain-computer interface (BCI) may allow people with sensorimotor disorders to actively interact in the world. In this study, visual information was paired with auditory feedback to improve the BCI control of a humanoid surrogate. Healthy and spinal cord injured (SCI) people were asked to embody a humanoid robot and complete a pick-and-place task by means of a visual evoked potentials BCI system. Participants observed the remote environment from the robot's perspective through a head mounted display. Human-footsteps and computer-beep sounds were used as synchronous/asynchronous auditory feedback. Healthy participants achieved better placing accuracy when listening to human footstep sounds relative to a computer-generated sound. SCI people demonstrated more difficulty in steering the robot during asynchronous auditory feedback conditions. Importantly, subjective reports highlighted that the BCI mask overlaying the display did not limit the observation of the scenario and the feeling of being in control of the robot. Overall, the data seem to suggest that sensorimotor-related information may improve the control of external devices. Further studies are required to understand how the contribution of residual sensory channels could improve the reliability of BCI systems.

Synchronization of Hierarchical Time-Varying Neural Networks Based on Asynchronous and Intermittent Sampled-Data Control.

PubMed

Xiong, Wenjun; Patel, Ragini; Cao, Jinde; Zheng, Wei Xing

In this brief, our purpose is to apply asynchronous and intermittent sampled-data control methods to achieve the synchronization of hierarchical time-varying neural networks. The asynchronous and intermittent sampled-data controllers are proposed for two reasons: 1) the controllers may not transmit the control information simultaneously and 2) the controllers cannot always exist at any time . The synchronization is then discussed for a kind of hierarchical time-varying neural networks based on the asynchronous and intermittent sampled-data controllers. Finally, the simulation results are given to illustrate the usefulness of the developed criteria.In this brief, our purpose is to apply asynchronous and intermittent sampled-data control methods to achieve the synchronization of hierarchical time-varying neural networks. The asynchronous and intermittent sampled-data controllers are proposed for two reasons: 1) the controllers may not transmit the control information simultaneously and 2) the controllers cannot always exist at any time . The synchronization is then discussed for a kind of hierarchical time-varying neural networks based on the asynchronous and intermittent sampled-data controllers. Finally, the simulation results are given to illustrate the usefulness of the developed criteria.

Digital Synchronizer without Metastability

NASA Technical Reports Server (NTRS)

Simle, Robert M.; Cavazos, Jose A.

2009-01-01

A proposed design for a digital synchronizing circuit would eliminate metastability that plagues flip-flop circuits in digital input/output interfaces. This metastability is associated with sampling, by use of flip-flops, of an external signal that is asynchronous with a clock signal that drives the flip-flops: it is a temporary flip-flop failure that can occur when a rising or falling edge of an asynchronous signal occurs during the setup and/or hold time of a flip-flop. The proposed design calls for (1) use of a clock frequency greater than the frequency of the asynchronous signal, (2) use of flip-flop asynchronous preset or clear signals for the asynchronous input, (3) use of a clock asynchronous recovery delay with pulse width discriminator, and (4) tying the data inputs to constant logic levels to obtain (5) two half-rate synchronous partial signals - one for the falling and one for the rising edge. Inasmuch as the flip-flop data inputs would be permanently tied to constant logic levels, setup and hold times would not be violated. The half-rate partial signals would be recombined to construct a signal that would replicate the original asynchronous signal at its original rate but would be synchronous with the clock signal.

The Effects of Asynchronous Visual Delays on Simulator Flight Performance and the Development of Simulator Sickness Symptomatology

DTIC Science & Technology

1986-12-26

NAVAL TRAINING SYSTEMS CENTER ORLANDO. FLORIDA IT FILE COPY THE EFFECTS OF ASYNCHRONOUS VISUAL DELAYS ON SIMULATOR FLIGHT PERFORMANCE AND THE...ASYNCHRONOUS VISUAL. DELAYS ON SI.WLATOR FLIGHT PERF OMANCE AND THE DEVELOPMENT OF SIMLATOR SICKNESS SYMPTOMATOLOGY K. C. Uliano, E. Y. Lambert, R. S. Kennedy...ACCESSION NO. N63733N SP-01 0785-7P6 I. 4780 11. TITLE (Include Security Classification) The Effects of Asynchronous Visual Delays on Simulator Flight

Modeling and Analysis of Mixed Synchronous/Asynchronous Systems

NASA Technical Reports Server (NTRS)

Driscoll, Kevin R.; Madl. Gabor; Hall, Brendan

2012-01-01

Practical safety-critical distributed systems must integrate safety critical and non-critical data in a common platform. Safety critical systems almost always consist of isochronous components that have synchronous or asynchronous interface with other components. Many of these systems also support a mix of synchronous and asynchronous interfaces. This report presents a study on the modeling and analysis of asynchronous, synchronous, and mixed synchronous/asynchronous systems. We build on the SAE Architecture Analysis and Design Language (AADL) to capture architectures for analysis. We present preliminary work targeted to capture mixed low- and high-criticality data, as well as real-time properties in a common Model of Computation (MoC). An abstract, but representative, test specimen system was created as the system to be modeled.

A novel comparator featured with input data characteristic

NASA Astrophysics Data System (ADS)

Jiang, Xiaobo; Ye, Desheng; Xu, Xiangmin; Zheng, Shuai

2016-03-01

Two types of low-power asynchronous comparators featured with input data statistical characteristic are proposed in this article. The asynchronous ripple comparator stops comparing at the first unequal bit but delivers the result to the least significant bit. The pre-stop asynchronous comparator can completely stop comparing and obtain results immediately. The proposed and contrastive comparators were implemented in SMIC 0.18 μm process with different bit widths. Simulation shows that the proposed pre-stop asynchronous comparator features the lowest power consumption, shortest average propagation delay and highest area efficiency among the comparators. Data path of low-density parity check decoder using the proposed pre-stop asynchronous comparators are most power efficient compared with other data paths with synthesised, clock gating and bitwise competition logic comparators.

Interactional Coherence in Asynchronous Learning Networks: A Rhetorical Approach

ERIC Educational Resources Information Center

Potter, Andrew

2008-01-01

Numerous studies have affirmed the value of asynchronous online communication as a learning resource. Several investigations, however, have indicated that discussions in asynchronous environments are often neither interactive nor coherent. The research reported sought to develop an enhanced understanding of interactional coherence, argumentation,…

Labeled Postings for Asynchronous Interaction

ERIC Educational Resources Information Center

ChanLin, Lih-Juan; Chen, Yong-Ting; Chan, Kung-Chi

2009-01-01

The Internet promotes computer-mediated communications, and so asynchronous learning network systems permit more flexibility in time, space, and interaction than synchronous mode of learning. The key point of asynchronous learning is the materials for web-aided teaching and the flow of knowledge. This research focuses on improving online…

An Asynchronous Augmentation to Traditional Course Delivery.

ERIC Educational Resources Information Center

Wolverton, Marvin L.; Wolverton, Mimi

Asynchronous augmentation facilitates distributed learning, which relies heavily on technology and self-learning. This paper reports the results of delivering a real estate principles course using an asynchronous course delivery format. It highlights one of many ways to enhance learning using technology, and it provides information concerning how…

A Taxonomy of Learning through Asynchronous Discussion

ERIC Educational Resources Information Center

Knowlton, Dave S.

2005-01-01

This article presents a five-tiered taxonomy that describes the nature of participation in, and learning through, asynchronous discussion. The taxonomy is framed by a constructivist view of asynchronous discussion. The five tiers of the taxonomy include the following: (a) passive participation, (b) developmental participation, (c) generative…

Designing Asynchronous Online Discussion Environments: Recent Progress and Possible Future Directions

ERIC Educational Resources Information Center

Gao, Fei; Zhang, Tianyi; Franklin, Teresa

2013-01-01

Asynchronous online discussion environments are important platforms to support learning. Research suggests, however, threaded forums, one of the most popular asynchronous discussion environments, do not often foster productive online discussions naturally. This paper explores how certain properties of threaded forums have affected or constrained…

Integrating Asynchronous Digital Design Into the Computer Engineering Curriculum

ERIC Educational Resources Information Center

Smith, S. C.; Al-Assadi, W. K.; Di, J.

2010-01-01

As demand increases for circuits with higher performance, higher complexity, and decreased feature size, asynchronous (clockless) paradigms will become more widely used in the semiconductor industry, as evidenced by the International Technology Roadmap for Semiconductors' (ITRS) prediction of a likely shift from synchronous to asynchronous design…

Actively Engaging Students in Asynchronous Online Classes. IDEA Paper #64

ERIC Educational Resources Information Center

Riggs, Shannon A.; Linder, Kathryn E.

2016-01-01

Active learning activities and pedagogical strategies can look different in online learning environments, particularly in asynchronous courses when students are not interacting with the instructor, or with each other, in real time. This paper suggests a three-pronged approach for conceptualizing active learning in the online asynchronous class:…

Exploring Asynchronous and Synchronous Tool Use in Online Courses

ERIC Educational Resources Information Center

Oztok, Murat; Zingaro, Daniel; Brett, Clare; Hewitt, Jim

2013-01-01

While the independent contributions of synchronous and asynchronous interaction in online learning are clear, comparatively less is known about the pedagogical consequences of using both modes in the same environment. In this study, we examine relationships between students' use of asynchronous discussion forums and synchronous private messages…

Teaching Presence and Communication Timeliness in Asynchronous Online Courses

ERIC Educational Resources Information Center

Skramstad, Erik; Schlosser, Charles; Orellana, Anymir

2012-01-01

This study examined student perceptions of teaching presence and communication timeliness in asynchronous online courses. Garrison, Anderson, and Archer's (2000) community of inquiry model provided the framework for the survey research methodology used. Participants were 59 student volunteers taking 1 or more asynchronous online graduate courses.…

Two Studies Examining Argumentation in Asynchronous Computer Mediated Communication

ERIC Educational Resources Information Center

Joiner, Richard; Jones, Sarah; Doherty, John

2008-01-01

Asynchronous computer mediated communication (CMC) would seem to be an ideal medium for supporting development in student argumentation. This paper investigates this assumption through two studies. The first study compared asynchronous CMC with face-to-face discussions. The transactional and strategic level of the argumentation (i.e. measures of…

Using Television Sitcoms to Facilitate Asynchronous Discussions in the Online Communication Course

ERIC Educational Resources Information Center

Tolman, Elizabeth; Asbury, Bryan

2012-01-01

Asynchronous discussions are a useful instructional resource in the online communication course. In discussion groups students have the opportunity to actively participate and interact with students and the instructor. Asynchronous communication allows for flexibility because "participants can interact with significant amounts of time between…

Asynchronous Discussion Board Facilitation and Rubric Use in a Blended Learning Environment

ERIC Educational Resources Information Center

Giacumo, Lisa

2012-01-01

The purpose of this study was to investigate the effects of instructor response prompts and rubrics on students' performance in an asynchronous discussion-board assignment, their learning achievement on an objective-type posttest, and their reported satisfaction levels. Researchers who have studied asynchronous computer-mediated student…

Designing Asynchronous, Text-Based Computer Conferences: Ten Research-Based Suggestions

ERIC Educational Resources Information Center

Choitz, Paul; Lee, Doris

2006-01-01

Asynchronous computer conferencing refers to the use of computer software and a network enabling participants to post messages that allow discourse to continue even though interactions may be extended over days and weeks. Asynchronous conferences are time-independent, adapting to multiple time zones and learner schedules. Such activities as…

Asynchronous Learning Forums for Business Acculturation

ERIC Educational Resources Information Center

Pence, Christine Cope; Wulf, Catharina

2009-01-01

The use of IT as a facilitator for student collaboration in higher business education has grown rapidly since 2000. Asynchronous discussion forums are used abundantly for collaborative training purposes and for teaching students business-relevant tools for their future careers. This article presents an analysis of the asynchronous discussion forum…

Asynchronous glimpsing of speech: Spread of masking and task set-size

PubMed Central

Ozmeral, Erol J.; Buss, Emily; Hall, Joseph W.

2012-01-01

Howard-Jones and Rosen [(1993). J. Acoust. Soc. Am. 93, 2915–2922] investigated the ability to integrate glimpses of speech that are separated in time and frequency using a “checkerboard” masker, with asynchronous amplitude modulation (AM) across frequency. Asynchronous glimpsing was demonstrated only for spectrally wide frequency bands. It is possible that the reduced evidence of spectro-temporal integration with narrower bands was due to spread of masking at the periphery. The present study tested this hypothesis with a dichotic condition, in which the even- and odd-numbered bands of the target speech and asynchronous AM masker were presented to opposite ears, minimizing the deleterious effects of masking spread. For closed-set consonant recognition, thresholds were 5.1–8.5 dB better for dichotic than for monotic asynchronous AM conditions. Results were similar for closed-set word recognition, but for open-set word recognition the benefit of dichotic presentation was more modest and level dependent, consistent with the effects of spread of masking being level dependent. There was greater evidence of asynchronous glimpsing in the open-set than closed-set tasks. Presenting stimuli dichotically supported asynchronous glimpsing with narrower frequency bands than previously shown, though the magnitude of glimpsing was reduced for narrower bandwidths even in some dichotic conditions. PMID:22894234

3D Medical Collaboration Technology to Enhance Emergency Healthcare

PubMed Central

Welch, Greg; Sonnenwald, Diane H; Fuchs, Henry; Cairns, Bruce; Mayer-Patel, Ketan; Söderholm, Hanna M.; Yang, Ruigang; State, Andrei; Towles, Herman; Ilie, Adrian; Ampalam, Manoj; Krishnan, Srinivas; Noel, Vincent; Noland, Michael; Manning, James E.

2009-01-01

Two-dimensional (2D) videoconferencing has been explored widely in the past 15–20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays or with mobile devices such as personal digital assistants (PDAs). The remote professionals’ viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing of the dynamic reconstructions. We call this idea remote 3D medical collaboration. In this article we motivate and explain the vision for 3D medical collaboration technology; we describe the relevant computer vision, computer graphics, display, and networking research; we present a proof-of-concept prototype system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare. PMID:19521951

3D medical collaboration technology to enhance emergency healthcare.

PubMed

Welch, Gregory F; Sonnenwald, Diane H; Fuchs, Henry; Cairns, Bruce; Mayer-Patel, Ketan; Söderholm, Hanna M; Yang, Ruigang; State, Andrei; Towles, Herman; Ilie, Adrian; Ampalam, Manoj K; Krishnan, Srinivas; Noel, Vincent; Noland, Michael; Manning, James E

2009-04-19

Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays or with mobile devices such as personal digital assistants (PDAs). The remote professionals' viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing of the dynamic reconstructions. We call this idea remote 3D medical collaboration. In this article we motivate and explain the vision for 3D medical collaboration technology; we describe the relevant computer vision, computer graphics, display, and networking research; we present a proof-of-concept prototype system; and we present evaluation results supporting the general hypothesis that 3D remote medical collaboration technology could offer benefits over conventional 2D videoconferencing in emergency healthcare.

Fostering Critical Reflection in a Computer-Based, Asynchronously Delivered Diversity Training Course

ERIC Educational Resources Information Center

Givhan, Shawn T.

2013-01-01

This dissertation study chronicles the creation of a computer-based, asynchronously delivered diversity training course for a state agency. The course format enabled efficient delivery of a mandatory curriculum to the Massachusetts Department of State Police workforce. However, the asynchronous format posed a challenge to achieving the learning…

Anonymity and Motivation in Asynchronous Discussions and L2 Vocabulary Learning

ERIC Educational Resources Information Center

Polat, Nihat; Mancilla, Rae; Mahalingappa, Laura

2013-01-01

This study investigates L2 attainment in asynchronous online environments, specifically possible relationships among anonymity, L2 motivation, participation in discussions, quality of L2 production, and success in L2 vocabulary learning. It examines, in asynchronous discussions, (a) if participation and (b) motivation contribute to L2 vocabulary…

Exploring the Effect of Scripted Roles on Cognitive Presence in Asynchronous Online Discussions

ERIC Educational Resources Information Center

Olesova, Larisa; Slavin, Margaret; Lim, Jieun

2016-01-01

The purpose of this study was to identify the effect of scripted roles on students' level of cognitive presence in asynchronous online threaded discussions. A quantitative content analysis was used to investigate: (1) what level of cognitive presence is achieved by students' assigned roles in asynchronous online discussions; (2) differences…

A Multi-Perspective Investigation into Learners' Interaction in Asynchronous Computer-Mediated Communication (CMC)

ERIC Educational Resources Information Center

Çardak, Çigdem Suzan

2016-01-01

This article focusses on graduate level students' interactions during asynchronous CMC activities of an online course about the teaching profession in Turkey. The instructor of the course designed and facilitated a semester-long asynchronous CMC on forum discussions, and investigated the interaction of learners in multiple perspectives: learners'…

The Negotiation Model in Asynchronous Computer-Mediated Communication (CMC): Negotiation in Task-Based Email Exchanges

ERIC Educational Resources Information Center

Kitade, Keiko

2006-01-01

Based on recent studies, computer-mediated communication (CMC) has been considered a tool to aid in language learning on account of its distinctive interactional features. However, most studies have referred to "synchronous" CMC and neglected to investigate how "asynchronous" CMC contributes to language learning. Asynchronous CMC possesses…

Integrating the Intangibles into Asynchronous Online Instruction: Strategies for Improving Interaction and Social Presence

ERIC Educational Resources Information Center

McGuire, Beverley Foulks

2016-01-01

This paper considers how instructors of asynchronous online courses in the Humanities might integrate intangibles associated with face-to-face instruction into their online environments. It presents a case study of asynchronous online instruction in a philosophy and religion department at a midsize public university in the southeastern United…

Postgraduate Students' Knowledge Construction during Asynchronous Computer Conferences in a Blended Learning Environment: A Malaysian Experience

ERIC Educational Resources Information Center

Kian-Sam, Hong; Lee, Julia Ai Cheng

2008-01-01

Blended learning, using e-learning tools to supplement existing on campus learning, often incorporates asynchronous computer conferencing as a means of augmenting knowledge construction among students. This case study reports findings about levels of knowledge construction amongst adult postgraduate students in six asynchronous computer…

Asynchronous Learning Sources in a High-Tech Organization

ERIC Educational Resources Information Center

Bouhnik, Dan; Giat, Yahel; Sanderovitch, Yafit

2009-01-01

Purpose: The purpose of this study is to characterize learning from asynchronous sources among research and development (R&D) personnel. It aims to examine four aspects of asynchronous source learning: employee preferences regarding self-learning; extent of source usage; employee satisfaction with these sources and the effect of the sources on the…

Asynchronous reference frame agreement in a quantum network

NASA Astrophysics Data System (ADS)

Islam, Tanvirul; Wehner, Stephanie

2016-03-01

An efficient implementation of many multiparty protocols for quantum networks requires that all the nodes in the network share a common reference frame. Establishing such a reference frame from scratch is especially challenging in an asynchronous network where network links might have arbitrary delays and the nodes do not share synchronised clocks. In this work, we study the problem of establishing a common reference frame in an asynchronous network of n nodes of which at most t are affected by arbitrary unknown error, and the identities of the faulty nodes are not known. We present a protocol that allows all the correctly functioning nodes to agree on a common reference frame as long as the network graph is complete and not more than t\\lt n/4 nodes are faulty. As the protocol is asynchronous, it can be used with some assumptions to synchronise clocks over a network. Also, the protocol has the appealing property that it allows any existing two-node asynchronous protocol for reference frame agreement to be lifted to a robust protocol for an asynchronous quantum network.

Vizualization of Arctic Landscapes in the Geoinformation System

NASA Astrophysics Data System (ADS)

Panidi, E. A.; Tsepelev, V. Yu.; Bobkov, A. A.

2010-12-01

In order to investigate the long-scale dynamics of an ice cover, authors suggest to use the geoinformation system (GIS) which allows to conduct the operative and historical analysis of the Polar Region water-ice landscapes variability. Such GIS should include longterm monthly average fields of sea ice, hydrological and atmospheric characters. All collected data and results of their processing have been structured in ArcGISTM . For presentation in the INTERNET resources all datasets were transformed to the open format KML for using in the virtual reality of Google EarthTM . The double component system elaborating on the base of ArcGIS and Google Earth allows to make accumulation, processing and joint synchronous and asynchronous analysis of data and provide wide circle of remote users with accessibility of visual datasets analysis.

Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study.

PubMed

Lim, Paul Chun Yih; Lee, Audry Shan Yin; Chua, Kelvin Chi Ming; Lim, Eric Tien Siang; Chong, Daniel Thuan Tee; Tan, Boon Yew; Ho, Kah Leng; Teo, Wee Siong; Ching, Chi Keong

2016-07-01

Remote monitoring of cardiac implantable electronic devices (CIED) has been shown to improve patient safety and reduce in-office visits. We report our experience with remote monitoring via the Medtronic CareLink(®) network. Patients were followed up for six months with scheduled monthly remote monitoring transmissions in addition to routine in-office checks. The efficacy of remote monitoring was evaluated by recording compliance to transmissions, number of device alerts requiring intervention and time from transmission to review. Questionnaires were administered to evaluate the experiences of patients, physicians and medical technicians. A total of 57 patients were enrolled; 16 (28.1%) had permanent pacemakers, 34 (59.6%) had implantable cardioverter defibrillators and 7 (12.3%) had cardiac resynchronisation therapy defibrillators. Overall, of 334 remote transmissions scheduled, 73.7% were on time, 14.5% were overdue and 11.8% were missed. 84.6% of wireless transmissions were on time, compared to 53.8% of non-wireless transmissions. Among all transmissions, 4.4% contained alerts for which physicians were informed and only 1.8% required intervention. 98.6% of remote transmissions were reviewed by the second working day. 73.2% of patients preferred remote monitoring. Physicians agreed that remote transmissions provided information equivalent to in-office checks 97.1% of the time. 77.8% of medical technicians felt that remote monitoring would help the hospital improve patient management. No adverse events were reported. Remote monitoring of CIED is safe and feasible. It has possible benefits to patient safety through earlier detection of arrhythmias or device malfunction, permitting earlier intervention. Wireless remote monitoring, in particular, may improve compliance to device monitoring. Patients may prefer remote monitoring due to possible improvements in quality of life. Copyright: © Singapore Medical Association.

Java-based browsing, visualization and processing of heterogeneous medical data from remote repositories.

PubMed

Masseroli, M; Bonacina, S; Pinciroli, F

2004-01-01

The actual development of distributed information technologies and Java programming enables employing them also in the medical arena to support the retrieval, integration and evaluation of heterogeneous data and multimodal images in a web browser environment. With this aim, we used them to implement a client-server architecture based on software agents. The client side is a Java applet running in a web browser and providing a friendly medical user interface to browse and visualize different patient and medical test data, integrating them properly. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. Based on the Java Advanced Imaging API, processing and analysis tools were developed to support the evaluation of remotely retrieved bioimages through the quantification of their features in different regions of interest. The Java platform-independence allows the centralized management of the implemented prototype and its deployment to each site where an intranet or internet connection is available. Giving healthcare providers effective support for comprehensively browsing, visualizing and evaluating medical images and records located in different remote repositories, the developed prototype can represent an important aid in providing more efficient diagnoses and medical treatments.

Modeling and Analysis of Asynchronous Systems Using SAL and Hybrid SAL

NASA Technical Reports Server (NTRS)

Tiwari, Ashish; Dutertre, Bruno

2013-01-01

We present formal models and results of formal analysis of two different asynchronous systems. We first examine a mid-value select module that merges the signals coming from three different sensors that are each asynchronously sampling the same input signal. We then consider the phase locking protocol proposed by Daly, Hopkins, and McKenna. This protocol is designed to keep a set of non-faulty (asynchronous) clocks phase locked even in the presence of Byzantine-faulty clocks on the network. All models and verifications have been developed using the SAL model checking tools and the Hybrid SAL abstractor.

Detection of Failure in Asynchronous Motor Using Soft Computing Method

NASA Astrophysics Data System (ADS)

Vinoth Kumar, K.; Sony, Kevin; Achenkunju John, Alan; Kuriakose, Anto; John, Ano P.

2018-04-01

This paper investigates the stator short winding failure of asynchronous motor also their effects on motor current spectrums. A fuzzy logic approach i.e., model based technique possibly will help to detect the asynchronous motor failure. Actually, fuzzy logic similar to humanoid intelligent methods besides expected linguistic empowering inferences through vague statistics. The dynamic model is technologically advanced for asynchronous motor by means of fuzzy logic classifier towards investigate the stator inter turn failure in addition open phase failure. A hardware implementation was carried out with LabVIEW for the online-monitoring of faults.

Asynchronous discrete control of continuous processes

NASA Astrophysics Data System (ADS)

Kaliski, M. E.; Johnson, T. L.

1984-07-01

The research during this second contract year continued to deal with the development of sound theoretical models for asynchronous systems. Two criteria served to shape the research pursued: the first, that the developed models extend and generalize previously developed research for synchronous discrete control; the second, that the models explicitly address the question of how to incorporate system transition times into themselves. The following sections of this report concisely delineate this year's work. Our original proposal for this research identified four general tasks of investigation: (1.1) Analysis of Qualitative Properties of Asynchronous Hybrid Systems; (1.2) Acceptance and Control for Asynchronous Hybrid Systems.

A mobile/web app for long distance caregivers of older adults: functional requirements and design implications from a user centered design process.

PubMed

Williamson, Steven S; Gorman, Paul N; Jimison, Holly B

2014-01-01

Recent trends of population aging and globalization have required an increasing number of individuals to act as long distance caregivers (LDCs) to aging family members. Information technology solutions may ease the burden placed on LDCs by providing remote monitoring, easier access to information and enhanced communication. While some technology tools have been introduced, the information and technology needs of LDCs in particular are not well understood. Consequently, a needs assessment was performed by using video conferencing software to conduct semi-structured interviews with 10 LDCs. Interviews were enriched through the use of stimulus materials that included the demonstration of a prototype LDC health management web/mobile app. Responses were recorded, transcribed and then analyzed. Subjects indicated that information regarding medication regimens and adherence, calendaring, and cognitive health were most needed. Participants also described needs for video calling, activity data regarding sleep and physical exercise, asynchronous communication, photo sharing, journaling, access to online health resources, real-time monitoring, an overall summary of health, and feedback/suggestions to help them improve as caregivers. In addition, all respondents estimated their usage of a LDC health management website would be at least once per week, with half indicating a desire to access the website from a smartphone. These findings are being used to inform the design of a LDC health management website to promote the meaningful involvement of distant family members in the care of older adults.

The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations

PubMed Central

Lin, Andrew H; Cole, Jacob H; Chin, John C; Mahnke, Chirstopher Becket

2016-01-01

Introduction: The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. Methods: A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. Results: From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Discussion: Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system. PMID:26985390

The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations.

PubMed

Lin, Andrew H; Cole, Jacob H; Chin, John C; Mahnke, Chirstopher Becket

2016-01-01

The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system.

Microfluidic-Based Platform for Universal Sample Preparation and Biological Assays Automation for Life-Sciences Research and Remote Medical Applications

NASA Astrophysics Data System (ADS)

Brassard, D.; Clime, L.; Daoud, J.; Geissler, M.; Malic, L.; Charlebois, D.; Buckley, N.; Veres, T.

2018-02-01

An innovative centrifugal microfluidic universal platform for remote bio-analytical assays automation required in life-sciences research and medical applications, including purification and analysis from body fluids of cellular and circulating markers.

Mobile Care (Moca) for Remote Diagnosis and Screening

PubMed Central

Celi, Leo Anthony; Sarmenta, Luis; Rotberg, Jhonathan; Marcelo, Alvin; Clifford, Gari

2010-01-01

Moca is a cell phone-facilitated clinical information system to improve diagnostic, screening and therapeutic capabilities in remote resource-poor settings. The software allows transmission of any medical file, whether a photo, x-ray, audio or video file, through a cell phone to (1) a central server for archiving and incorporation into an electronic medical record (to facilitate longitudinal care, quality control, and data mining), and (2) a remote specialist for real-time decision support (to leverage expertise). The open source software is designed as an end-to-end clinical information system that seamlessly connects health care workers to medical professionals. It is integrated with OpenMRS, an existing open source medical records system commonly used in developing countries. PMID:21822397

[Research on Three-dimensional Medical Image Reconstruction and Interaction Based on HTML5 and Visualization Toolkit].

PubMed

Gao, Peng; Liu, Peng; Su, Hongsen; Qiao, Liang

2015-04-01

Integrating visualization toolkit and the capability of interaction, bidirectional communication and graphics rendering which provided by HTML5, we explored and experimented on the feasibility of remote medical image reconstruction and interaction in pure Web. We prompted server-centric method which did not need to download the big medical data to local connections and avoided considering network transmission pressure and the three-dimensional (3D) rendering capability of client hardware. The method integrated remote medical image reconstruction and interaction into Web seamlessly, which was applicable to lower-end computers and mobile devices. Finally, we tested this method in the Internet and achieved real-time effects. This Web-based 3D reconstruction and interaction method, which crosses over internet terminals and performance limited devices, may be useful for remote medical assistant.

Combining Live Video and Audio Broadcasting, Synchronous Chat, and Asynchronous Open Forum Discussions in Distance Education

ERIC Educational Resources Information Center

Teng, Tian-Lih; Taveras, Marypat

2004-01-01

This article outlines the evolution of a unique distance education program that began as a hybrid--combining face-to-face instruction with asynchronous online teaching--and evolved to become an innovative combination of synchronous education using live streaming video, audio, and chat over the Internet, blended with asynchronous online discussions…

Utilizing Spectrum Efficiently (USE)

DTIC Science & Technology

2011-02-28

18 4.8 Space-Time Coded Asynchronous DS - CDMA with Decentralized MAI Suppression: Performance and...numerical results. 4.8 Space-Time Coded Asynchronous DS - CDMA with Decentralized MAI Suppression: Performance and Spectral Efficiency In [60] multiple...supported at a given signal-to-interference ratio in asynchronous direct-sequence code-division multiple-access ( DS - CDMA ) sys- tems was examined. It was

The Development, Validity, and Reliability of Communication Satisfaction in an Online Asynchronous Discussion Scale

ERIC Educational Resources Information Center

Hung, Min-Ling; Chou, Chien

2014-01-01

The purpose of this study was to identify dimensions of students' communication satisfaction in an asynchronous discussion forum. An asynchronous discussion may be defined as text-based human-to-human communication via computer networks that provides a platform for the participants to interact with one another to exchange ideas, insights, and…

Web-based Cases in Teaching and Learning - the Quality of Discussions and a Stage of Perspective Taking in Asynchronous Communication.

ERIC Educational Resources Information Center

Jarvela, Sanna; Hakkinen, Paivi

2002-01-01

Examines the quality of asynchronous interaction in Web-based conferencing among preservice teachers. The study combines asynchronous conferencing with peer and mentor collaboration to electronically apprentice student learning. Results point out different levels of Web-based discussion: higher-level, progressive, and lower-level discussion. A…

10 CFR 35.643 - Periodic spot-checks for remote afterloader units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Periodic spot-checks for remote afterloader units. 35.643... spot-checks for remote afterloader units. (a) A licensee authorized to use a remote afterloader unit for medical use shall perform spot-checks of each remote afterloader facility and on each unit— (1...

Extreme Tele-Echocardiography: Methodology for Remote Guidance of In-flight Echocardiography Aboard the International Space Station

NASA Technical Reports Server (NTRS)

Martin, David; Borowski, Allan; Bungo, Michael W.; Dulchavsky, Scott; Gladding, Patrick; Greenberg, Neil; Hamilton, Doug; Levine, Benjamin D.; Norwoord, Kelly; Platts, Steven H.;

[A novel proposal explaining sleep disturbance of children in Japan--asynchronization].

PubMed

Kohyama, Jun

2008-07-01

It has been reported that more than half of the children in Japan suffer from daytime sleepiness. In contrast, about one quarter of junior high-school students in Japan complain of insomnia. According to the International Classification of Sleep Disorders (Second edition), these children could be diagnosed as having behaviorally-induced insufficient sleep syndrome due to inadequate sleeping habits. Getting on adequate amount of sleep should solve such problems;however, such a therapeutic approach often fails. Although social factors are involved in these sleep disturbances, I feel that a novel notion - asynchronization - leads to an understanding of the pathophysiology of disturbances in these children. Further, it could contribute to resolve their problems. The essence of asynchronization is a disturbance of various aspects (e.g., cycle, amplitude, phase, and interrelationship) of the biological rhythms that normally exhibits circadian oscillation. The main cause of asynchronization is hypothesized to be the combination of light exposure during night and the lack of light exposure in the morning. Asynchronization results in the disturbance of variable systems. Thus, symptoms of asynchronization include disturbances of the autonomic nervous system (sleepiness, insomnia, disturbance of hormonal excretion, gastrointestinal problems, etc.) and higher brain function (disorientation, loss of sociality, loss of will or motivation, impaired alertness and performance, etc.). Neurological (attention deficit, aggression, impulsiveness, hyperactivity, etc.), psychiatric (depressive disorders, personality disorders, anxiety disorders, etc.) and somatic (tiredness, fatigue, etc.) disturbances could also be symptoms of asynchronization. At the initial phase of asynchronization, disturbances are functional and can be resolved relatively easily, such as by the establishment of a regular sleep-wakefulness cycle;however, without adequate intervention the disturbances could gradually worsen and become hard to resolve.

Stand-Alone and Hybrid Positioning Using Asynchronous Pseudolites

PubMed Central

Gioia, Ciro; Borio, Daniele

2015-01-01

global navigation satellite system (GNSS) receivers are usually unable to achieve satisfactory performance in difficult environments, such as open-pit mines, urban canyons and indoors. Pseudolites have the potential to extend GNSS usage and significantly improve receiver performance in such environments by providing additional navigation signals. This also applies to asynchronous pseudolite systems, where different pseudolites operate in an independent way. Asynchronous pseudolite systems require, however, dedicated strategies in order to properly integrate GNSS and pseudolite measurements. In this paper, several asynchronous pseudolite/GNSS integration strategies are considered: loosely- and tightly-coupled approaches are developed and combined with pseudolite proximity and receiver signal strength (RSS)-based positioning. The performance of the approaches proposed has been tested in different scenarios, including static and kinematic conditions. The tests performed demonstrate that the methods developed are effective techniques for integrating heterogeneous measurements from different sources, such as asynchronous pseudolites and GNSS. PMID:25609041

Distributed Consensus of Stochastic Delayed Multi-agent Systems Under Asynchronous Switching.

PubMed

Wu, Xiaotai; Tang, Yang; Cao, Jinde; Zhang, Wenbing

2016-08-01

In this paper, the distributed exponential consensus of stochastic delayed multi-agent systems with nonlinear dynamics is investigated under asynchronous switching. The asynchronous switching considered here is to account for the time of identifying the active modes of multi-agent systems. After receipt of confirmation of mode's switching, the matched controller can be applied, which means that the switching time of the matched controller in each node usually lags behind that of system switching. In order to handle the coexistence of switched signals and stochastic disturbances, a comparison principle of stochastic switched delayed systems is first proved. By means of this extended comparison principle, several easy to verified conditions for the existence of an asynchronously switched distributed controller are derived such that stochastic delayed multi-agent systems with asynchronous switching and nonlinear dynamics can achieve global exponential consensus. Two examples are given to illustrate the effectiveness of the proposed method.

Hydrodynamic advantages of swimming by salp chains.

PubMed

Sutherland, Kelly R; Weihs, Daniel

2017-08-01

Salps are marine invertebrates comprising multiple jet-propelled swimming units during a colonial life-cycle stage. Using theory, we show that asynchronous swimming with multiple pulsed jets yields substantial hydrodynamic benefit due to the production of steady swimming velocities, which limit drag. Laboratory comparisons of swimming kinematics of aggregate salps ( Salpa fusiformis and Weelia cylindrica ) using high-speed video supported that asynchronous swimming by aggregates results in a smoother velocity profile and showed that this smoother velocity profile is the result of uncoordinated, asynchronous swimming by individual zooids. In situ flow visualizations of W. cylindrica swimming wakes revealed that another consequence of asynchronous swimming is that fluid interactions between jet wakes are minimized. Although the advantages of multi-jet propulsion have been mentioned elsewhere, this is the first time that the theory has been quantified and the role of asynchronous swimming verified using experimental data from the laboratory and the field. © 2017 The Author(s).

Unraveling Network-induced Memory Contention: Deeper Insights with Machine Learning

DOE PAGES

Groves, Taylor Liles; Grant, Ryan; Gonzales, Aaron; ...

2017-11-21

Remote Direct Memory Access (RDMA) is expected to be an integral communication mechanism for future exascale systems enabling asynchronous data transfers, so that applications may fully utilize CPU resources while simultaneously sharing data amongst remote nodes. We examine Network-induced Memory Contention (NiMC) on Infiniband networks. We expose the interactions between RDMA, main-memory and cache, when applications and out-of-band services compete for memory resources. We then explore NiMCs resulting impact on application-level performance. For a range of hardware technologies and HPC workloads, we quantify NiMC and show that NiMCs impact grows with scale resulting in up to 3X performance degradation atmore » scales as small as 8K processes even in applications that previously have been shown to be performance resilient in the presence of noise. In addition, this work examines the problem of predicting NiMC's impact on applications by leveraging machine learning and easily accessible performance counters. This approach provides additional insights about the root cause of NiMC and facilitates dynamic selection of potential solutions. Finally, we evaluated three potential techniques to reduce NiMCs impact, namely hardware offloading, core reservation and network throttling.« less

Unraveling Network-induced Memory Contention: Deeper Insights with Machine Learning

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

Groves, Taylor Liles; Grant, Ryan; Gonzales, Aaron

Remote Direct Memory Access (RDMA) is expected to be an integral communication mechanism for future exascale systems enabling asynchronous data transfers, so that applications may fully utilize CPU resources while simultaneously sharing data amongst remote nodes. We examine Network-induced Memory Contention (NiMC) on Infiniband networks. We expose the interactions between RDMA, main-memory and cache, when applications and out-of-band services compete for memory resources. We then explore NiMCs resulting impact on application-level performance. For a range of hardware technologies and HPC workloads, we quantify NiMC and show that NiMCs impact grows with scale resulting in up to 3X performance degradation atmore » scales as small as 8K processes even in applications that previously have been shown to be performance resilient in the presence of noise. In addition, this work examines the problem of predicting NiMC's impact on applications by leveraging machine learning and easily accessible performance counters. This approach provides additional insights about the root cause of NiMC and facilitates dynamic selection of potential solutions. Finally, we evaluated three potential techniques to reduce NiMCs impact, namely hardware offloading, core reservation and network throttling.« less

On the Suitability of MPI as a PGAS Runtime

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

Daily, Jeffrey A.; Vishnu, Abhinav; Palmer, Bruce J.

2014-12-18

Partitioned Global Address Space (PGAS) models are emerging as a popular alternative to MPI models for designing scalable applications. At the same time, MPI remains a ubiquitous communication subsystem due to its standardization, high performance, and availability on leading platforms. In this paper, we explore the suitability of using MPI as a scalable PGAS communication subsystem. We focus on the Remote Memory Access (RMA) communication in PGAS models which typically includes {\\em get, put,} and {\\em atomic memory operations}. We perform an in-depth exploration of design alternatives based on MPI. These alternatives include using a semantically-matching interface such as MPI-RMA,more » as well as not-so-intuitive interfaces such as MPI two-sided with a combination of multi-threading and dynamic process management. With an in-depth exploration of these alternatives and their shortcomings, we propose a novel design which is facilitated by the data-centric view in PGAS models. This design leverages a combination of highly tuned MPI two-sided semantics and an automatic, user-transparent split of MPI communicators to provide asynchronous progress. We implement the asynchronous progress ranks approach and other approaches within the Communication Runtime for Exascale which is a communication subsystem for Global Arrays. Our performance evaluation spans pure communication benchmarks, graph community detection and sparse matrix-vector multiplication kernels, and a computational chemistry application. The utility of our proposed PR-based approach is demonstrated by a 2.17x speed-up on 1008 processors over the other MPI-based designs.« less

Advances in Small Remotely Piloted Aircraft Communications and Remote Sensing in Maritime Environments including the Arctic

NASA Astrophysics Data System (ADS)

McGillivary, P. A.; Borges de Sousa, J.; Wackowski, S.; Walker, G.

2011-12-01

Small remotely piloted aircraft have recently been used for maritime remote sensing, including launch and retrieval operations from land, ships and sea ice. Such aircraft can also function to collect and communicate data from other ocean observing system platforms including moorings, tagged animals, drifters, autonomous surface vessels (ASVs), and autonomous underwater vessels (AUVs). The use of small remotely piloted aircraft (or UASs, unmanned aerial systems) with a combination of these capabilities will be required to monitor the vast areas of the open ocean, as well as in harsh high-latitude ecosystems. Indeed, these aircraft are a key component of planned high latitude maritime domain awareness environmental data collection capabilities, including use of visible, IR and hyperspectral sensors, as well as lidar, meteorological sensors, and interferometric synthetic aperture radars (ISARs). We here first describe at-sea demonstrations of improved reliability and bandwidth of communications from ocean sensors on autonomous underwater vehicles to autonomous surface vessels, and then via remotely piloted aircraft to shore, ships and manned aircraft using Delay and Disruption Tolerant (DTN) communication protocols. DTN enables data exchange in communications-challenged environments, such as remote regions of the ocean including high latitudes where low satellite angles and auroral disturbances can be problematic. DTN provides a network architecture and application interface structured around optionally-reliable asynchronous message forwarding, with limited expectations of end-to-end connectivity and node resources. This communications method enables aircraft and surface vessels to function as data mules to move data between physically disparate nodes. We provide examples of the uses of this communication protocol for environmental data collection and data distribution with a variety of different remotely piloted aircraft in a coastal ocean environment. Next, we highlight use in the arctic of two different small remotely piloted aircraft (ScanEagle and RAVEN) for remote sensing of ice and ocean conditions as well as surveys of marine mammals. Finally, we explain how these can be used in future networked environments with DTN support not only for the collection of ocean and ice data for maritime domain awareness, but also for monitoring oil spill dynamics in high latitude environments, including spills in and under sea ice. The networked operation of heterogeneous air and ocean vehicle systems using DTN communications methods can provide unprecedented levels of spatial-temporal sampling resolution important to improving arctic remote sensing and maritime domain awareness capabilities.

Merging the Forces of Asynchronous Tutoring and Synchronous Conferencing: A Qualitative Study of Arab ESL Academic Writers Using E-Tutoring

ERIC Educational Resources Information Center

Alqadoumi, Omar Mohamed

2012-01-01

Previous studies in the field of e-tutoring dealt either with asynchronous tutoring or synchronous conferencing as modes for providing e-tutoring services to English learners. This qualitative research study reports the experiences of Arab ESL tutees with both asynchronous tutoring and synchronous conferencing. It also reports the experiences of…

Differences in Electronic Exchanges in Synchronous and Asynchronous Computer-Mediated Communication: The Effect of Culture as a Mediating Variable

ERIC Educational Resources Information Center

Angeli, Charoula; Schwartz, Neil H.

2016-01-01

Two hundred and eighty undergraduates from universities in two countries were asked to read didactic material, and then think and write about potential solutions to an ill-defined problem. The writing was conducted within a synchronous or asynchronous computer-mediated communication (CMC) environment. Asynchronous CMC took the form of email…

Localized radio frequency communication using asynchronous transfer mode protocol

DOEpatents

Witzke, Edward L [Edgewood, NM; Robertson, Perry J [Albuquerque, NM; Pierson, Lyndon G [Albuquerque, NM

2007-08-14

A localized wireless communication system for communication between a plurality of circuit boards, and between electronic components on the circuit boards. Transceivers are located on each circuit board and electronic component. The transceivers communicate with one another over spread spectrum radio frequencies. An asynchronous transfer mode protocol controls communication flow with asynchronous transfer mode switches located on the circuit boards.

Features of the Asynchronous Correlation between the China Coal Price Index and Coal Mining Accidental Deaths.

PubMed

Huang, Yuecheng; Cheng, Wuyi; Luo, Sida; Luo, Yun; Ma, Chengchen; He, Tailin

2016-01-01

The features of the asynchronous correlation between accident indices and the factors that influence accidents can provide an effective reference for warnings of coal mining accidents. However, what are the features of this correlation? To answer this question, data from the China coal price index and the number of deaths from coal mining accidents were selected as the sample data. The fluctuation modes of the asynchronous correlation between the two data sets were defined according to the asynchronous correlation coefficients, symbolization, and sliding windows. We then built several directed and weighted network models, within which the fluctuation modes and the transformations between modes were represented by nodes and edges. Then, the features of the asynchronous correlation between these two variables could be studied from a perspective of network topology. We found that the correlation between the price index and the accidental deaths was asynchronous and fluctuating. Certain aspects, such as the key fluctuation modes, the subgroups characteristics, the transmission medium, the periodicity and transmission path length in the network, were analyzed by using complex network theory, analytical methods and spectral analysis method. These results provide a scientific reference for generating warnings for coal mining accidents based on economic indices.

Expectations of medical specialists about image-based teleconsultation - A qualitative study on acute burns in South Africa.

PubMed

Blom, Lisa; Laflamme, Lucie; Mölsted Alvesson, Helle

2018-01-01

Image-based teleconsultation between medical experts and healthcare staff at remote emergency centres can improve the diagnosis of conditions which are challenging to assess. One such condition is burns. Knowledge is scarce regarding how medical experts perceive the influence of such teleconsultation on their roles and relations to colleagues at point of care. In this qualitative study, semi-structured interviews were conducted with 15 medical experts to explore their expectations of a newly developed App for burns diagnostics and care prior to its implementation. Purposive sampling included male and female physicians at different stages of their career, employed at different referral hospitals and all potential future tele-experts in remote teleconsultation using the App. Positioning theory was used to analyse the data. The experts are already facing changes in their diagnostic practices due to the informal use of open access applications like WhatsApp. Additional changes are expected when the new App is launched. Four positions of medical experts were identified in situations of diagnostic advice, two related to patient flow-clinical specialist and gatekeeper-and two to point of care staff-educator and mentor. The experts move flexibly between the positions during diagnostic practices with remote colleagues. A new position in relation to previous research on medical roles-the mentor-came to light in this setting. The App is expected to have an important educational impact, streamline the diagnostic process, improve both triage and referrals and be a more secure option for remote diagnosis compared to current practices. Verbal communication is however expected to remain important for certain situations, in particular those related to the mentor position. The quality and security of referrals are expected to be improved through the App but the medical experts see less potential for conveying moral support via the App during remote consultations. Experts' reflections on remote consultations highlight the embedded social and cultural dimensions of implementing new technology.

Expectations of medical specialists about image-based teleconsultation – A qualitative study on acute burns in South Africa

PubMed Central

Laflamme, Lucie; Mölsted Alvesson, Helle

2018-01-01

Background Image-based teleconsultation between medical experts and healthcare staff at remote emergency centres can improve the diagnosis of conditions which are challenging to assess. One such condition is burns. Knowledge is scarce regarding how medical experts perceive the influence of such teleconsultation on their roles and relations to colleagues at point of care. Methods In this qualitative study, semi-structured interviews were conducted with 15 medical experts to explore their expectations of a newly developed App for burns diagnostics and care prior to its implementation. Purposive sampling included male and female physicians at different stages of their career, employed at different referral hospitals and all potential future tele-experts in remote teleconsultation using the App. Positioning theory was used to analyse the data. Results The experts are already facing changes in their diagnostic practices due to the informal use of open access applications like WhatsApp. Additional changes are expected when the new App is launched. Four positions of medical experts were identified in situations of diagnostic advice, two related to patient flow–clinical specialist and gatekeeper–and two to point of care staff–educator and mentor. The experts move flexibly between the positions during diagnostic practices with remote colleagues. A new position in relation to previous research on medical roles–the mentor–came to light in this setting. The App is expected to have an important educational impact, streamline the diagnostic process, improve both triage and referrals and be a more secure option for remote diagnosis compared to current practices. Verbal communication is however expected to remain important for certain situations, in particular those related to the mentor position. Conclusion The quality and security of referrals are expected to be improved through the App but the medical experts see less potential for conveying moral support via the App during remote consultations. Experts’ reflections on remote consultations highlight the embedded social and cultural dimensions of implementing new technology. PMID:29543847

James Cook University's rurally orientated medical school selection process: quality graduates and positive workforce outcomes.

PubMed

Ray, Robin A; Woolley, Torres; Sen Gupta, Tarun

2015-01-01

The regionally based James Cook University (JCU) College of Medicine and Dentistry aims to meet its mission to address the health needs of the region by using a selection policy favouring rural origin applicants and providing students with early and repeated exposure to rural experiences during training. This study seeks to determine if the JCU medical school's policy of preferentially selecting rural and remote background students is associated with differing patterns of undergraduate performance or graduate practice location. Data at application to medical school and during the undergraduate years was retrieved from administrative databases held by the university and the medical school. Postgraduate location data were obtained either from personal contact via email, telephone or Facebook or electronically from the Australian Health Practitioner Regulation Authority website. Practice location was described across Australian Standard Geographical Classification Remoteness Area (ASGC-RA) categories, with 1 being a major city and 5 being a very remote location. The 856 Australian-based students accepted into the JCU medical program between 2000 and 2008 came from all geographical regions across Australia: 20% metropolitan (ASGC-RA 1), 20% inner regional (ASGC-RA 2), 56% outer regional (ASGC-RA 3), and 5% from remote or very remote locations (ASGC-RA 4 and 5). Having a rural or remote hometown at application (ASGC-RA 3-5) was significantly associated with a lower tertiary entrance score (p<0.001), a lower interview score in the medical school selection process (p<0.001), being less likely to be admitted into the Honours program (p=0.001), being an advanced standing student (p=0.025), being awarded a Medical Rural Bonded Scholarship (p=0.005), taking longer to complete the 6-year course (p=<0.009) and having a lower academic achievement across years 1 to 3 (p=0.002, p=0.005 and p=0.025, respectively). Graduates having either a rural or a remote home town at application were more likely to practise in rural (RA 3-5) towns than graduates from metropolitan/inner regional centre across all postgraduate years. For example, the prevalence odds ratios (POR) for graduates practising in a rural town at postgraduate year 1 (PGY 1) having either a rural or remote hometown were 2.6 and 1.8, respectively, times that of graduates having a metropolitan/inner regional hometown, while at PGY 9 the PORs had increased to 4.2 and 9.5, respectively. Bonded medical place students showed many similar trends to rural students in both their pre-medical school and undergraduate performance indicators but lower engagement in rural practice in the 5 years of data available. Some significant differences were noted between rural and remote origin students and metropolitan or inner regional origin students in terms of academic achievement in the first 3 years of the course and length of time taken to complete the course. However, this group of rural and remote-origin students seems to do just as well in the exams in the clinical years (years 4-6) and are much more likely to practise in rural and remote areas. These data suggest that JCU's selection process favouring rural origin applicants does not compromise academic standards, but does produce graduates whose patterns of practice accord with the mission of the school.

Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

PubMed

Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

2015-03-01

Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

Telemedicine for patients with rheumatic diseases: Systematic review and proposal for research agenda.

PubMed

Piga, Matteo; Cangemi, Ignazio; Mathieu, Alessandro; Cauli, Alberto

2017-08-01

To systematically review the scientific literature regarding tele-rheumatology and draw conclusions about feasibility, effectiveness, and patient satisfaction. PubMed, Scopus, and Cochrane database searches were performed (April 2016) using relevant MeSH and keyword terms for telemedicine and rheumatic diseases. Articles were selected if reporting outcomes for feasibility, effectiveness, and patient satisfaction and methodologically appraised using the Cochrane Collaboration's tool for assessing risk of bias and a modified version of CONSORT 2010 Statement. A total of 177 articles were screened, 23 were selected for the present review but only 9 were RCTs. Five studies reported on feasibility, 14 effectiveness, and 9 satisfaction rates for different tele-rheumatology interventions grouped in synchronous (remotely delivered consultation) and asynchronous (remote disease activity assessment; tele-monitoring of treatment strategies or rehabilitation; and remotely delivered self-management programs). Seven studies (30.4%) were on rheumatoid arthritis, 2 (8.7%) were on systemic sclerosis (1 including also rheumatoid arthritis patients), 5 (21.7%) on fibromyalgia, 2 (8.7%) on osteoarthritis, 3 (13.0%) on juvenile idiopathic arthritis and 4 (17.4%) on mixed disease cohorts. Interventions and outcomes heterogeneity prevented meta-analysis of results. Overall, feasibility and patient satisfaction rates were high or very high across intervention types. Effectiveness was equal or higher than standard face-to-face approach in controlled trials which, however, were affected by small sample size and lack of blinding participants according to appraisal tools. Telemedicine may provide a well-accepted way to remotely deliver consultation, treatment and monitoring disease activity in rheumatology. Higher quality RCTs demonstrating effectiveness of different tele-rheumatology interventions are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Improving access to specialists in remote communities: a cross-sectional study and cost analysis of the use of eConsult in Nunavut.

PubMed

Liddy, Clare; McKellips, Fanny; Armstrong, Catherine Deri; Afkham, Amir; Fraser-Roberts, Leigh; Keely, Erin

2017-01-01

Residents of remote communities face inequities in access to specialists, excessive wait times, and poorly coordinated care. The Champlain BASE TM (Building Access to Specialists through eConsultation) service facilitates asynchronous communication between primary care providers (PCP) and specialists. The service was extended to several PCPs in Nunavut in 2014. To (1) describe the use of eConsult services in Nunavut, and (2) conduct a costing evaluation. A cross-sectional study and cost analysis of all eConsult cases submitted between August 2014 and April 2016. PCPs from Nunavut submitted 165 eConsult cases. The most popular specialties were dermatology (16%), cardiology (8%), endocrinology (7%), otolaryngology (7%), and obstetrics/gynaecology (7%). Specialists provided a response in a median of 0.9 days (IQR=0.3-3.0, range=0.01-15.02). In 35% of cases, PCPs were able to avoid the face-to-face specialist visits they had originally planned for their patients. Total savings associated with eConsult in Nunavut are estimated at $180,552.73 or $1,100.93 per eConsult. The eConsult service provided patients in Nunavut's remote communities with prompt access to specialist advice. The service's chief advantage in Canada's northern communities is its ability to offer electronic access to a breadth of specialties far greater than could be supported locally. Our findings suggest that a territory-wide adoption of eConsult would generate enormous savings.

The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review

PubMed Central

Ros, Wynand JG; Schrijvers, Guus

2014-01-01

Background In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. Objective The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. Methods A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Results Patients’ knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. Conclusions The effect of asynchronous communication is not shown unequivocally in these studies. Patients seem to be interested in using email. Patients are willing to participate and are taking the initiative to discuss health issues with their providers. Additional testing of the effects of asynchronous communication on self-management in chronically ill patients is needed. PMID:24434570

The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

PubMed

de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

2014-01-16

In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of asynchronous communication is not shown unequivocally in these studies. Patients seem to be interested in using email. Patients are willing to participate and are taking the initiative to discuss health issues with their providers. Additional testing of the effects of asynchronous communication on self-management in chronically ill patients is needed.

Implementation of a 4-Year Point-of-Care Ultrasound Curriculum in a Liaison Committee on Medical Education-Accredited US Medical School.

PubMed

Wilson, Sean P; Mefford, Jason M; Lahham, Shadi; Lotfipour, Shahram; Subeh, Mohammad; Maldonado, Gracie; Spann, Sophie; Fox, John C

2017-02-01

The established benefits of point-of-care ultrasound have given rise to multiple new and innovative curriculums to incorporate ultrasound teaching into medical education. This study sought to measure the educational success of a comprehensive and integrated 4-year point-of-care ultrasound curriculum. We integrated a curriculum consisting of traditional didactics combined with asynchronous learning modules and hands-on practice on live models with skilled sonographers into all 4 years of education at a Liaison Committee on Medical Education-accredited US Medical School. Each graduating student was administered an exit examination with 48 questions that corresponded to ultrasound milestones. Ninety-five percent (n = 84) of fourth-year medical students completed the exit examination. The mean score was 79.5% (SD, 10.2%), with mean scores on the ultrasound physics and anatomy subsections being 77.1% (SD, 11.0%) and 85.9% (SD, 21.0%), respectively. A comprehensive 4-year point-of-care ultrasound curriculum integrated into medical school may successfully equip graduating medical students with a fundamental understanding of ultrasound physics, anatomy, and disease recognition. © 2016 by the American Institute of Ultrasound in Medicine.

Longitudinal rural clerkships: increased likelihood of more remote rural medical practice following graduation.

PubMed

Playford, Denese E; Nicholson, Asha; Riley, Geoffrey J; Puddey, Ian B

2015-03-21

Extended rural clerkships clearly increase the likelihood of rural practice post-graduation. What has not been determined is whether such rural interventions increase the likelihood of graduates practicing in more remote, versus inner regional, locations. The Australian Health Practitioner Regulation Agency database was used to identify the current workplace of every graduate of the Medical School of Western Australia, 1980 to 2011. There were 324 graduates working in a primary practice location defined by the Australian Standard Geographical Classification as inner regional to very remote. They were divided into 3 groups - 200 graduates who entered medical school before commencement of the Rural Clinical School of Western Australia (RCSWA), 63 who entered after the RCSWA had started, but not participated in RCSWA, and 61 who participated in the RCSWA. The RCSWA offers a longitudinal rural clinical clerkship throughout level 5 of the MBBS course. The two groups not participating in the RCSWA had 45.5% and 52.4% of subjects in outer regional/very remote locations, respectively. In comparison, 78.7% of those who had participated in the RCSWA were currently practicing in outer regional/very remote locations. When the 3 groups were compared, the significant predictors of working in a more remote practice compared to working in an inner regional area were being female (OR 1.75 95% CI 1.13, 2.72, P = 0.013) and participating in the RCSWA (OR 4.42, 95% CI 2.26, 8.67, P < 0.001). In multivariate logistic regression that corrected for gender and remoteness of rural address before entry to medical school, participation in the RCSWA still predicted a more than 4-fold increase in the odds of practicing in a more remote area (OR 4.11, 95% CI 2.04, 8.30, P < 0.001). Extended rural clinical clerkship during an undergraduate MBBS course is related to a much greater likelihood of practicing in more remote, under-serviced rural locations.

Asynchronous vibration problem of centrifugal compressor

NASA Technical Reports Server (NTRS)

Fujikawa, T.; Ishiguro, N.; Ito, M.

1980-01-01

An unstable asynchronous vibration problem in a high pressure centrifugal compressor and the remedial actions against it are described. Asynchronous vibration of the compressor took place when the discharge pressure (Pd) was increased, after the rotor was already at full speed. The typical spectral data of the shaft vibration indicate that as the pressure Pd increases, pre-unstable vibration appears and becomes larger, and large unstable asynchronous vibration occurs suddenly (Pd = 5.49MPa). A computer program was used which calculated the logarithmic decrement and the damped natural frequency of the rotor bearing systems. The analysis of the log-decrement is concluded to be effective in preventing unstable vibration in both the design stage and remedial actions.

FRR: fair remote retrieval of outsourced private medical records in electronic health networks.

PubMed

Wang, Huaqun; Wu, Qianhong; Qin, Bo; Domingo-Ferrer, Josep

2014-08-01

Cloud computing is emerging as the next-generation IT architecture. However, cloud computing also raises security and privacy concerns since the users have no physical control over the outsourced data. This paper focuses on fairly retrieving encrypted private medical records outsourced to remote untrusted cloud servers in the case of medical accidents and disputes. Our goal is to enable an independent committee to fairly recover the original private medical records so that medical investigation can be carried out in a convincing way. We achieve this goal with a fair remote retrieval (FRR) model in which either t investigation committee members cooperatively retrieve the original medical data or none of them can get any information on the medical records. We realize the first FRR scheme by exploiting fair multi-member key exchange and homomorphic privately verifiable tags. Based on the standard computational Diffie-Hellman (CDH) assumption, our scheme is provably secure in the random oracle model (ROM). A detailed performance analysis and experimental results show that our scheme is efficient in terms of communication and computation. Copyright © 2014 Elsevier Inc. All rights reserved.

Mobile health in cardiology: a review of currently available medical apps and equipment for remote monitoring.

PubMed

Treskes, Roderick Willem; van der Velde, Enno Tjeerd; Barendse, Rogier; Bruining, Nico

2016-09-01

Recent developments in implantable cardioverter-defibrillators (ICDs) and smartphone technology have increased the possibilities for remote monitoring. It is the purpose of this review to give an overview of these new possibilities. Remote monitoring in ICD allows for early detection of lead fractures and remote follow-up of patients. Possible limitations are the lack of standardization and the possible unsafety of the data stored on the ICD. Secondly, remote monitoring of health parameters using smartphone compatible wearables and smartphone medical apps is addressed. Possible limitations include the fact that the majority of smartphone apps are unregulated by the regulatory authorities and privacy issues such as selling of app-generated data to third parties. Lastly, clinical studies with smartphone apps are discussed. Expert commentary: New technologies in ICDs and smartphones have the potential to be used for remote monitoring. However, unreliability of smartphone technology, inadequate legislation and lack of reimbursement impede implementation.

Medicine on Mars: Remote medical care and the space exploration initiative

NASA Technical Reports Server (NTRS)

Simmons, S. C.; Billica, R. D.

1992-01-01

Mars exploration missions as described in the Synthesis Group report will involve extended exposures of crew members to remote, hazardous environments for up to 100 days. Maintenance of crew health and performance will be critical to ensure mission success. Because of the great distances between the Earth and Mars, round trip telecommunication will take from seven to forty minutes and immediate return to Earth will not be feasible: an autonomous medical care system that integrates preventive, occupational, and environmental aspects of health care and provides diagnostic and treatment capabilities will be necessary. Providing medical care for Mars explorers will pose some unique technical and engineering challenges. Medical care equipment will need to be designed to be modular and portable to ensure that it is interchangeable between vehicle and planetary surface elements. Miniaturization will be necessary to reduce mass and volume. Computerized systems that automatically acquire and manage medical information and provide medical references (literature), decision support, and automated medical record keeping will be a crucial part of a Martian medical care system. Medical care will also rely on remote consultation with Earth-based specialists. This presentation will provide an overview of the health and medical concerns associated with Mars exploration missions and will describe some specific concepts for Mars medical care systems.

A Role for YouTube in Telerehabilitation

PubMed Central

Manasco, M. Hunter; Barone, Nicholas; Brown, Amanda

2010-01-01

YouTube (http://youtube.com) is a free video sharing website that allows users to post and view videos. Although there are definite limitations in the applicability of this website to telerehabilitation, the YouTube technology offers potential uses that should not be overlooked. For example, some types of therapy, such as errorless learning therapy for certain language and cognitive deficits can be provided remotely via YouTube. In addition, the website’s social networking capabilities, via the asynchronous posting of comments and videos in response to posted videos, enables individuals to gain valuable emotional support by communicating with others with similar health and rehabilitation challenges. This article addresses the benefits and limitations of YouTube in the context of telerehabilitation and reports patient feedback on errorless learning therapy for aphasia delivered via videos posted on YouTube. PMID:25945173

Optimization of parameters of special asynchronous electric drives

NASA Astrophysics Data System (ADS)

Karandey, V. Yu; Popov, B. K.; Popova, O. B.; Afanasyev, V. L.

2018-03-01

The article considers the solution of the problem of parameters optimization of special asynchronous electric drives. The solution of the problem will allow one to project and create special asynchronous electric drives for various industries. The created types of electric drives will have optimum mass-dimensional and power parameters. It will allow one to realize and fulfill the set characteristics of management of technological processes with optimum level of expenses of electric energy, time of completing the process or other set parameters. The received decision allows one not only to solve a certain optimizing problem, but also to construct dependences between the optimized parameters of special asynchronous electric drives, for example, with the change of power, current in a winding of the stator or rotor, induction in a gap or steel of magnetic conductors and other parameters. On the constructed dependences, it is possible to choose necessary optimum values of parameters of special asynchronous electric drives and their components without carrying out repeated calculations.

Asynchronous Communication of TLNS3DMB Boundary Exchange

NASA Technical Reports Server (NTRS)

Hammond, Dana P.

1997-01-01

This paper describes the recognition of implicit serialization due to coarse-grain, synchronous communication and demonstrates the conversion to asynchronous communication for the exchange of boundary condition information in the Thin-Layer Navier Stokes 3-Dimensional Multi Block (TLNS3DMB) code. The implementation details of using asynchronous communication is provided including buffer allocation, message identification, and barrier control. The IBM SP2 was used for the tests presented.

Features of the Asynchronous Correlation between the China Coal Price Index and Coal Mining Accidental Deaths

PubMed Central

Huang, Yuecheng; Cheng, Wuyi; Luo, Sida; Luo, Yun; Ma, Chengchen; He, Tailin

2016-01-01

The features of the asynchronous correlation between accident indices and the factors that influence accidents can provide an effective reference for warnings of coal mining accidents. However, what are the features of this correlation? To answer this question, data from the China coal price index and the number of deaths from coal mining accidents were selected as the sample data. The fluctuation modes of the asynchronous correlation between the two data sets were defined according to the asynchronous correlation coefficients, symbolization, and sliding windows. We then built several directed and weighted network models, within which the fluctuation modes and the transformations between modes were represented by nodes and edges. Then, the features of the asynchronous correlation between these two variables could be studied from a perspective of network topology. We found that the correlation between the price index and the accidental deaths was asynchronous and fluctuating. Certain aspects, such as the key fluctuation modes, the subgroups characteristics, the transmission medium, the periodicity and transmission path length in the network, were analyzed by using complex network theory, analytical methods and spectral analysis method. These results provide a scientific reference for generating warnings for coal mining accidents based on economic indices. PMID:27902748

Efficacy of an asynchronous electronic curriculum in emergency medicine education in the United States.

PubMed

Wray, Alisa; Bennett, Kathryn; Boysen-Osborn, Megan; Wiechmann, Warren; Toohey, Shannon

2017-01-01

The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing 1 hour of weekly didactic time) would result in non-inferior ITE scores compared to the historical scores of residents who had participated in the traditional 5-hour weekly didactic curriculum. The study was a retrospective, non-inferiority study. conducted at the University of California, Irvine Emergency Medicine Residency Program. We compared ITE scores from 2012 and 2013, when there were 5 weekly hours of didactic content, with scores from 2014 and 2015, when 1 hour of conference was replaced with asynchro-nous content. Examination results were compared using a non-inferiority data analysis with a 10% margin of difference. Using a non-inferiority test with a 95% confidence interval, there was no difference between the 2 groups (before and after implementation of asynchronous learning), as the confidence interval for the change of the ITE was -3.5 to 2.3 points, whereas the 10% non-inferiority margin was 7.8 points. Replacing 1 hour of didactic conference with asynchronous learning showed no negative impact on resident ITE scores.

21 CFR 880.6315 - Remote Medication Management System.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... to record a history of the event for the health care professional. The system is intended for use as...

21 CFR 880.6315 - Remote Medication Management System.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... to record a history of the event for the health care professional. The system is intended for use as...

21 CFR 880.6315 - Remote Medication Management System.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... to record a history of the event for the health care professional. The system is intended for use as...

21 CFR 880.6315 - Remote Medication Management System.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... to record a history of the event for the health care professional. The system is intended for use as...

Telecommunications Information Network: A Model for On-Demand Transfer of Medical Information. Final Report.

ERIC Educational Resources Information Center

Lorenzi, Nancy M.; And Others

This report summarizes the third phase of the Telecommunications Information Network (TIN), which provides a telecommunications link between four remote southwest Ohio hospitals and the University of Cincinnati Medical Center, thereby reducing the isolation of healthcare providers at the remote hospitals. A description of the system explains the…

Development of Telemedicine Capabilities for a Joint US-Russian Space Biomedical Center for Training and Research

NASA Technical Reports Server (NTRS)

DeBakey, Michael E.

1998-01-01

From the perspective of scheduling, some medical consultations can have asynchronous and synchronous components. Consultations frequently involve the compilation of patient data, its analysis, a consultant's report, and a real-time conference between the referring physician and the consultant. The bandwidth of the Internet with Moscow and advances in the hardware and software of personal computing now make possible telemedicine events with store-and-forward components and real-time components. These are hybrid telemedicine and this paper describes such a case.

10 CFR 35.2647 - Records of additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... remote afterloader units. 35.2647 Section 35.2647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2647 Records of additional technical requirements for mobile remote afterloader units. (a) A licensee shall retain a record of each check for mobile remote afterloader units...

10 CFR 35.2647 - Records of additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... remote afterloader units. 35.2647 Section 35.2647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2647 Records of additional technical requirements for mobile remote afterloader units. (a) A licensee shall retain a record of each check for mobile remote afterloader units...

10 CFR 35.2647 - Records of additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... remote afterloader units. 35.2647 Section 35.2647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2647 Records of additional technical requirements for mobile remote afterloader units. (a) A licensee shall retain a record of each check for mobile remote afterloader units...

10 CFR 35.2647 - Records of additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... remote afterloader units. 35.2647 Section 35.2647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2647 Records of additional technical requirements for mobile remote afterloader units. (a) A licensee shall retain a record of each check for mobile remote afterloader units...

10 CFR 35.2647 - Records of additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... remote afterloader units. 35.2647 Section 35.2647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2647 Records of additional technical requirements for mobile remote afterloader units. (a) A licensee shall retain a record of each check for mobile remote afterloader units...

Initial Field Test of a Cloud-Based Cardiac Auscultation System to Determine Murmur Etiology in Rural China.

PubMed

Pyles, Lee; Hemmati, Pouya; Pan, J; Yu, Xiaoju; Liu, Ke; Wang, Jing; Tsakistos, Andreas; Zheleva, Bistra; Shao, Weiguang; Ni, Quan

2017-04-01

A system for collection, distribution, and long distant, asynchronous interpretation of cardiac auscultation has been developed and field-tested in rural China. We initiated a proof-of-concept test as a critical component of design of a system to allow rural physicians with little experience in evaluation of congenital heart disease (CHD) to obtain assistance in diagnosis and management of children with significant heart disease. The project tested the hypothesis that acceptable screening of heart murmurs could be accomplished using a digital stethoscope and internet cloud transmittal to deliver phonocardiograms to an experienced observer. Of the 7993 children who underwent school-based screening in the Menghai District of Yunnan Province, Peoples Republic of China, 149 had a murmur noted by a screener. They had digital heart sounds and phonocardiograms collected with the HeartLink tele auscultation system, and underwent echocardiography by a cardiology resident from the First Affiliated Hospital of Kunming Medical University. The digital phonocardiograms, stored on a cloud server, were later remotely reviewed by a board-certified American pediatric cardiologist. Fourteen of these subjects were found to have CHD confirmed by echocardiogram. Using the HeartLink system, the pediatric cardiologist identified 11 of the 14 subjects with pathological murmurs, and missed three subjects with atrial septal defects, which were incorrectly identified as venous hum or Still's murmur. In addition, ten subjects were recorded as having pathological murmurs, when no CHD was confirmed by echocardiography during the field study. The overall test accuracy was 91% with 78.5% sensitivity and 92.6% specificity. This proof-of-concept study demonstrated the feasibility of differentiating pathologic murmurs due to CHD from normal functional heart murmurs with the HeartLink system. This field study is an initial step to develop a cost-effective CHD screening strategy in low-resource settings with a shortage of trained medical professionals and pediatric heart programs.

How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study.

PubMed

Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R

2017-02-23

Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. 4 DAPs at 2 teaching and 2 community hospitals in Canada. 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural-remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. 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/.

Real-Time Teleguidance of a Non-Surgeon Crew Medical Officer Performing Orthopedic Surgery at the Amundsen-Scott South Pole Station During Winter-Over

NASA Technical Reports Server (NTRS)

Otto, Christian

2010-01-01

The Amundsen-Scott South Pole Research station located at the geographic South Pole, is the most isolated, permanently inhabited human outpost on Earth. Medical care is provided to station personnel by a non-surgeon crew medical officer (CMO). During the winter-over period from February to October, the station is isolated, with no incoming or outgoing flights due to severe weather conditions. In late June, four months after the station had closed for the austral winter, a 31 year old meteorologist suffered a complete rupture of his patellar tendon while sliding done an embankment. An evacuation was deemed to be too risky to aircrews due to the extreme cold and darkness. A panel of physicians from Massachusetts General Hospital, Johns Hopkins University and the University of Texas Medical Branch were able to assess the patient remotely via telemedicine and agreed that surgery was the only means to restore mobility and prevent long term disability. The lack of a surgical facility and a trained surgical team were overcome by conversion of the clinic treatment area, and intensive preparation of medical laypersons as surgical assistants. The non-surgeon CMO and CMO assistant at South Pole, were guided through the administration of spinal anesthetic, and the two-hour operative repair by medical consultants at Massachusetts General Hospital. Real-time video of the operative field, directions from the remote consultants and audio communication were provided by videoconferencing equipment, operative cameras, and high bandwidth satellite communications. In real-time, opening incision/exposure, tendon relocation, hemostatsis, and operative closure by the CMO was closely monitored and guided and by the remote consultants. The patient s subsequent physical rehabilitation over the ensuing months of isolation was also monitored remotely via telemedicine. This was the first time in South Pole s history that remote teleguidance had been used for surgery and represents a model for real-time guidance of CMO s working at remote duty stations.

Aviation and the delivery of medical care in remote regions: the Lesotho HIV experience.

PubMed

Furin, Jennifer; Shutts, Mike; Keshavjee, Salmaan

2008-02-01

In many regions of the world plagued by high burdens of disease, there is difficulty in accessing basic medical care. This is often due to logistical constraints and a lack of infrastructure such as roads. Medical aviation can play a major role in addressing some of these crucial issues as it allows for the rapid transport of patients, personnel, and medications to remote-and sometimes otherwise inaccessible-areas. Lesotho is a mountainous nation of 2 million people that provides a good example of medical aviation as a cornerstone in the delivery of health care. The population has a reported HIV seroprevalence of 25%, and many patients live in rural areas that are inaccessible by road. Mission Aviation Fellowship has joined forces with a medical team from the nongovernmental organization Partners In Health in an effort to launch a comprehensive program to address HIV and related problems in rural Lesotho. This medical aviation partnership has allowed for the provision of HIV prevention and treatment services to thousands of people living in the mountains. This commentary describes how medical aviation has been crucial in developing models to address complex, serious health problems in remote settings.

The First Government Sanctioned Delivery of Medical Supplies by Remotely Controlled Unmanned Aerial System (UAS)

NASA Technical Reports Server (NTRS)

Howell, Charles T., III; Jones, Frank; Thorson, Taylor; Grube, Richard; Mellanson, Cecil; Joyce, Lee; Coggin, John; Kennedy, Jack

2016-01-01

The first government sanctioned delivery of medical supplies by UAS occurred at Wise, Virginia, on July 17, 2015. The "Let's Fly Wisely" event was a demonstration of the humanitarian use of UAS to facilitate delivery of medical supplies to remote or otherwise difficult-to-reach areas. The event was the result of coordinated efforts by a partnership which included the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC), Virginia Polytechnic Institute, the Mid-Atlantic Aviation Partnership (MAAP), Flirtey Corporation, Lonesome Pine Airport, Remote Area Medical (RAM), Health Wagon, SEESPAN Aerial Interactive, Rx Partnership, and Wise County, Virginia. The historic event occurred during the annual Remote Area Medical clinic at the Wise County Fairgrounds. The medical supplies in small packages were delivered to the Wise County Fairgrounds from the Lonesome Pine Airport by UAS operated by Firtey. A larger supply of medical supplies were delivered to the Lonesome Pine Airport from the Tazewell County Airport by NASA Langley's SR22 UAS Surrogate Research aircraft. The UAS Surrogate aircraft was remotely controlled for most of the flight by a UAS Ground Control Station located at the Lonesome Pine Airport. The medical supplies were delivered from the UAS Surrogate to Flirtey for final delivery by Hex Multi-Rotor UAS in smaller packages and multiple trips to the fairgrounds. A Certificate of Authorization (COA) issued by the Federal Aviation Administration (FAA) designated the site as an authorized UAS test site. The paper will present additional details of the historic delivery of pharmaceuticals by UAS during the "Let's Fly Wisely" event. The paper will also provide details of NASA's SR22 UAS Surrogate Research aircraft. The UAS Surrogate was designed to investigate the procedures, aircraft sensors and other systems that may be required to allow Unmanned Aerial Systems (UAS) to safely operate with manned aircraft in the National Airspace System (NAS).

Asynchronous networks: modularization of dynamics theorem

NASA Astrophysics Data System (ADS)

Bick, Christian; Field, Michael

2017-02-01

Building on the first part of this paper, we develop the theory of functional asynchronous networks. We show that a large class of functional asynchronous networks can be (uniquely) represented as feedforward networks connecting events or dynamical modules. For these networks we can give a complete description of the network function in terms of the function of the events comprising the network: the modularization of dynamics theorem. We give examples to illustrate the main results.

Distributed Data-aggregation Consensus for Sensor Networks: Relaxation of Consensus Concept and Convergence Property

DTIC Science & Technology

2014-08-01

consensus algorithm called randomized gossip is more suitable [7, 8]. In asynchronous randomized gossip algorithms, pairs of neighboring nodes exchange...messages and perform updates in an asynchronous and unattended manner, and they also 1 The class of broadcast gossip algorithms [9, 10, 11, 12] are...dynamics [2] and asynchronous pairwise randomized gossip [7, 8], broadcast gossip algorithms do not require that nodes know the identities of their

Simulating fail-stop in asynchronous distributed systems

NASA Technical Reports Server (NTRS)

Sabel, Laura; Marzullo, Keith

1994-01-01

The fail-stop failure model appears frequently in the distributed systems literature. However, in an asynchronous distributed system, the fail-stop model cannot be implemented. In particular, it is impossible to reliably detect crash failures in an asynchronous system. In this paper, we show that it is possible to specify and implement a failure model that is indistinguishable from the fail-stop model from the point of view of any process within an asynchronous system. We give necessary conditions for a failure model to be indistinguishable from the fail-stop model, and derive lower bounds on the amount of process replication needed to implement such a failure model. We present a simple one-round protocol for implementing one such failure model, which we call simulated fail-stop.

Asynchronous Video Interviewing as a New Technology in Personnel Selection: The Applicant’s Point of View

PubMed Central

Brenner, Falko S.; Ortner, Tuulia M.; Fay, Doris

2016-01-01

The present study aimed to integrate findings from technology acceptance research with research on applicant reactions to new technology for the emerging selection procedure of asynchronous video interviewing. One hundred six volunteers experienced asynchronous video interviewing and filled out several questionnaires including one on the applicants’ personalities. In line with previous technology acceptance research, the data revealed that perceived usefulness and perceived ease of use predicted attitudes toward asynchronous video interviewing. Furthermore, openness revealed to moderate the relation between perceived usefulness and attitudes toward this particular selection technology. No significant effects emerged for computer self-efficacy, job interview self-efficacy, extraversion, neuroticism, and conscientiousness. Theoretical and practical implications are discussed. PMID:27378969

Use of Mobile Apps Among Medical and Nursing Students in Iran.

PubMed

Sheikhtaheri, Abbas; Kermani, Farzaneh

2018-01-01

Mobile technologies have a positive impact on patient care and cause to improved decision making, reduced medical errors and improved communication in care team. The purpose of this study was to investigate the use of mobile technologies by medical and nursing students and their tendency in future. This study was conducted among 372 medical and nursing students of Tehran University of Medical Science. Respectively, 60.8% and 62.4% of medical and nursing students use smartphone. The most commonly used apps among medical students were medical dictionary, drug apps, medical calculators and anatomical atlases and among nursing students were medical dictionary, anatomical atlases and nursing care guides. Also, the use of decision support systems, remote monitoring, patient imagery and remote diagnosis, patient records documentation, diagnostic guidelines and laboratory tests will be increased in the future.

Technology and the future of medical equipment maintenance.

PubMed

Wear, J O

1999-05-01

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

A Hash Based Remote User Authentication and Authenticated Key Agreement Scheme for the Integrated EPR Information System.

PubMed

Li, Chun-Ta; Weng, Chi-Yao; Lee, Cheng-Chi; Wang, Chun-Cheng

2015-11-01

To protect patient privacy and ensure authorized access to remote medical services, many remote user authentication schemes for the integrated electronic patient record (EPR) information system have been proposed in the literature. In a recent paper, Das proposed a hash based remote user authentication scheme using passwords and smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various passive and active attacks. However, in this paper, we found that Das's authentication scheme is still vulnerable to modification and user duplication attacks. Thereafter we propose a secure and efficient authentication scheme for the integrated EPR information system based on lightweight hash function and bitwise exclusive-or (XOR) operations. The security proof and performance analysis show our new scheme is well-suited to adoption in remote medical healthcare services.

Health care for all: effective, community supported, healthcare with innovative use of telemedicine technology.

PubMed

Shah, Tariq Kazim; Tariq, Tasneem; Phillips, Roger; Davison, Steve; Hoare, Adam; Hasan, Syed Shahzad; Babar, Zaheer-Ud-Din

2018-01-01

Almost half of the world's total population reside in rural and remote areas and a large number of these people remain deprived of most basic facilities like healthcare and education. It is deemed impossible for government with scarce resources in developing countries to open and run a health facility in every remote community using conventional means. One increasingly popular unconventional mean is the use of existing technology to improve exchange of medical information for the purpose of improving health of underprivileged communities. Telemedicine implies the use of information and communication technology to provide health care remotely from a distance. With the induction of telemedicine, patients who live in rural and remote areas can have increased access to medical services. In many developing countries, use of telemedicine however has been limited mainly to teleconferencing between primary and secondary/tertiary care facilities for diagnosis and management of patients. This system still requires patients from remote communities to travel, often long and arduous journeys to the centre where telecom and medical facilities are available. Health Care 4 All International, a not for profit registered charity is providing primary care to patients by taking telemedicine into their homes in remote communities, thus obviating the need and hardships of travel for patient.

A comparative cost analysis of an integrated military telemental health-care service.

PubMed

Grady, Brian J

2002-01-01

The National Naval Medical Center, Bethesda, Maryland, integrated telemental health care into its primary behavioral health-care outreach service in 1998. To date, there have been over 1,800 telemental health visits, and the service encounters approximately 100 visits per month at this time. The objective of this study was to compare and contrast the costs to the beneficiary, the medical system, and the military organization as a whole via one of the four methods currently employed to access mental health care from remotely located military medical clinics. The four methods include local access via the military's civilian health maintenance organization (HMO) network, patient travel to the military treatment facility, military mental health specialists' travel to the remote clinic (circuit riding) and TeleMental Healthcare (TMH). Interactive video conferencing, phone, electronic mail, and facsimile were used to provide telemental health care from a military treatment facility to a remote military medical clinic. The costs of health-care services, equipment, patient travel, lost work time, and communications were tabulated and evaluated. While the purpose of providing telemental healthcare services was to improve access to mental health care for our beneficiaries at remote military medical clinics, it became apparent that this could be done at comparable or reduced costs.

Network evolution induced by asynchronous stimuli through spike-timing-dependent plasticity.

PubMed

Yuan, Wu-Jie; Zhou, Jian-Fang; Zhou, Changsong

2013-01-01

In sensory neural system, external asynchronous stimuli play an important role in perceptual learning, associative memory and map development. However, the organization of structure and dynamics of neural networks induced by external asynchronous stimuli are not well understood. Spike-timing-dependent plasticity (STDP) is a typical synaptic plasticity that has been extensively found in the sensory systems and that has received much theoretical attention. This synaptic plasticity is highly sensitive to correlations between pre- and postsynaptic firings. Thus, STDP is expected to play an important role in response to external asynchronous stimuli, which can induce segregative pre- and postsynaptic firings. In this paper, we study the impact of external asynchronous stimuli on the organization of structure and dynamics of neural networks through STDP. We construct a two-dimensional spatial neural network model with local connectivity and sparseness, and use external currents to stimulate alternately on different spatial layers. The adopted external currents imposed alternately on spatial layers can be here regarded as external asynchronous stimuli. Through extensive numerical simulations, we focus on the effects of stimulus number and inter-stimulus timing on synaptic connecting weights and the property of propagation dynamics in the resulting network structure. Interestingly, the resulting feedforward structure induced by stimulus-dependent asynchronous firings and its propagation dynamics reflect both the underlying property of STDP. The results imply a possible important role of STDP in generating feedforward structure and collective propagation activity required for experience-dependent map plasticity in developing in vivo sensory pathways and cortices. The relevance of the results to cue-triggered recall of learned temporal sequences, an important cognitive function, is briefly discussed as well. Furthermore, this finding suggests a potential application for examining STDP by measuring neural population activity in a cultured neural network.

FAST: A fully asynchronous and status-tracking pattern for geoprocessing services orchestration

NASA Astrophysics Data System (ADS)

Wu, Huayi; You, Lan; Gui, Zhipeng; Gao, Shuang; Li, Zhenqiang; Yu, Jingmin

2014-09-01

Geoprocessing service orchestration (GSO) provides a unified and flexible way to implement cross-application, long-lived, and multi-step geoprocessing service workflows by coordinating geoprocessing services collaboratively. Usually, geoprocessing services and geoprocessing service workflows are data and/or computing intensive. The intensity feature may make the execution process of a workflow time-consuming. Since it initials an execution request without blocking other interactions on the client side, an asynchronous mechanism is especially appropriate for GSO workflows. Many critical problems remain to be solved in existing asynchronous patterns for GSO including difficulties in improving performance, status tracking, and clarifying the workflow structure. These problems are a challenge when orchestrating performance efficiency, making statuses instantly available, and constructing clearly structured GSO workflows. A Fully Asynchronous and Status-Tracking (FAST) pattern that adopts asynchronous interactions throughout the whole communication tier of a workflow is proposed for GSO. The proposed FAST pattern includes a mechanism that actively pushes the latest status to clients instantly and economically. An independent proxy was designed to isolate the status tracking logic from the geoprocessing business logic, which assists the formation of a clear GSO workflow structure. A workflow was implemented in the FAST pattern to simulate the flooding process in the Poyang Lake region. Experimental results show that the proposed FAST pattern can efficiently tackle data/computing intensive geoprocessing tasks. The performance of all collaborative partners was improved due to the asynchronous mechanism throughout communication tier. A status-tracking mechanism helps users retrieve the latest running status of a GSO workflow in an efficient and instant way. The clear structure of the GSO workflow lowers the barriers for geospatial domain experts and model designers to compose asynchronous GSO workflows. Most importantly, it provides better support for locating and diagnosing potential exceptions.

Asynchronous collision integrators: Explicit treatment of unilateral contact with friction and nodal restraints

PubMed Central

Wolff, Sebastian; Bucher, Christian

2013-01-01

This article presents asynchronous collision integrators and a simple asynchronous method treating nodal restraints. Asynchronous discretizations allow individual time step sizes for each spatial region, improving the efficiency of explicit time stepping for finite element meshes with heterogeneous element sizes. The article first introduces asynchronous variational integration being expressed by drift and kick operators. Linear nodal restraint conditions are solved by a simple projection of the forces that is shown to be equivalent to RATTLE. Unilateral contact is solved by an asynchronous variant of decomposition contact response. Therein, velocities are modified avoiding penetrations. Although decomposition contact response is solving a large system of linear equations (being critical for the numerical efficiency of explicit time stepping schemes) and is needing special treatment regarding overconstraint and linear dependency of the contact constraints (for example from double-sided node-to-surface contact or self-contact), the asynchronous strategy handles these situations efficiently and robust. Only a single constraint involving a very small number of degrees of freedom is considered at once leading to a very efficient solution. The treatment of friction is exemplified for the Coulomb model. Special care needs the contact of nodes that are subject to restraints. Together with the aforementioned projection for restraints, a novel efficient solution scheme can be presented. The collision integrator does not influence the critical time step. Hence, the time step can be chosen independently from the underlying time-stepping scheme. The time step may be fixed or time-adaptive. New demands on global collision detection are discussed exemplified by position codes and node-to-segment integration. Numerical examples illustrate convergence and efficiency of the new contact algorithm. Copyright © 2013 The Authors. International Journal for Numerical Methods in Engineering published by John Wiley & Sons, Ltd. PMID:23970806

Within-female plasticity in sex allocation is associated with a behavioural polyphenism in house wrens.

PubMed

Bowers, E K; Thompson, C F; Sakaluk, S K

2016-03-01

Sex allocation theory assumes individual plasticity in maternal strategies, but few studies have investigated within-individual changes across environments. In house wrens, differences between nests in the degree of hatching synchrony of eggs represent a behavioural polyphenism in females, and its expression varies with seasonal changes in the environment. Between-nest differences in hatching asynchrony also create different environments for offspring, and sons are more strongly affected than daughters by sibling competition when hatching occurs asynchronously over several days. Here, we examined variation in hatching asynchrony and sex allocation, and its consequences for offspring fitness. The number and condition of fledglings declined seasonally, and the frequency of asynchronous hatching increased. In broods hatched asynchronously, sons, which are over-represented in the earlier-laid eggs, were in better condition than daughters, which are over-represented in the later-laid eggs. Nonetheless, asynchronous broods were more productive later within seasons. The proportion of sons in asynchronous broods increased seasonally, whereas there was a seasonal increase in the production of daughters by mothers hatching their eggs synchronously, which was characterized by within-female changes in offspring sex and not by sex-biased mortality. As adults, sons from asynchronous broods were in better condition and produced more broods of their own than males from synchronous broods, and both males and females from asynchronous broods had higher lifetime reproductive success than those from synchronous broods. In conclusion, hatching patterns are under maternal control, representing distinct strategies for allocating offspring within broods, and are associated with offspring sex ratios and differences in offspring reproductive success. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

Intelligent distributed medical image management

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.

1995-05-01

The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

Asynchronous P300-based brain-computer interface to control a virtual environment: initial tests on end users.

PubMed

Aloise, Fabio; Schettini, Francesca; Aricò, Pietro; Salinari, Serenella; Guger, Christoph; Rinsma, Johanna; Aiello, Marco; Mattia, Donatella; Cincotti, Febo

2011-10-01

Motor disability and/or ageing can prevent individuals from fully enjoying home facilities, thus worsening their quality of life. Advances in the field of accessible user interfaces for domotic appliances can represent a valuable way to improve the independence of these persons. An asynchronous P300-based Brain-Computer Interface (BCI) system was recently validated with the participation of healthy young volunteers for environmental control. In this study, the asynchronous P300-based BCI for the interaction with a virtual home environment was tested with the participation of potential end-users (clients of a Frisian home care organization) with limited autonomy due to ageing and/or motor disabilities. System testing revealed that the minimum number of stimulation sequences needed to achieve correct classification had a higher intra-subject variability in potential end-users with respect to what was previously observed in young controls. Here we show that the asynchronous modality performed significantly better as compared to the synchronous mode in continuously adapting its speed to the users' state. Furthermore, the asynchronous system modality confirmed its reliability in avoiding misclassifications and false positives, as previously shown in young healthy subjects. The asynchronous modality may contribute to filling the usability gap between BCI systems and traditional input devices, representing an important step towards their use in the activities of daily living.

Universal filtered multi-carrier system for asynchronous uplink transmission in optical access network

NASA Astrophysics Data System (ADS)

Kang, Soo-Min; Kim, Chang-Hun; Han, Sang-Kook

2016-02-01

In passive optical network (PON), orthogonal frequency division multiplexing (OFDM) has been studied actively due to its advantages such as high spectra efficiency (SE), dynamic resource allocation in time or frequency domain, and dispersion robustness. However, orthogonal frequency division multiple access (OFDMA)-PON requires tight synchronization among multiple access signals. If not, frequency orthogonality could not be maintained. Also its sidelobe causes inter-channel interference (ICI) to adjacent channel. To prevent ICI caused by high sidelobes, guard band (GB) is usually used which degrades SE. Thus, OFDMA-PON is not suitable for asynchronous uplink transmission in optical access network. In this paper, we propose intensity modulation/direct detection (IM/DD) based universal filtered multi-carrier (UFMC) PON for asynchronous multiple access. The UFMC uses subband filtering to subsets of subcarriers. Since it reduces sidelobe of each subband by applying subband filtering, it could achieve better performance compared to OFDM. For the experimental demonstration, different sample delay was applied to subbands to implement asynchronous transmission condition. As a result, time synchronization robustness of UFMC was verified in asynchronous multiple access system.

Evaluation of a web-based asynchronous pediatric emergency medicine learning tool for residents and medical students.

PubMed

Burnette, Kreg; Ramundo, Maria; Stevenson, Michelle; Beeson, Michael S

2009-12-01

To examine the effectiveness of an asynchronous learning tool consisting of web-based lectures for trainees covering major topics pertinent to pediatric emergency medicine (PEM) and to assess resident and student evaluation of this mode of education. PEM faculty and fellows created a 21-lecture, web-based curriculum. These 20-minute online lectures used Microsoft PowerPoint with the voice-over feature. A 75-question test was created to assess the effectiveness of the web-based learning model, administered online before and after the rotation in the pediatric emergency department (PED). All fourth-year medical students and residents (across all specialties) rotating through the PED were required to complete 10 of the 21 lectures during their 1-month rotation. The main outcome variable was difference in score between pre- and post-rotation tests of participants who viewed no lectures and those who viewed at least one lecture. Evaluation of the program was assessed by anonymous survey using 5-point discrete visual analog scales. Responses of 4 or 5 were considered positive for analysis. One hundred eleven residents and fourth-year medical students participated in the program. An initial 32 completed testing before implementation of the on-line lectures (March 2007-August 2007), and another five did not complete the on-line lectures after implementation (September 2007-February 2008). Seventy-one completed testing and on-line lectures, and all but three completed at least 10 on-line lectures during their rotation. Fourteen of 111 trainees did not complete the pre- or post-test (including two who viewed the lectures). The mean change in score was a 1% improvement from pre-test to post-test for trainees who viewed no lectures and a 6.2% improvement for those who viewed the lectures (mean difference = 5.2%, 95% confidence interval = 2.5% to 7.9%). In the linear regression model, the estimate of the coefficient was 0.43 (p < 0.001), meaning that, for each lecture viewed, post-test score rose by 0.43%. Sixty-nine of 75 test items (92%) had a point biserial correlation greater than 0.15. Thirty of the 72 trainees who completed the online lectures and testing (42%) returned surveys. All were comfortable using the Internet, and 87% (26/30) found the web-site easy to use. All felt that their educational goals were met, and 100% felt that the format would be useful in other areas of education. Although not a replacement for traditional bedside teaching, the use of web-based lectures as an asynchronous learning tool has a positive effect on medical knowledge test scores. Trainees were able to view online lectures on their own schedules, in the location of their choice. This is helpful in a field with shift work, in which trainees rarely work together, making it difficult to synchronously provide lectures to all trainees. (c) 2009 by the Society for Academic Emergency Medicine.

A Hartree-Fock Application Using UPC++ and the New DArray Library

DOE PAGES

Ozog, David; Kamil, Amir; Zheng, Yili; ...

2016-07-21

The Hartree-Fock (HF) method is the fundamental first step for incorporating quantum mechanics into many-electron simulations of atoms and molecules, and it is an important component of computational chemistry toolkits like NWChem. The GTFock code is an HF implementation that, while it does not have all the features in NWChem, represents crucial algorithmic advances that reduce communication and improve load balance by doing an up-front static partitioning of tasks, followed by work stealing whenever necessary. To enable innovations in algorithms and exploit next generation exascale systems, it is crucial to support quantum chemistry codes using expressive and convenient programming modelsmore » and runtime systems that are also efficient and scalable. Here, this paper presents an HF implementation similar to GTFock using UPC++, a partitioned global address space model that includes flexible communication, asynchronous remote computation, and a powerful multidimensional array library. UPC++ offers runtime features that are useful for HF such as active messages, a rich calculus for array operations, hardware-supported fetch-and-add, and functions for ensuring asynchronous runtime progress. We present a new distributed array abstraction, DArray, that is convenient for the kinds of random-access array updates and linear algebra operations on block-distributed arrays with irregular data ownership. Finally, we analyze the performance of atomic fetch-and-add operations (relevant for load balancing) and runtime attentiveness, then compare various techniques and optimizations for each. Our optimized implementation of HF using UPC++ and the DArrays library shows up to 20% improvement over GTFock with Global Arrays at scales up to 24,000 cores.« less

A Hartree-Fock Application Using UPC++ and the New DArray Library

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

Ozog, David; Kamil, Amir; Zheng, Yili

The Hartree-Fock (HF) method is the fundamental first step for incorporating quantum mechanics into many-electron simulations of atoms and molecules, and it is an important component of computational chemistry toolkits like NWChem. The GTFock code is an HF implementation that, while it does not have all the features in NWChem, represents crucial algorithmic advances that reduce communication and improve load balance by doing an up-front static partitioning of tasks, followed by work stealing whenever necessary. To enable innovations in algorithms and exploit next generation exascale systems, it is crucial to support quantum chemistry codes using expressive and convenient programming modelsmore » and runtime systems that are also efficient and scalable. Here, this paper presents an HF implementation similar to GTFock using UPC++, a partitioned global address space model that includes flexible communication, asynchronous remote computation, and a powerful multidimensional array library. UPC++ offers runtime features that are useful for HF such as active messages, a rich calculus for array operations, hardware-supported fetch-and-add, and functions for ensuring asynchronous runtime progress. We present a new distributed array abstraction, DArray, that is convenient for the kinds of random-access array updates and linear algebra operations on block-distributed arrays with irregular data ownership. Finally, we analyze the performance of atomic fetch-and-add operations (relevant for load balancing) and runtime attentiveness, then compare various techniques and optimizations for each. Our optimized implementation of HF using UPC++ and the DArrays library shows up to 20% improvement over GTFock with Global Arrays at scales up to 24,000 cores.« less

A Binary Array Asynchronous Sorting Algorithm with Using Petri Nets

NASA Astrophysics Data System (ADS)

Voevoda, A. A.; Romannikov, D. O.

2017-01-01

Nowadays the tasks of computations speed-up and/or their optimization are actual. Among the approaches on how to solve these tasks, a method applying approaches of parallelization and asynchronization to a sorting algorithm is considered in the paper. The sorting methods are ones of elementary methods and they are used in a huge amount of different applications. In the paper, we offer a method of an array sorting that based on a division into a set of independent adjacent pairs of numbers and their parallel and asynchronous comparison. And this one distinguishes the offered method from the traditional sorting algorithms (like quick sorting, merge sorting, insertion sorting and others). The algorithm is implemented with the use of Petri nets, like the most suitable tool for an asynchronous systems description.

KAMEDIN: a telemedicine system for computer supported cooperative work and remote image analysis in radiology.

PubMed

Handels, H; Busch, C; Encarnação, J; Hahn, C; Kühn, V; Miehe, J; Pöppl, S I; Rinast, E; Rossmanith, C; Seibert, F; Will, A

1997-03-01

The software system KAMEDIN (Kooperatives Arbeiten und MEdizinische Diagnostik auf Innovativen Netzen) is a multimedia telemedicine system for exchange, cooperative diagnostics, and remote analysis of digital medical image data. It provides components for visualisation, processing, and synchronised audio-visual discussion of medical images. Techniques of computer supported cooperative work (CSCW) synchronise user interactions during a teleconference. Visibility of both local and remote cursor on the conference workstations facilitates telepointing and reinforces the conference partner's telepresence. Audio communication during teleconferences is supported by an integrated audio component. Furthermore, brain tissue segmentation with artificial neural networks can be performed on an external supercomputer as a remote image analysis procedure. KAMEDIN is designed as a low cost CSCW tool for ISDN based telecommunication. However it can be used on any TCP/IP supporting network. In a field test, KAMEDIN was installed in 15 clinics and medical departments to validate the systems' usability. The telemedicine system KAMEDIN has been developed, tested, and evaluated within a research project sponsored by German Telekom.

Staggered scheduling of sensor estimation and fusion for tracking over long-haul links

DOE PAGES

Liu, Qiang; Rao, Nageswara S. V.; Wang, Xin

2016-08-01

Networked sensing can be found in a multitude of real-world applications. Here, we focus on the communication-and computation-constrained long-haul sensor networks, where sensors are remotely deployed over a vast geographical area to perform certain tasks. Of special interest is a class of such networks where sensors take measurements of one or more dynamic targets and send their state estimates to a remote fusion center via long-haul satellite links. The severe loss and delay over such links can easily reduce the amount of sensor data received by the fusion center, thereby limiting the potential information fusion gain and resulting in suboptimalmore » tracking performance. In this paper, starting with the temporal-domain staggered estimation for an individual sensor, we explore the impact of the so-called intra-state prediction and retrodiction on estimation errors. We then investigate the effect of such estimation scheduling across different sensors on the spatial-domain fusion performance, where the sensing time epochs across sensors are scheduled in an asynchronous and staggered manner. In particular, the impact of communication delay and loss as well as sensor bias on such scheduling is explored by means of numerical and simulation studies that demonstrate the validity of our analysis.« less

Interpolation algorithm for asynchronous ADC-data

NASA Astrophysics Data System (ADS)

Bramburger, Stefan; Zinke, Benny; Killat, Dirk

2017-09-01

This paper presents a modified interpolation algorithm for signals with variable data rate from asynchronous ADCs. The Adaptive weights Conjugate gradient Toeplitz matrix (ACT) algorithm is extended to operate with a continuous data stream. An additional preprocessing of data with constant and linear sections and a weighted overlap of step-by-step into spectral domain transformed signals improve the reconstruction of the asycnhronous ADC signal. The interpolation method can be used if asynchronous ADC data is fed into synchronous digital signal processing.

Application of intelligent soft start in asynchronous motor

NASA Astrophysics Data System (ADS)

Du, Xue; Ye, Ying; Wang, Yuelong; Peng, Lei; Zhang, Suying

2018-05-01

The starting way of three phase asynchronous motor has full voltage start and step-down start. Direct starting brings large current impact, causing excessive local temperature to the power grid and larger starting torque will also impact the motor equipment and affect the service life of the motor. Aim at the problem of large current and torque caused by start-up, an intelligent soft starter is proposed. Through the application of intelligent soft start on asynchronous motor, highlights its application advantage in motor control.

Remote Antimicrobial Stewardship in Community Hospitals

PubMed Central

Wood, Zachary H.; Nicolsen, Nicole C.; Allen, Nichole; Cook, Paul P.

2015-01-01

Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to streamline, discontinue, or switch antimicrobial agents. Totals of charts reviewed, recommendations made, recommendations accepted, and categories of intervention were recorded. Linear regression was utilized to measure changes in antimicrobial use over time. For the four larger hospitals, recommendations for changes were made in an average of 45 charts per month per hospital and physician acceptance of the pharmacists’ recommendations varied between 83% and 88%. There was no significant decrease in total antimicrobial use, but much of the use was outside of the stewardship program’s review. Quinolone use decreased by more than 50% in two of the four larger hospitals. Remote antimicrobial stewardship utilizing an EMR is feasible in community hospitals and is generally received favorably by physicians. As more community hospitals adopt EMRs, there is an opportunity to expand antimicrobial stewardship beyond the academic medical center. PMID:27025642

New information technology tools for a medical command system for mass decontamination.

PubMed

Fuse, Akira; Okumura, Tetsu; Hagiwara, Jun; Tanabe, Tomohide; Fukuda, Reo; Masuno, Tomohiko; Mimura, Seiji; Yamamoto, Kaname; Yokota, Hiroyuki

2013-06-01

In a mass decontamination during a nuclear, biological, or chemical (NBC) response, the capability to command, control, and communicate is crucial for the proper flow of casualties at the scene and their subsequent evacuation to definitive medical facilities. Information Technology (IT) tools can be used to strengthen medical control, command, and communication during such a response. Novel IT tools comprise a vehicle-based, remote video camera and communication network systems. During an on-site verification event, an image from a remote video camera system attached to the personal protective garment of a medical responder working in the warm zone was transmitted to the on-site Medical Commander for aid in decision making. Similarly, a communication network system was used for personnel at the following points: (1) the on-site Medical Headquarters; (2) the decontamination hot zone; (3) an on-site coordination office; and (4) a remote medical headquarters of a local government office. A specially equipped, dedicated vehicle was used for the on-site medical headquarters, and facilitated the coordination with other agencies. The use of these IT tools proved effective in assisting with the medical command and control of medical resources and patient transport decisions during a mass-decontamination exercise, but improvements are required to overcome transmission delays and camera direction settings, as well as network limitations in certain areas.

[Development and evaluation of the medical imaging distribution system with dynamic web application and clustering technology].

PubMed

Yokohama, Noriya; Tsuchimoto, Tadashi; Oishi, Masamichi; Itou, Katsuya

2007-01-20

It has been noted that the downtime of medical informatics systems is often long. Many systems encounter downtimes of hours or even days, which can have a critical effect on daily operations. Such systems remain especially weak in the areas of database and medical imaging data. The scheme design shows the three-layer architecture of the system: application, database, and storage layers. The application layer uses the DICOM protocol (Digital Imaging and Communication in Medicine) and HTTP (Hyper Text Transport Protocol) with AJAX (Asynchronous JavaScript+XML). The database is designed to decentralize in parallel using cluster technology. Consequently, restoration of the database can be done not only with ease but also with improved retrieval speed. In the storage layer, a network RAID (Redundant Array of Independent Disks) system, it is possible to construct exabyte-scale parallel file systems that exploit storage spread. Development and evaluation of the test-bed has been successful in medical information data backup and recovery in a network environment. This paper presents a schematic design of the new medical informatics system that can be accommodated from a recovery and the dynamic Web application for medical imaging distribution using AJAX.

10 CFR 35.647 - Additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Additional technical requirements for mobile remote afterloader units. 35.647 Section 35.647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery...

10 CFR 35.647 - Additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Additional technical requirements for mobile remote afterloader units. 35.647 Section 35.647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery...

10 CFR 35.647 - Additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Additional technical requirements for mobile remote afterloader units. 35.647 Section 35.647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery...

10 CFR 35.647 - Additional technical requirements for mobile remote afterloader units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Additional technical requirements for mobile remote afterloader units. 35.647 Section 35.647 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery...

Determination of power and moment on shaft of special asynchronous electric drives

NASA Astrophysics Data System (ADS)

Karandey, V. Yu; Popov, B. K.; Popova, O. B.; Afanasyev, V. L.

2018-03-01

In the article, questions and tasks of determination of power and the moment on a shaft of special asynchronous electric drives are considered. Use of special asynchronous electric drives in mechanical engineering and other industries is relevant. The considered types of electric drives possess the improved mass-dimensional indicators in comparison with singleengine systems. Also these types of electric drives have constructive advantages; the improved characteristics allow one to realize the technological process. But creation and design of new electric drives demands adjustment of existing or development of new methods and approaches of calculation of parameters. Determination of power and the moment on a shaft of special asynchronous electric drives is the main objective during design of electric drives. This task has been solved based on a method of electromechanical transformation of energy.

Distributed asynchronous microprocessor architectures in fault tolerant integrated flight systems

NASA Technical Reports Server (NTRS)

Dunn, W. R.

1983-01-01

The paper discusses the implementation of fault tolerant digital flight control and navigation systems for rotorcraft application. It is shown that in implementing fault tolerance at the systems level using advanced LSI/VLSI technology, aircraft physical layout and flight systems requirements tend to define a system architecture of distributed, asynchronous microprocessors in which fault tolerance can be achieved locally through hardware redundancy and/or globally through application of analytical redundancy. The effects of asynchronism on the execution of dynamic flight software is discussed. It is shown that if the asynchronous microprocessors have knowledge of time, these errors can be significantly reduced through appropiate modifications of the flight software. Finally, the papear extends previous work to show that through the combined use of time referencing and stable flight algorithms, individual microprocessors can be configured to autonomously tolerate intermittent faults.

The Design of Finite State Machine for Asynchronous Replication Protocol

NASA Astrophysics Data System (ADS)

Wang, Yanlong; Li, Zhanhuai; Lin, Wei; Hei, Minglei; Hao, Jianhua

Data replication is a key way to design a disaster tolerance system and to achieve reliability and availability. It is difficult for a replication protocol to deal with the diverse and complex environment. This means that data is less well replicated than it ought to be. To reduce data loss and to optimize replication protocols, we (1) present a finite state machine, (2) run it to manage an asynchronous replication protocol and (3) report a simple evaluation of the asynchronous replication protocol based on our state machine. It's proved that our state machine is applicable to guarantee the asynchronous replication protocol running in the proper state to the largest extent in the event of various possible events. It also can helpful to build up replication-based disaster tolerance systems to ensure the business continuity.

The Use of Efficient Broadcast Protocols in Asynchronous Distributed Systems. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Schmuck, Frank Bernhard

1988-01-01

Reliable broadcast protocols are important tools in distributed and fault-tolerant programming. They are useful for sharing information and for maintaining replicated data in a distributed system. However, a wide range of such protocols has been proposed. These protocols differ in their fault tolerance and delivery ordering characteristics. There is a tradeoff between the cost of a broadcast protocol and how much ordering it provides. It is, therefore, desirable to employ protocols that support only a low degree of ordering whenever possible. This dissertation presents techniques for deciding how strongly ordered a protocol is necessary to solve a given application problem. It is shown that there are two distinct classes of application problems: problems that can be solved with efficient, asynchronous protocols, and problems that require global ordering. The concept of a linearization function that maps partially ordered sets of events to totally ordered histories is introduced. How to construct an asynchronous implementation that solves a given problem if a linearization function for it can be found is shown. It is proved that in general the question of whether a problem has an asynchronous solution is undecidable. Hence there exists no general algorithm that would automatically construct a suitable linearization function for a given problem. Therefore, an important subclass of problems that have certain commutativity properties are considered. Techniques for constructing asynchronous implementations for this class are presented. These techniques are useful for constructing efficient asynchronous implementations for a broad range of practical problems.

10 CFR 35.633 - Full calibration measurements on remote afterloader units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Full calibration measurements on remote afterloader units. 35.633 Section 35.633 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.633...

Impacts of telemation on modern society

NASA Technical Reports Server (NTRS)

Alexander, A. D., III

1973-01-01

A survey study of state-of-the-art technology, major civil sector user needs, and recommendations for federal initiatives in the field of teleoperators, robotics, and remote systems is reviewed. Impending developments in the application of telemation to remote emergency medical care and to remote mining operations are speculated upon.

10 CFR 35.643 - Periodic spot-checks for remote afterloader units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Periodic spot-checks for remote afterloader units. 35.643 Section 35.643 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.643 Periodic...

10 CFR 35.633 - Full calibration measurements on remote afterloader units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Full calibration measurements on remote afterloader units. 35.633 Section 35.633 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.633...

10 CFR 35.643 - Periodic spot-checks for remote afterloader units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Periodic spot-checks for remote afterloader units. 35.643 Section 35.643 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.643 Periodic...

10 CFR 35.643 - Periodic spot-checks for remote afterloader units.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Periodic spot-checks for remote afterloader units. 35.643 Section 35.643 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.643 Periodic...

10 CFR 35.633 - Full calibration measurements on remote afterloader units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Full calibration measurements on remote afterloader units. 35.633 Section 35.633 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.633...

10 CFR 35.643 - Periodic spot-checks for remote afterloader units.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Periodic spot-checks for remote afterloader units. 35.643 Section 35.643 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.643 Periodic...

10 CFR 35.633 - Full calibration measurements on remote afterloader units.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Full calibration measurements on remote afterloader units. 35.633 Section 35.633 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.633...

10 CFR 35.633 - Full calibration measurements on remote afterloader units.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Full calibration measurements on remote afterloader units. 35.633 Section 35.633 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and Gamma Stereotactic Radiosurgery Units § 35.633...

21 CFR 892.5700 - Remote controlled radionuclide applicator system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote controlled radionuclide applicator system. 892.5700 Section 892.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5700 Remote controlled...

EMR management system for patient pulse data.

PubMed

Lee, Junyoung

2012-10-01

The purpose of this study is to build an integrated medical information system for effective database management of clinical information and to improve the existing Electronic Medical Record (EMR)-based system that is currently being used in hospitals. The integrated medical information system of hospitals consists of an Order Communication System (OCS), Picture Archiving Communication System (PACS), and Laboratory Information System (LIS), as well as Electronic Medical Record (EMR). It is designed so that remote health screening and patient data search can be accessed through a high speed network-even in remote areas-in order to effectively manage data on medical treatment that patients received at their respective hospitals. The existing oriental treatment system is one in which the doctor requires the patient to visit the hospital in person, so as to be able to check the patient's pulse and measure it with his hand for proper diagnosis and treatment. However, due to the recent development of digitalized medical measurement equipment, not only can doctors now check a patient's pulse without touching it directly, but the measured data are computerized and stored into the database as the electronic obligation record. Thus, even if a patient cannot visit the hospital, proper medical treatment is available by analyzing the patient's medical history and diagnosis process in the remote area. Furthermore, when a comprehensive medical testing center system including the people medical examination and diverse physical examination is established, the quality of medical service is expected to be improved than now.

What do medical residents learn on a rural Japanese island?

PubMed Central

Ohta, Ryuichi; Son, Daisuke

2018-01-01

Objective: Community-based medical education (CBME) serves as a complement to university medical education, and it is practiced in several urban undergraduate and postgraduate curriculums. However, there are few reports on CBME learning content in rural Japanese settings. Materials and Methods: This research aimed to clarify learning content through semi-structured interviews and qualitative analysis of second-year residents who studied on a remote, rural island located 400 km from the mainland of Okinawa, Japan. Analysis was based on Steps for Coding and Theorization (SCAT). Results: Fifteen concepts were extracted, and four categories were generated: a strong connection among the islanders, the necessary abilities for rural physicians, islander-centered care, and the differences between rural and hospital medicine. In contrast to hospital medicine, various kinds of learning occurred in deep relationships with the islanders. Conclusion: Through CBME on a remote island, the residents learned not only about medical aspects, but also the importance of community health through the social and cultural aspects, whole-person medical care in a remote location, and the importance of reflection in their self-directed learning. PMID:29875892

Digital Self-Interference Cancellation for Asynchronous In-Band Full-Duplex Underwater Acoustic Communication.

PubMed

Qiao, Gang; Gan, Shuwei; Liu, Songzuo; Ma, Lu; Sun, Zongxin

2018-05-24

To improve the throughput of underwater acoustic (UWA) networking, the In-band full-duplex (IBFD) communication is one of the most vital pieces of research. The major drawback of IBFD-UWA communication is Self-Interference (SI). This paper presents a digital SI cancellation algorithm for asynchronous IBFD-UWA communication system. We focus on two issues: one is asynchronous communication dissimilar to IBFD radio communication, the other is nonlinear distortion caused by power amplifier (PA). First, we discuss asynchronous IBFD-UWA signal model with the nonlinear distortion of PA. Then, we design a scheme for asynchronous IBFD-UWA communication utilizing the non-overlapping region between SI and intended signal to estimate the nonlinear SI channel. To cancel the nonlinear distortion caused by PA, we propose an Over-Parameterization based Recursive Least Squares (RLS) algorithm (OPRLS) to estimate the nonlinear SI channel. Furthermore, we present the OPRLS with a sparse constraint to estimate the SI channel, which reduces the requirement of the length of the non-overlapping region. Finally, we verify our concept through simulation and the pool experiment. Results demonstrate that the proposed digital SI cancellation scheme can cancel SI efficiently.

A massively asynchronous, parallel brain.

PubMed

Zeki, Semir

2015-05-19

Whether the visual brain uses a parallel or a serial, hierarchical, strategy to process visual signals, the end result appears to be that different attributes of the visual scene are perceived asynchronously--with colour leading form (orientation) by 40 ms and direction of motion by about 80 ms. Whatever the neural root of this asynchrony, it creates a problem that has not been properly addressed, namely how visual attributes that are perceived asynchronously over brief time windows after stimulus onset are bound together in the longer term to give us a unified experience of the visual world, in which all attributes are apparently seen in perfect registration. In this review, I suggest that there is no central neural clock in the (visual) brain that synchronizes the activity of different processing systems. More likely, activity in each of the parallel processing-perceptual systems of the visual brain is reset independently, making of the brain a massively asynchronous organ, just like the new generation of more efficient computers promise to be. Given the asynchronous operations of the brain, it is likely that the results of activities in the different processing-perceptual systems are not bound by physiological interactions between cells in the specialized visual areas, but post-perceptually, outside the visual brain.

"Persons That Live Remote from London": Apothecaries and the Medical Marketplace in Seventeenth-and Eighteenth-Century Wales

PubMed Central

Withey, Alun

2011-01-01

Summary This article uses evidence from Welsh apothecary shops as a means to access the mechanisms of the "medical marketplace" in seventeenth- and eighteenth-century Wales. As a country physically remote from large urban medical centers, and with few large towns, Wales has often been overlooked in terms of medical commerce. Nevertheless, evidence suggests that Welsh apothecaries participated in broad and sophisticated networks of trade with London suppliers. Moreover, their shops contained a wide range of medicines from herbal simples to exotic ingredients and chemical preparations, highlighting the availability of such goods far from large urban centers. PMID:21804184

Scenario Decomposition for 0-1 Stochastic Programs: Improvements and Asynchronous Implementation

DOE PAGES

Ryan, Kevin; Rajan, Deepak; Ahmed, Shabbir

2016-05-01

We recently proposed scenario decomposition algorithm for stochastic 0-1 programs finds an optimal solution by evaluating and removing individual solutions that are discovered by solving scenario subproblems. In our work, we develop an asynchronous, distributed implementation of the algorithm which has computational advantages over existing synchronous implementations of the algorithm. Improvements to both the synchronous and asynchronous algorithm are proposed. We also test the results on well known stochastic 0-1 programs from the SIPLIB test library and is able to solve one previously unsolved instance from the test set.

Finite-time synchronization of uncertain coupled switched neural networks under asynchronous switching.

PubMed

Wu, Yuanyuan; Cao, Jinde; Li, Qingbo; Alsaedi, Ahmed; Alsaadi, Fuad E

2017-01-01

This paper deals with the finite-time synchronization problem for a class of uncertain coupled switched neural networks under asynchronous switching. By constructing appropriate Lyapunov-like functionals and using the average dwell time technique, some sufficient criteria are derived to guarantee the finite-time synchronization of considered uncertain coupled switched neural networks. Meanwhile, the asynchronous switching feedback controller is designed to finite-time synchronize the concerned networks. Finally, two numerical examples are introduced to show the validity of the main results. Copyright © 2016 Elsevier Ltd. All rights reserved.

A medical application integrating remote 3D visualization tools to access picture archiving and communication system on mobile devices.

PubMed

He, Longjun; Ming, Xing; Liu, Qian

2014-04-01

With computing capability and display size growing, the mobile device has been used as a tool to help clinicians view patient information and medical images anywhere and anytime. However, for direct interactive 3D visualization, which plays an important role in radiological diagnosis, the mobile device cannot provide a satisfactory quality of experience for radiologists. This paper developed a medical system that can get medical images from the picture archiving and communication system on the mobile device over the wireless network. In the proposed application, the mobile device got patient information and medical images through a proxy server connecting to the PACS server. Meanwhile, the proxy server integrated a range of 3D visualization techniques, including maximum intensity projection, multi-planar reconstruction and direct volume rendering, to providing shape, brightness, depth and location information generated from the original sectional images for radiologists. Furthermore, an algorithm that changes remote render parameters automatically to adapt to the network status was employed to improve the quality of experience. Finally, performance issues regarding the remote 3D visualization of the medical images over the wireless network of the proposed application were also discussed. The results demonstrated that this proposed medical application could provide a smooth interactive experience in the WLAN and 3G networks.

Interaction between the Stress Phase Angle (SPA) and the Oscillatory Shear Index (OSI) Affects Endothelial Cell Gene Expression.

PubMed

Amaya, Ronny; Cancel, Limary M; Tarbell, John M

2016-01-01

Hemodynamic forces play an important role in the non-uniform distribution of atherosclerotic lesions. Endothelial cells are exposed simultaneously to fluid wall shear stress (WSS) and solid circumferential stress (CS). Due to variations in impedance (global factors) and geometric complexities (local factors) in the arterial circulation a time lag arises between these two forces that can be characterized by the temporal phase angle between CS and WSS (stress phase angle-SPA). Asynchronous flows (SPA close to -180°) that are most prominent in coronary arteries have been associated with localization of atherosclerosis. Reversing oscillatory flows characterized by an oscillatory shear index (OSI) that is great than zero are also associated with atherosclerosis localization. In this study we examined the relationship between asynchronous flows and reversing flows in altering the expression of 37 genes relevant to atherosclerosis development. In the case of reversing oscillatory flow, we observed that the asynchronous condition upregulated 8 genes compared to synchronous hemodynamics, most of them proatherogenic. Upregulation of the pro-inflammatory transcription factor NFκB p65 was confirmed by western blot, and nuclear translocation of NFκB p65 was confirmed by immunofluorescence staining. A comparative study between non-reversing flow and reversing flow found that in the case of synchronous hemodynamics, reversing flow altered the expression of 11 genes, while in the case of asynchronous hemodynamics, reversing flow altered the expression of 17 genes. Reversing flow significantly upregulated protein expression of NFκB p65 for both synchronous and asynchronous conditions. Nuclear translocation of NFκB p65 was confirmed for synchronous and asynchronous conditions in the presence of flow reversal. These data suggest that asynchronous hemodynamics and reversing flow can elicit proatherogenic responses in endothelial cells compared to synchronous hemodynamics without shear stress reversal, indicating that SPA as well as reversal flow (OSI) are important parameters characterizing arterial susceptibility to disease.

Interaction between the Stress Phase Angle (SPA) and the Oscillatory Shear Index (OSI) Affects Endothelial Cell Gene Expression

PubMed Central

Amaya, Ronny; Cancel, Limary M.; Tarbell, John M.

2016-01-01

Hemodynamic forces play an important role in the non-uniform distribution of atherosclerotic lesions. Endothelial cells are exposed simultaneously to fluid wall shear stress (WSS) and solid circumferential stress (CS). Due to variations in impedance (global factors) and geometric complexities (local factors) in the arterial circulation a time lag arises between these two forces that can be characterized by the temporal phase angle between CS and WSS (stress phase angle–SPA). Asynchronous flows (SPA close to -180°) that are most prominent in coronary arteries have been associated with localization of atherosclerosis. Reversing oscillatory flows characterized by an oscillatory shear index (OSI) that is great than zero are also associated with atherosclerosis localization. In this study we examined the relationship between asynchronous flows and reversing flows in altering the expression of 37 genes relevant to atherosclerosis development. In the case of reversing oscillatory flow, we observed that the asynchronous condition upregulated 8 genes compared to synchronous hemodynamics, most of them proatherogenic. Upregulation of the pro-inflammatory transcription factor NFκB p65 was confirmed by western blot, and nuclear translocation of NFκB p65 was confirmed by immunofluorescence staining. A comparative study between non-reversing flow and reversing flow found that in the case of synchronous hemodynamics, reversing flow altered the expression of 11 genes, while in the case of asynchronous hemodynamics, reversing flow altered the expression of 17 genes. Reversing flow significantly upregulated protein expression of NFκB p65 for both synchronous and asynchronous conditions. Nuclear translocation of NFκB p65 was confirmed for synchronous and asynchronous conditions in the presence of flow reversal. These data suggest that asynchronous hemodynamics and reversing flow can elicit proatherogenic responses in endothelial cells compared to synchronous hemodynamics without shear stress reversal, indicating that SPA as well as reversal flow (OSI) are important parameters characterizing arterial susceptibility to disease. PMID:27846267

Proactive authenticated notifications for health practitioners: two way human computer interaction through phone.

PubMed

Majeed, Raphael W; Stöhr, Mark R; Röhrig, Rainer

2012-01-01

Notifications and alerts play an important role in clinical daily routine. Rising prevalence of clinical decision support systems and electronic health records also result in increasing demands on notification systems. Failure adequately to communicate a critical value is a potential cause of adverse events. Critical laboratory values and changing vital data depend on timely notifications of medical staff. Vital monitors and medical devices rely on acoustic signals for alerting which are prone to "alert fatigue" and require medical staff to be present within audible range. Personal computers are unsuitable to display time critical notification messages, since the targeted medical staff are not always operating or watching the computer. On the other hand, mobile phones and smart devices enjoy increasing popularity. Previous notification systems sending text messages to mobile phones depend on asynchronous confirmations. By utilizing an automated telephony server, we provide a method to deliver notifications quickly and independently of the recipients' whereabouts while allowing immediate feedback and confirmations. Evaluation results suggest the feasibility of the proposed notification system for real-time notifications.

Electrical engineering unit for the reactive power control of the load bus at the voltage instability

NASA Astrophysics Data System (ADS)

Kotenev, A. V.; Kotenev, V. I.; Kochetkov, V. V.; Elkin, D. A.

2018-01-01

For the purpose of reactive power control error reduction and decrease of the voltage sags in the electric power system caused by the asynchronous motors started the mathematical model of the load bus was developed. The model was built up of the sub-models of the following elements: a transformer, a transmission line, a synchronous and an asynchronous loads and a capacitor bank load, and represents the automatic reactive power control system taking into account electromagnetic processes of the asynchronous motors started and reactive power changing of the electric power system elements caused by the voltage fluctuation. The active power/time and reactive power/time characteristics based on the recommended procedure of the equivalent electric circuit parameters calculation were obtained. The derived automatic reactive power control system was shown to eliminate the voltage sags in the electric power system caused by the asynchronous motors started.

An improved asynchronous brain interface: making use of the temporal history of the LF-ASD feature vectors

NASA Astrophysics Data System (ADS)

Bashashati, Ali; Mason, Steve; Ward, Rabab K.; Birch, Gary E.

2006-06-01

The low-frequency asynchronous switch design (LF-ASD) has been introduced as a direct brain interface (BI) for asynchronous control applications. Asynchronous interfaces, as opposed to synchronous interfaces, have the advantage of being operational at all times and not only at specific system-defined periods. This paper modifies the LF-ASD design by incorporating into the system more knowledge about the attempted movements. Specifically, the history of feature values extracted from the EEG signal is used to detect a right index finger movement attempt. Using data collected from individuals with high-level spinal cord injuries and able-bodied subjects, it is shown that the error characteristics of the modified design are significantly better than the previous LF-ASD design. The true positive rate percentage increased by up to 15 which corresponds to 50% improvement when the system is operating with false positive rates in the 1-2% range.

MEETING REPORT: OMG Technical Committee Meeting in Orlando, FL, sees significant enhancement to CORBA

NASA Astrophysics Data System (ADS)

1998-06-01

The Object Management Group (OMG) Platform Technology Committee (PTC) ratified its support for a new asynchronous messaging service for CORBA at OMG's recent Technical Committee Meeting in Orlando, FL. The meeting, held from 8 - 12 June, saw the PTC send the Messaging Service out for a final vote among the OMG membership. The Messaging Service, which will integrate Message Oriented Middleware (MOM) with CORBA, will give CORBA a true asynchronous messaging capability - something of great interest to users and developers. Formal adoption of the specification will most likely occur by the end of the year. The Messaging Service The Messaging Service, when adopted, will be the world's first standard for Message Oriented Middleware and will give CORBA a true asynchronous messaging capability. Asynchronous messaging allows developers to build simpler, richer client environments. With asynchronous messaging there is less need for multi-threaded clients because the Asynchronous Method Invocation is non-blocking, meaning the client thread can continue work while the application waits for a reply. David Curtis, Director of Platform Technology for OMG, said: `This messaging service is one of the more valuable additions to CORBA. It enhances CORBA's existing asynchronous messaging capabilities which is a feature of many popular message oriented middleware products. This service will allow better integration between ORBs and MOM products. This enhanced messaging capability will only make CORBA more valuable for builders of distributed object systems.' The Messaging Service is one of sixteen technologies currently being worked on by the PTC. Additionally, seventeen Revision Task Forces (RTFs) are working on keeping OMG specifications up to date. The purpose of these Revision Task Forces is to take input from the implementors of OMG specifications and clarify or make necessary changes based on the implementor's input. The RTFs also ensure that the specifications remain up to date with changes in the OMA and with industry advances in general. Domain work Thirty-eight technology processes are ongoing in the Domain Technology Committee (DTC). These range over a wide variety of industries, including healthcare, telecommunications, life sciences, manufacturing, business objects, electronic commerce, finance, transportation, utilities, and distributed simulation. These processes aim to enhance CORBA's value and provide interoperability for specific vertical industries. At the Orlando meeting, the Domain Technology Committee issued the following requests to industry: Telecom Wireless Access Request For Information (RFI); Statistics RFI; Clinical Image Access Service Request For Proposal (RFP); Distributed Simulation Request For Comment (RFC). The newly-formed Statistics group at OMG plans to standarize interfaces for Statistical Services in CORBA, and their RFI, to which any person or company can respond, asks for input and guidance as they start this work which will impact the broad spectrum of industries and processes which use statistics. The Clinical Image Access Service will standarize access to important medical images including digital x-rays, MRI scans, and other formats. The Distributed Simulation RFC, when complete, will establish the Distributed Simulation High-Level Architecture of the US Defense Military Simulation Office as an OMG standard. For the next 90 days any person or company, not only OMG members, may submit their comments on the submission. The OMG looks forward to its next meeting to be held in Helsinki, Finland, on 27 - 31 July and hosted by Nokia. OMG encourages anyone considering OMG membership to attend the meeting as a guest. For more information on attending call +1-508-820-4300 or e-mail info@omg.org. Note: descriptions for all RFPs, RFIs and RFCs in progress are available for viewing on the OMG Website at http://www.omg.org/schedule.htm, or contact OMG for a copy of the `Work in Progress' document. For more information on the OMG Technology Process please call Jeurgen Boldt, OMG Process Manager, at +1-508-820-4300 or email jeurgen@omg.org.

Remote supervision of medical training via videoconference in northern Australia: a qualitative study of the perspectives of supervisors and trainees

PubMed Central

Ray, Robin; Sabesan, Sabe

2015-01-01

Objectives Telemedicine has revolutionised the ability to provide care to patients, relieve professional isolation and provide guidance and supervision to junior medical officers in rural areas. This study evaluated the Townsville teleoncology supervision model for the training of junior medical officers in rural areas of North Queensland, Australia. Specifically, the perspectives of junior and senior medical officers were explored to identify recommendations for future implementation. Design A qualitative approach incorporating observation and semistructured interviews was used to collect data. Interviews were uploaded into NVivo 10 data management software. Template analysis enabled themes to be tested and developed through consensus between researchers. Setting One tertiary level and four secondary level healthcare centres in rural and regional Queensland, Australia. Participants 10 junior medical officers (Interns, Registrars) and 10 senior medical officers (Senior Medical Officers, Consultants) who participated in the Townsville teleoncology model of remote supervision via videoconference (TTMRS) were included in the study. Primary and Secondary outcome measures Perspectives on the telemedicine experience, technology, engagement, professional support, satisfaction and limitations were examined. Perspectives on topics raised by participants were also examined as the interviews progressed. Results Four major themes with several subthemes emerged from the data: learning environment, beginning the learning relationship, stimulus for learning and practicalities of remote supervision via videoconference. While some themes were consistent with the current literature, new themes like increased professional edge, recognising non-verbal cues and physical examination challenges were identified. Conclusions Remote supervision via videoconference provides readily available guidance to trainees supporting their delivery of appropriate care to patients. However, resources required for upskilling, training in the use of supervision via videoconference, administration issues and nursing support, as well as physical barriers to examinations, must be addressed to enable more efficient implementation. PMID:25795687

Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

NASA Technical Reports Server (NTRS)

Barsten, Kristina; Hurst, Victor, IV; Scheuring, Richard; Baumann, David K.; Johnson-Throop, Kathy

2010-01-01

Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.615 - Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.615 Section 35.615 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.615 - Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.615 Section 35.615 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and...

10 CFR 35.615 - Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.615 Section 35.615 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.610 - Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Safety procedures and instructions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.610 Section 35.610 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units...

10 CFR 35.615 - Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Safety precautions for remote afterloader units, teletherapy units, and gamma stereotactic radiosurgery units. 35.615 Section 35.615 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and...

[Chairman's introductory remarks].

PubMed

Shimo, Masamune

2013-01-01

Remote medicine, as well as the technological development of IT, has been realized in various fields of medical care. Reports have been published of the actual utilization of a system of remote diagnosis by infectious disease surveillance in each region of Nagano Prefecture, a telepathology system in Nagano, operation case of a radiological image remote diagnosis. Situation in the lack of pathologists and radiologists, that changes in the way of working of the physician, or medical information digitized convey how the doctor involved in the diagnosis, any diagnosis based on the information that was received doctor such as whether to perform, various issues have been raised. Soot digitization of information.

Space medicine innovation and telehealth concept implementation for medical care during exploration-class missions

NASA Astrophysics Data System (ADS)

Martin, Annie; Sullivan, Patrick; Beaudry, Catherine; Kuyumjian, Raffi; Comtois, Jean-Marc

2012-12-01

Medical care on the International Space Station (ISS) is provided using real-time communication with limited medical data transmission. In the occurrence of an off-nominal medical event, the medical care paradigm employed is 'stabilization and transportation', involving real-time management from ground and immediate return to Earth in the event that the medical contingency could not be resolved in due time in space. In preparation for future missions beyond Low-Earth orbit (LEO), medical concepts of operations are being developed to ensure adequate support for the new mission profiles: increased distance, duration and communication delays, as well as impossibility of emergency returns and limitations in terms of medical equipment availability. The current ISS paradigm of medical care would no longer be adequate due to these new constraints. The Operational Space Medicine group at the Canadian Space Agency (CSA) is looking towards synergies between terrestrial and space medicine concepts for the delivery of medical care to deal with the new challenges of human space exploration as well as to provide benefits to the Canadian population. Remote and rural communities on Earth are, in fact, facing similar problems such as isolation, remoteness to tertiary care centers, resource scarcity, difficult (and expensive) emergency transfers, limited access to physicians and specialists and limited training of medical and nursing staff. There are a number of researchers and organizations, outside the space communities, working in the area of telehealth. They are designing and implementing terrestrial telehealth programs using real-time and store-and-forward techniques to provide isolated populations access to medical care. The cross-fertilization of space-Earth research could provide support for increased spin-off and spin-in effects and stimulate telehealth and space medicine innovations to engage in the new era of human space exploration. This paper will discuss the benefits of space-Earth research projects for the advancement of both terrestrial and space medicine and will use examples of operational space medicine projects conducted at the CSA in areas such as remote training, tele-mentoring and remote control of an ultrasound.

A Communication Perspective on Sexual Harassment: Affiliative Nonverbal Behaviors in Asynchronous Relationships.

ERIC Educational Resources Information Center

Hickson, Mark, III; And Others

1991-01-01

Develops a communication perspective on sexual harassment in asynchronous relationships. Presents a six-step process model to predict private harassing behavior among faculty members in higher education. Makes suggestions for prevention of sexual harassment. (SR)

Remote monitoring of patients with cardiac implantable electronic devices: a Southeast Asian, single-centre pilot study

PubMed Central

Lim, Paul Chun Yih; Lee, Audry Shan Yin; Chua, Kelvin Chi Ming; Lim, Eric Tien Siang; Chong, Daniel Thuan Tee; Tan, Boon Yew; Ho, Kah Leng; Teo, Wee Siong; Ching, Chi Keong

2016-01-01

INTRODUCTION Remote monitoring of cardiac implantable electronic devices (CIED) has been shown to improve patient safety and reduce in-office visits. We report our experience with remote monitoring via the Medtronic CareLink® network. METHODS Patients were followed up for six months with scheduled monthly remote monitoring transmissions in addition to routine in-office checks. The efficacy of remote monitoring was evaluated by recording compliance to transmissions, number of device alerts requiring intervention and time from transmission to review. Questionnaires were administered to evaluate the experiences of patients, physicians and medical technicians. RESULTS A total of 57 patients were enrolled; 16 (28.1%) had permanent pacemakers, 34 (59.6%) had implantable cardioverter defibrillators and 7 (12.3%) had cardiac resynchronisation therapy defibrillators. Overall, of 334 remote transmissions scheduled, 73.7% were on time, 14.5% were overdue and 11.8% were missed. 84.6% of wireless transmissions were on time, compared to 53.8% of non-wireless transmissions. Among all transmissions, 4.4% contained alerts for which physicians were informed and only 1.8% required intervention. 98.6% of remote transmissions were reviewed by the second working day. 73.2% of patients preferred remote monitoring. Physicians agreed that remote transmissions provided information equivalent to in-office checks 97.1% of the time. 77.8% of medical technicians felt that remote monitoring would help the hospital improve patient management. No adverse events were reported. CONCLUSION Remote monitoring of CIED is safe and feasible. It has possible benefits to patient safety through earlier detection of arrhythmias or device malfunction, permitting earlier intervention. Wireless remote monitoring, in particular, may improve compliance to device monitoring. Patients may prefer remote monitoring due to possible improvements in quality of life. PMID:27439396

The Design of Data Disaster Recovery of National Fundamental Geographic Information System

NASA Astrophysics Data System (ADS)

Zhai, Y.; Chen, J.; Liu, L.; Liu, J.

2014-04-01

With the development of information technology, data security of information system is facing more and more challenges. The geographic information of surveying and mapping is fundamental and strategic resource, which is applied in all areas of national economic, defence and social development. It is especially vital to national and social interests when such classified geographic information is directly concerning Chinese sovereignty. Several urgent problems that needs to be resolved for surveying and mapping are how to do well in mass data storage and backup, establishing and improving the disaster backup system especially after sudden natural calamity accident, and ensuring all sectors rapidly restored on information system will operate correctly. For overcoming various disaster risks, protect the security of data and reduce the impact of the disaster, it's no doubt the effective way is to analysis and research on the features of storage and management and security requirements, as well as to ensure that the design of data disaster recovery system suitable for the surveying and mapping. This article analyses the features of fundamental geographic information data and the requirements of storage management, three site disaster recovery system of DBMS plan based on the popular network, storage and backup, data replication and remote switch of application technologies. In LAN that synchronous replication between database management servers and the local storage of backup management systems, simultaneously, remote asynchronous data replication between local storage backup management systems and remote database management servers. The core of the system is resolving local disaster in the remote site, ensuring data security and business continuity of local site. This article focuses on the following points: background, the necessity of disaster recovery system, the analysis of the data achievements and data disaster recovery plan. Features of this program is to use a hardware-based data hot backup, and remote online disaster recovery support for Oracle database system. The achievement of this paper is in summarizing and analysing the common characteristics of disaster of surveying and mapping business system requirements, while based on the actual situation of the industry, designed the basic GIS disaster recovery solutions, and we also give the conclusions about key technologies of RTO and RPO.

E-learning in graduate medical education: survey of residency program directors.

PubMed

Wittich, Christopher M; Agrawal, Anoop; Cook, David A; Halvorsen, Andrew J; Mandrekar, Jayawant N; Chaudhry, Saima; Dupras, Denise M; Oxentenko, Amy S; Beckman, Thomas J

2017-07-11

E-learning-the use of Internet technologies to enhance knowledge and performance-has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs. Of the 368 PDs, 214 (58.2%) completed the e-learning survey. Use of synchronous e-learning at least sometimes, somewhat often, or very often was reported by 85 (39.7%); 153 programs (71.5%) use asynchronous e-learning at least sometimes, somewhat often, or very often. Most programs (168; 79%) do not have a budget to integrate e-learning. Mean (SD) scores for the PD perceptions of e-learning ranged from 3.01 (0.94) to 3.86 (0.72) on a 5-point scale. The odds of synchronous e-learning use were higher in programs with a budget for its implementation (odds ratio, 3.0 [95% CI, 1.04-8.7]; P = .04). Residency programs could be better resourced to integrate e-learning technologies. Asynchronous e-learning was used more than synchronous, which may be to accommodate busy resident schedules and duty-hour restrictions. PD perceptions of e-learning are relatively moderate and future research should determine whether PD reluctance to adopt e-learning is based on unawareness of the evidence, perceptions that e-learning is expensive, or judgments about value versus effectiveness.

A Study on Secure Medical-Contents Strategies with DRM Based on Cloud Computing

PubMed Central

Měsíček, Libor; Choi, Jongsun

2018-01-01

Many hospitals and medical clinics have been using a wearable sensor in its health care system because the wearable sensor, which is able to measure the patients' biometric information, has been developed to analyze their patients remotely. The measured information is saved to a server in a medical center, and the server keeps the medical information, which also involves personal information, on a cloud system. The server and network devices are used by connecting each other, and sensitive medical records are dealt with remotely. However, these days, the attackers, who try to attack the server or the network systems, are increasing. In addition, the server and the network system have a weak protection and security policy against the attackers. In this paper, it is suggested that security compliance of medical contents should be followed to improve the level of security. As a result, the medical contents are kept safely. PMID:29796233

A Study on Secure Medical-Contents Strategies with DRM Based on Cloud Computing.

PubMed

Ko, Hoon; Měsíček, Libor; Choi, Jongsun; Hwang, Seogchan

2018-01-01

Many hospitals and medical clinics have been using a wearable sensor in its health care system because the wearable sensor, which is able to measure the patients' biometric information, has been developed to analyze their patients remotely. The measured information is saved to a server in a medical center, and the server keeps the medical information, which also involves personal information, on a cloud system. The server and network devices are used by connecting each other, and sensitive medical records are dealt with remotely. However, these days, the attackers, who try to attack the server or the network systems, are increasing. In addition, the server and the network system have a weak protection and security policy against the attackers. In this paper, it is suggested that security compliance of medical contents should be followed to improve the level of security. As a result, the medical contents are kept safely.

Remote control of an MR imaging study via tele-collaboration tools

NASA Astrophysics Data System (ADS)

Sullivan, John M., Jr.; Mullen, Julia S.; Benz, Udo A.; Schmidt, Karl F.; Murugavel, Murali; Chen, Wei; Ghadyani, Hamid

2005-04-01

In contrast to traditional 'video conferencing' the Access Grid (AG), developed by Argonne National Laboratory, is a collaboration of audio, video and shared application tools which provide the 'persistent presence' of each participant. Among the shared application tools are the ability to share viewing and control of presentations, browsers, images and movies. When used in conjunction with Virtual Network Computing (VNC) software, an investigator can interact with colleagues at a remote site, and control remote systems via local keyboard and mouse commands. This combination allows for effective viewing and discussion of information, i.e. data, images, and results. It is clear that such an approach when applied to the medical sciences will provide a means by which a team of experts can not only access, but interact and control medical devices for the purpose of experimentation, diagnosis, surgery and therapy. We present the development of an application node at our 4.7 Tesla MR magnet facility, and a demonstration of remote investigator control of the magnet. A local magnet operator performs manual tasks such as loading the test subject into the magnet and administering the stimulus associated with the functional MRI study. The remote investigator has complete control of the magnet console. S/he can adjust the gradient coil settings, the pulse sequence, image capture frequency, etc. A geographically distributed audience views and interacts with the remote investigator and local MR operator. This AG demonstration of MR magnet control illuminates the potential of untethered medical experiments, procedures and training.

Student Satisfaction with Asynchronous Learning

ERIC Educational Resources Information Center

Dziuban, Charles; Moskal, Patsy; Brophy, Jay; Shea, Peter

2007-01-01

The authors discuss elements that potentially impact student satisfaction with asynchronous learning: the media culture, digital, personal and mobile technologies, student learning preferences, pedagogy, complexities of measurement, and the digital generation. They describe a pilot study to identify the underlying dimensions of student…

Software and hardware complex for research and management of the separation process

NASA Astrophysics Data System (ADS)

Borisov, A. P.

2018-01-01

The article is devoted to the development of a program for studying the operation of an asynchronous electric drive using vector-algorithmic switching of windings, as well as the development of a hardware-software complex for controlling parameters and controlling the speed of rotation of an asynchronous electric drive for investigating the operation of a cyclone. To study the operation of an asynchronous electric drive, a method was used in which the average value of flux linkage is found and a method for vector-algorithmic calculation of the power and electromagnetic moment of an asynchronous electric drive feeding from a single-phase network is developed, with vector-algorithmic commutation, and software for calculating parameters. The software part of the complex allows to regulate the speed of rotation of the motor by vector-algorithmic switching of transistors or, using pulse-width modulation (PWM), set any engine speed. Also sensors are connected to the hardware-software complex at the inlet and outlet of the cyclone. The developed cyclone with an inserted complex allows to receive high efficiency of product separation at various entrance speeds. At an inlet air speed of 18 m / s, the cyclone’s maximum efficiency is achieved. For this, it is necessary to provide the rotational speed of an asynchronous electric drive with a frequency of 45 Hz.

An exploration of teaching presence in online interprofessional education facilitation.

PubMed

Evans, Sherryn Maree; Ward, Catherine; Reeves, Scott

2017-07-01

Although the prevalence of online asynchronous interprofessional education (IPE) has increased in the last decade, little is known about the processes of facilitation in this environment. The teaching presence element of the Community of Inquiry Framework offers an approach to analyze the contributions of online facilitators, however, to date it has only been used on a limited basis in health professions education literature. Using an exploratory case study design, we explored the types of contributions made by IPE facilitators to asynchronous interprofessional team discussions by applying the notion of teaching presence. Using a purposeful sampling approach, we analyzed 14 facilitators' contributions to asynchronous team discussion boards in an online IPE course. We analyzed data using directed content analysis based on the key indicators of teaching presence. The online IPE facilitators undertook the three critical pedagogical functions identified in teaching presence: facilitating discourse, direct instruction, and instructional design and organization. While our data fitted well with a number of key activities embedded in these three functions, further modification of the teaching presence concept was needed to describe our facilitators' teaching presence. This study provides an initial insight into the key elements of online asynchronous IPE facilitation. Further research is required to continue to illuminate the complexity of online asynchronous IPE facilitation.

Asynchronous P300 classification in a reactive brain-computer interface during an outlier detection task

NASA Astrophysics Data System (ADS)

Krumpe, Tanja; Walter, Carina; Rosenstiel, Wolfgang; Spüler, Martin

2016-08-01

Objective. In this study, the feasibility of detecting a P300 via an asynchronous classification mode in a reactive EEG-based brain-computer interface (BCI) was evaluated. The P300 is one of the most popular BCI control signals and therefore used in many applications, mostly for active communication purposes (e.g. P300 speller). As the majority of all systems work with a stimulus-locked mode of classification (synchronous), the field of applications is limited. A new approach needs to be applied in a setting in which a stimulus-locked classification cannot be used due to the fact that the presented stimuli cannot be controlled or predicted by the system. Approach. A continuous observation task requiring the detection of outliers was implemented to test such an approach. The study was divided into an offline and an online part. Main results. Both parts of the study revealed that an asynchronous detection of the P300 can successfully be used to detect single events with high specificity. It also revealed that no significant difference in performance was found between the synchronous and the asynchronous approach. Significance. The results encourage the use of an asynchronous classification approach in suitable applications without a potential loss in performance.

A program wide framework for evaluating data driven teaching and learning - earth analytics approaches, results and lessons learned

NASA Astrophysics Data System (ADS)

Wasser, L. A.; Gold, A. U.

2017-12-01

There is a deluge of earth systems data available to address cutting edge science problems yet specific skills are required to work with these data. The Earth analytics education program, a core component of Earth Lab at the University of Colorado - Boulder - is building a data intensive program that provides training in realms including 1) interdisciplinary communication and collaboration 2) earth science domain knowledge including geospatial science and remote sensing and 3) reproducible, open science workflows ("earth analytics"). The earth analytics program includes an undergraduate internship, undergraduate and graduate level courses and a professional certificate / degree program. All programs share the goals of preparing a STEM workforce for successful earth analytics driven careers. We are developing an program-wide evaluation framework that assesses the effectiveness of data intensive instruction combined with domain science learning to better understand and improve data-intensive teaching approaches using blends of online, in situ, asynchronous and synchronous learning. We are using targeted online search engine optimization (SEO) to increase visibility and in turn program reach. Finally our design targets longitudinal program impacts on participant career tracts over time.. Here we present results from evaluation of both an interdisciplinary undergrad / graduate level earth analytics course and and undergraduate internship. Early results suggest that a blended approach to learning and teaching that includes both synchronous in-person teaching and active classroom hands-on learning combined with asynchronous learning in the form of online materials lead to student success. Further we will present our model for longitudinal tracking of participant's career focus overtime to better understand long-term program impacts. We also demonstrate the impact of SEO optimization on online content reach and program visibility.

A comparative evaluation of the effect of Internet-based CME delivery format on satisfaction, knowledge and confidence.

PubMed

Curran, Vernon R; Fleet, Lisa J; Kirby, Fran

2010-01-29

Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME.

Putting a Medical Library Online: Phase III--Remote Access to CD-ROMs.

ERIC Educational Resources Information Center

Kittle, Paul

1989-01-01

Describes the implementation of a project that provides dial-up access to MEDLINE on remote optical data disk (CD-ROM) using software that enables callers to use programs like Wordstar, Lotus, and dBase. Highlights include networking CD-ROM databases, hardware considerations, advantages and disadvantages of remote access, and future plans. A…

Healthcare Blockchain System Using Smart Contracts for Secure Automated Remote Patient Monitoring.

PubMed

Griggs, Kristen N; Ossipova, Olya; Kohlios, Christopher P; Baccarini, Alessandro N; Howson, Emily A; Hayajneh, Thaier

2018-06-06

As Internet of Things (IoT) devices and other remote patient monitoring systems increase in popularity, security concerns about the transfer and logging of data transactions arise. In order to handle the protected health information (PHI) generated by these devices, we propose utilizing blockchain-based smart contracts to facilitate secure analysis and management of medical sensors. Using a private blockchain based on the Ethereum protocol, we created a system where the sensors communicate with a smart device that calls smart contracts and writes records of all events on the blockchain. This smart contract system would support real-time patient monitoring and medical interventions by sending notifications to patients and medical professionals, while also maintaining a secure record of who has initiated these activities. This would resolve many security vulnerabilities associated with remote patient monitoring and automate the delivery of notifications to all involved parties in a HIPAA compliant manner.

The Effectiveness of Remote Facilitation in Simulation-Based Pediatric Resuscitation Training for Medical Students.

PubMed

Ohta, Kunio; Kurosawa, Hiroshi; Shiima, Yuko; Ikeyama, Takanari; Scott, James; Hayes, Scott; Gould, Michael; Buchanan, Newton; Nadkarni, Vinay; Nishisaki, Akira

2017-08-01

To assess the effectiveness of pediatric simulation by remote facilitation. We hypothesized that simulation by remote facilitation is more effective compared to simulation by an on-site facilitator. We defined remote facilitation as a facilitator remotely (1) introduces simulation-based learning and simulation environment, (2) runs scenarios, and (3) performs debriefing with an on-site facilitator. A remote simulation program for medical students during pediatric rotation was implemented. Groups were allocated to either remote or on-site facilitation depending on the availability of telemedicine technology. Both groups had identical 1-hour simulation sessions with 2 scenarios and debriefing. Their team performance was assessed with behavioral assessment tool by a trained rater. Perception by students was evaluated with Likert scale (1-7). Fifteen groups with 89 students participated in a simulation by remote facilitation, and 8 groups with 47 students participated in a simulation by on-site facilitation. Participant demographics and previous simulation experience were similar. Both groups improved their performance from first to second scenario: groups by remote simulation (first [8.5 ± 4.2] vs second [13.2 ± 6.2], P = 0.003), and groups by on-site simulation (first [6.9 ± 4.1] vs second [12.4 ± 6.4], P = 0.056). The performance improvement was not significantly different between the 2 groups (P = 0.94). Faculty evaluation by students was equally high in both groups (7 vs 7; P = 0.65). A pediatric acute care simulation by remote facilitation significantly improved students' performance. In this pilot study, remote facilitation seems as effective as a traditional, locally facilitated simulation. The remote simulation can be a strong alternative method, especially where experienced facilitators are limited.

Detection of cyst using image segmentation and building knowledge-based intelligent decision support system as an aid to telemedicine

NASA Astrophysics Data System (ADS)

Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen

2005-02-01

An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.

Learning Objects and Gerontology

ERIC Educational Resources Information Center

Weinreich, Donna M.; Tompkins, Catherine J.

2006-01-01

Virtual AGE (vAGE) is an asynchronous educational environment that utilizes learning objects focused on gerontology and a learning anytime/anywhere philosophy. This paper discusses the benefits of asynchronous instruction and the process of creating learning objects. Learning objects are "small, reusable chunks of instructional media" Wiley…

Redundant Asynchronous Microprocessor System

NASA Technical Reports Server (NTRS)

Meyer, G.; Johnston, J. O.; Dunn, W. R.

1985-01-01

Fault-tolerant computer structure called RAMPS (for redundant asynchronous microprocessor system) has simplicity of static redundancy but offers intermittent-fault handling ability of complex, dynamically redundant systems. New structure useful wherever several microprocessors are employed for control - in aircraft, industrial processes, robotics, and automatic machining, for example.

A comparison of classroom and online asynchronous problem-based learning for students undertaking statistics training as part of a Public Health Masters degree.

PubMed

de Jong, N; Verstegen, D M L; Tan, F E S; O'Connor, S J

2013-05-01

This case-study compared traditional, face-to-face classroom-based teaching with asynchronous online learning and teaching methods in two sets of students undertaking a problem-based learning module in the multilevel and exploratory factor analysis of longitudinal data as part of a Masters degree in Public Health at Maastricht University. Students were allocated to one of the two study variants on the basis of their enrolment status as full-time or part-time students. Full-time students (n = 11) followed the classroom-based variant and part-time students (n = 12) followed the online asynchronous variant which included video recorded lectures and a series of asynchronous online group or individual SPSS activities with synchronous tutor feedback. A validated student motivation questionnaire was administered to both groups of students at the start of the study and a second questionnaire was administered at the end of the module. This elicited data about student satisfaction with the module content, teaching and learning methods, and tutor feedback. The module coordinator and problem-based learning tutor were also interviewed about their experience of delivering the experimental online variant and asked to evaluate its success in relation to student attainment of the module's learning outcomes. Student examination results were also compared between the two groups. Asynchronous online teaching and learning methods proved to be an acceptable alternative to classroom-based teaching for both students and staff. Educational outcomes were similar for both groups, but importantly, there was no evidence that the asynchronous online delivery of module content disadvantaged part-time students in comparison to their full-time counterparts.

Direct measurements of meltwater runoff on the Greenland ice sheet surface

NASA Astrophysics Data System (ADS)

Smith, Laurence C.; Yang, Kang; Pitcher, Lincoln H.; Overstreet, Brandon T.; Chu, Vena W.; Rennermalm, Åsa K.; Ryan, Jonathan C.; Cooper, Matthew G.; Gleason, Colin J.; Tedesco, Marco; Jeyaratnam, Jeyavinoth; van As, Dirk; van den Broeke, Michiel R.; van de Berg, Willem Jan; Noël, Brice; Langen, Peter L.; Cullather, Richard I.; Zhao, Bin; Willis, Michael J.; Hubbard, Alun; Box, Jason E.; Jenner, Brittany A.; Behar, Alberto E.

2017-12-01

Meltwater runoff from the Greenland ice sheet surface influences surface mass balance (SMB), ice dynamics, and global sea level rise, but is estimated with climate models and thus difficult to validate. We present a way to measure ice surface runoff directly, from hourly in situ supraglacial river discharge measurements and simultaneous high-resolution satellite/drone remote sensing of upstream fluvial catchment area. A first 72-h trial for a 63.1-km2 moulin-terminating internally drained catchment (IDC) on Greenland's midelevation (1,207–1,381 m above sea level) ablation zone is compared with melt and runoff simulations from HIRHAM5, MAR3.6, RACMO2.3, MERRA-2, and SEB climate/SMB models. Current models cannot reproduce peak discharges or timing of runoff entering moulins but are improved using synthetic unit hydrograph (SUH) theory. Retroactive SUH applications to two older field studies reproduce their findings, signifying that remotely sensed IDC area, shape, and supraglacial river length are useful for predicting delays in peak runoff delivery to moulins. Applying SUH to HIRHAM5, MAR3.6, and RACMO2.3 gridded melt products for 799 surrounding IDCs suggests their terminal moulins receive lower peak discharges, less diurnal variability, and asynchronous runoff timing relative to climate/SMB model output alone. Conversely, large IDCs produce high moulin discharges, even at high elevations where melt rates are low. During this particular field experiment, models overestimated runoff by +21 to +58%, linked to overestimated surface ablation and possible meltwater retention in bare, porous, low-density ice. Direct measurements of ice surface runoff will improve climate/SMB models, and incorporating remotely sensed IDCs will aid coupling of SMB with ice dynamics and subglacial systems.

Direct measurements of meltwater runoff on the Greenland ice sheet surface.

PubMed

Smith, Laurence C; Yang, Kang; Pitcher, Lincoln H; Overstreet, Brandon T; Chu, Vena W; Rennermalm, Åsa K; Ryan, Jonathan C; Cooper, Matthew G; Gleason, Colin J; Tedesco, Marco; Jeyaratnam, Jeyavinoth; van As, Dirk; van den Broeke, Michiel R; van de Berg, Willem Jan; Noël, Brice; Langen, Peter L; Cullather, Richard I; Zhao, Bin; Willis, Michael J; Hubbard, Alun; Box, Jason E; Jenner, Brittany A; Behar, Alberto E

2017-12-12

Meltwater runoff from the Greenland ice sheet surface influences surface mass balance (SMB), ice dynamics, and global sea level rise, but is estimated with climate models and thus difficult to validate. We present a way to measure ice surface runoff directly, from hourly in situ supraglacial river discharge measurements and simultaneous high-resolution satellite/drone remote sensing of upstream fluvial catchment area. A first 72-h trial for a 63.1-km 2 moulin-terminating internally drained catchment (IDC) on Greenland's midelevation (1,207-1,381 m above sea level) ablation zone is compared with melt and runoff simulations from HIRHAM5, MAR3.6, RACMO2.3, MERRA-2, and SEB climate/SMB models. Current models cannot reproduce peak discharges or timing of runoff entering moulins but are improved using synthetic unit hydrograph (SUH) theory. Retroactive SUH applications to two older field studies reproduce their findings, signifying that remotely sensed IDC area, shape, and supraglacial river length are useful for predicting delays in peak runoff delivery to moulins. Applying SUH to HIRHAM5, MAR3.6, and RACMO2.3 gridded melt products for 799 surrounding IDCs suggests their terminal moulins receive lower peak discharges, less diurnal variability, and asynchronous runoff timing relative to climate/SMB model output alone. Conversely, large IDCs produce high moulin discharges, even at high elevations where melt rates are low. During this particular field experiment, models overestimated runoff by +21 to +58%, linked to overestimated surface ablation and possible meltwater retention in bare, porous, low-density ice. Direct measurements of ice surface runoff will improve climate/SMB models, and incorporating remotely sensed IDCs will aid coupling of SMB with ice dynamics and subglacial systems. Copyright © 2017 the Author(s). Published by PNAS.

Direct measurements of meltwater runoff on the Greenland ice sheet surface

PubMed Central

Smith, Laurence C.; Yang, Kang; Pitcher, Lincoln H; Overstreet, Brandon T.; Chu, Vena W.; Rennermalm, Åsa K.; Ryan, Jonathan C.; Cooper, Matthew G.; Gleason, Colin J.; Tedesco, Marco; Jeyaratnam, Jeyavinoth; van As, Dirk; van den Broeke, Michiel R.; van de Berg, Willem Jan; Noël, Brice; Langen, Peter L.; Cullather, Richard I.; Zhao, Bin; Hubbard, Alun; Box, Jason E.; Jenner, Brittany A.; Behar, Alberto E.

2017-01-01

Meltwater runoff from the Greenland ice sheet surface influences surface mass balance (SMB), ice dynamics, and global sea level rise, but is estimated with climate models and thus difficult to validate. We present a way to measure ice surface runoff directly, from hourly in situ supraglacial river discharge measurements and simultaneous high-resolution satellite/drone remote sensing of upstream fluvial catchment area. A first 72-h trial for a 63.1-km2 moulin-terminating internally drained catchment (IDC) on Greenland’s midelevation (1,207–1,381 m above sea level) ablation zone is compared with melt and runoff simulations from HIRHAM5, MAR3.6, RACMO2.3, MERRA-2, and SEB climate/SMB models. Current models cannot reproduce peak discharges or timing of runoff entering moulins but are improved using synthetic unit hydrograph (SUH) theory. Retroactive SUH applications to two older field studies reproduce their findings, signifying that remotely sensed IDC area, shape, and supraglacial river length are useful for predicting delays in peak runoff delivery to moulins. Applying SUH to HIRHAM5, MAR3.6, and RACMO2.3 gridded melt products for 799 surrounding IDCs suggests their terminal moulins receive lower peak discharges, less diurnal variability, and asynchronous runoff timing relative to climate/SMB model output alone. Conversely, large IDCs produce high moulin discharges, even at high elevations where melt rates are low. During this particular field experiment, models overestimated runoff by +21 to +58%, linked to overestimated surface ablation and possible meltwater retention in bare, porous, low-density ice. Direct measurements of ice surface runoff will improve climate/SMB models, and incorporating remotely sensed IDCs will aid coupling of SMB with ice dynamics and subglacial systems. PMID:29208716

E-therapy: practical, ethical, and legal issues.

PubMed

Manhal-Baugus, M

2001-10-01

E-therapy is a term that has been coined to describe the process of interacting with a therapist online in ongoing conversations over time when the client and counselor are in separate or remote locations and utilize electronic means to communicate with each other. It is a relatively new modality of assisting individuals resolve life and relationship issues. E-therapy utilizes the power and convenience of the internet to allow simultaneous (synchronous) and time-delayed (asynchronous) communication between an individual and a professional. For the purposes of this paper, e-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. It does not include self-help methods such as public bulletin boards or private listservs. E-therapy is not psychotherapy or psychological counseling per se since it does to presume to diagnose or treat mental or medical disorders. However, e-therapy is flexible enough to also address many difficulties which clients present to the online therapist. As in other types of therapy, such as bibliotherapy, occupational therapy, and rehabilitation therapy), e-therapy does assist a person in addressing specific concerns with specific skills. This article examines the following issues of e-therapy. First, the types of e-therapy and related services are described to provide a background for the article. Second, the ethical codes which have been adopted by three major professional organizations (American Counseling Association, National Board for Certified Counselors, and the International Society for Mental Health Online) pertaining to e-therapy are summarized for professional and consumer use. Finally, the practical, ethical, and legal issues of e-therapy services are discussed fully.

Climate-driven increase of natural wetland methane emissions offset by human-induced wetland reduction in China over the past three decades

USGS Publications Warehouse

Zhu, Qiuan; Peng, Changhui; Liu, Jinxun; Jiang, Hong; Fang, Xiuqin; Chen, Huai; Niu, Zhichun; Gong, Peng; Lin, Guanghui; Wang, Meng; Yang, Yanzheng; Chang, Jie; Ge, Ying; Xiang, Wenhua; Deng, Xiangwen; He, Jin-Sheng

2016-01-01

Both anthropogenic activities and climate change can affect the biogeochemical processes of natural wetland methanogenesis. Quantifying possible impacts of changing climate and wetland area on wetland methane (CH4) emissions in China is important for improving our knowledge on CH4 budgets locally and globally. However, their respective and combined effects are uncertain. We incorporated changes in wetland area derived from remote sensing into a dynamic CH4 model to quantify the human and climate change induced contributions to natural wetland CH4 emissions in China over the past three decades. Here we found that human-induced wetland loss contributed 34.3% to the CH4 emissions reduction (0.92 TgCH4), and climate change contributed 20.4% to the CH4 emissions increase (0.31 TgCH4), suggesting that decreasing CH4 emissions due to human-induced wetland reductions has offset the increasing climate-driven CH4 emissions. With climate change only, temperature was a dominant controlling factor for wetland CH4 emissions in the northeast (high latitude) and Qinghai-Tibet Plateau (high altitude) regions, whereas precipitation had a considerable influence in relative arid north China. The inevitable uncertainties caused by the asynchronous for different regions or periods due to inter-annual or seasonal variations among remote sensing images should be considered in the wetland CH4 emissions estimation.

InGaAs/InP SPAD photon-counting module with auto-calibrated gate-width generation and remote control

NASA Astrophysics Data System (ADS)

Tosi, Alberto; Ruggeri, Alessandro; Bahgat Shehata, Andrea; Della Frera, Adriano; Scarcella, Carmelo; Tisa, Simone; Giudice, Andrea

2013-01-01

We present a photon-counting module based on InGaAs/InP SPAD (Single-Photon Avalanche Diode) for detecting single photons up to 1.7 μm. The module exploits a novel architecture for generating and calibrating the gate width, along with other functions (such as module supervision, counting and processing of detected photons, etc.). The gate width, i.e. the time interval when the SPAD is ON, is user-programmable in the range from 500 ps to 1.5 μs, by means of two different delay generation methods implemented with an FPGA (Field-Programmable Gate Array). In order to compensate chip-to-chip delay variation, an auto-calibration circuit picks out a combination of delays in order to match at best the selected gate width. The InGaAs/InP module accepts asynchronous and aperiodic signals and introduces very low timing jitter. Moreover the photon counting module provides other new features like a microprocessor for system supervision, a touch-screen for local user interface, and an Ethernet link for smart remote control. Thanks to the fullyprogrammable and configurable architecture, the overall instrument provides high system flexibility and can easily match all requirements set by many different applications requiring single photon-level sensitivity in the near infrared with very low photon timing jitter.

Climate-driven increase of natural wetland methane emissions offset by human-induced wetland reduction in China over the past three decades

PubMed Central

Zhu, Qiuan; Peng, Changhui; Liu, Jinxun; Jiang, Hong; Fang, Xiuqin; Chen, Huai; Niu, Zhenguo; Gong, Peng; Lin, Guanghui; Wang, Meng; Wang, Han; Yang, Yanzheng; Chang, Jie; Ge, Ying; Xiang, Wenhua; Deng, Xiangwen; He, Jin-Sheng

2016-01-01

Both anthropogenic activities and climate change can affect the biogeochemical processes of natural wetland methanogenesis. Quantifying possible impacts of changing climate and wetland area on wetland methane (CH4) emissions in China is important for improving our knowledge on CH4 budgets locally and globally. However, their respective and combined effects are uncertain. We incorporated changes in wetland area derived from remote sensing into a dynamic CH4 model to quantify the human and climate change induced contributions to natural wetland CH4 emissions in China over the past three decades. Here we found that human-induced wetland loss contributed 34.3% to the CH4 emissions reduction (0.92 TgCH4), and climate change contributed 20.4% to the CH4 emissions increase (0.31 TgCH4), suggesting that decreasing CH4 emissions due to human-induced wetland reductions has offset the increasing climate-driven CH4 emissions. With climate change only, temperature was a dominant controlling factor for wetland CH4 emissions in the northeast (high latitude) and Qinghai-Tibet Plateau (high altitude) regions, whereas precipitation had a considerable influence in relative arid north China. The inevitable uncertainties caused by the asynchronous for different regions or periods due to inter-annual or seasonal variations among remote sensing images should be considered in the wetland CH4 emissions estimation. PMID:27892535

Spatiotemporal variations in the difference between satellite-observed daily maximum land surface temperature and station-based daily maximum near-surface air temperature

NASA Astrophysics Data System (ADS)

Lian, Xu; Zeng, Zhenzhong; Yao, Yitong; Peng, Shushi; Wang, Kaicun; Piao, Shilong

2017-02-01

There is an increasing demand to integrate land surface temperature (LST) into climate research due to its global coverage, which requires a comprehensive knowledge of its distinctive characteristics compared to near-surface air temperature (Tair). Using satellite observations and in situ station-based data sets, we conducted a global-scale assessment of the spatial and seasonal variations in the difference between daily maximum LST and daily maximum Tair (δT, LST - Tair) during 2003-2014. Spatially, LST is generally higher than Tair over arid and sparsely vegetated regions in the middle-low latitudes, but LST is lower than Tair in tropical rainforests due to strong evaporative cooling, and in the high-latitude regions due to snow-induced radiative cooling. Seasonally, δT is negative in tropical regions throughout the year, while it displays a pronounced seasonality in both the midlatitudes and boreal regions. The seasonality in the midlatitudes is a result of the asynchronous responses of LST and Tair to the seasonal cycle of radiation and vegetation abundance, whereas in the boreal regions, seasonality is mainly caused by the change in snow cover. Our study identified substantial spatial heterogeneity and seasonality in δT, as well as its determinant environmental drivers, and thus provides a useful reference for monitoring near-surface air temperature changes using remote sensing, particularly in remote regions.

Innovative Methods for Providing Instruction to Distance Students Using Technology.

ERIC Educational Resources Information Center

Pival, Paul R.; Tunon, Johanna

2001-01-01

Examines three innovative methods tried at Nova Southeastern University for providing quality bibliographic instruction to distance students: one synchronous, one asynchronous, and one that combined features from both synchronous and asynchronous methods of delivering instruction. Topics include compressed video, collaborative groupware, streaming…

Miscellany of Students' Satisfaction in an Asynchronous Learning Environment

ERIC Educational Resources Information Center

Larbi-Siaw, Otu; Owusu-Agyeman, Yaw

2017-01-01

This study investigates the determinants of students' satisfaction in an asynchronous learning environment using seven key considerations: the e-learning environment, student-content interaction, student and student interaction, student-teacher interaction, group cohesion and timely participation, knowledge of Internet usage, and satisfaction. The…

Developing asynchronous online interprofessional education.

PubMed

Sanborn, Heidi

2016-09-01

For many health programmes, developing interprofessional education (IPE) has been a challenge. Evidence on the best method for design and implementation of IPE has been slow to emerge, with little research on how to best incorporate IPE in the asynchronous online learning environment. This leaves online programmes with no clear guidance when embarking upon an initiative to integrate IPE into the curriculum. One tool that can be effective at guiding the incorporation of IPE across all learning platforms is the Interprofessional Education Collaborative (IPEC) competencies. A project was designed to integrate the nationally defined IPEC competencies throughout an asynchronous, online baccalaureate nursing completion programme. A programme-wide review led to targeted revision of course and unit-level objectives, learning experiences, and assessments based on the IPEC framework. As a result of this effort, the programme curriculum now provides interprofessional learning activities across all courses. This report provides a method for using the IPEC competencies to incorporate IPE within various asynchronous learning assessments, assuring students learn about, with, and from other professions.

AP-IO: asynchronous pipeline I/O for hiding periodic output cost in CFD simulation.

PubMed

Xiaoguang, Ren; Xinhai, Xu

2014-01-01

Computational fluid dynamics (CFD) simulation often needs to periodically output intermediate results to files in the form of snapshots for visualization or restart, which seriously impacts the performance. In this paper, we present asynchronous pipeline I/O (AP-IO) optimization scheme for the periodically snapshot output on the basis of asynchronous I/O and CFD application characteristics. In AP-IO, dedicated background I/O processes or threads are in charge of handling the file write in pipeline mode, therefore the write overhead can be hidden with more calculation than classic asynchronous I/O. We design the framework of AP-IO and implement it in OpenFOAM, providing CFD users with a user-friendly interface. Experimental results on the Tianhe-2 supercomputer demonstrate that AP-IO can achieve a good optimization effect for the periodical snapshot output in CFD application, and the effect is especially better for massively parallel CFD simulations, which can reduce the total execution time up to about 40%.

Asynchronous Cholinergic Drive Correlates with Excitation-Inhibition Imbalance via a Neuronal Ca2+ Sensor Protein.

PubMed

Zhou, Keming; Cherra, Salvatore J; Goncharov, Alexandr; Jin, Yishi

2017-05-09

Excitation-inhibition imbalance in neural networks is widely linked to neurological and neuropsychiatric disorders. However, how genetic factors alter neuronal activity, leading to excitation-inhibition imbalance, remains unclear. Here, using the C. elegans locomotor circuit, we examine how altering neuronal activity for varying time periods affects synaptic release pattern and animal behavior. We show that while short-duration activation of excitatory cholinergic neurons elicits a reversible enhancement of presynaptic strength, persistent activation results to asynchronous and reduced cholinergic drive, inducing imbalance between endogenous excitation and inhibition. We find that the neuronal calcium sensor protein NCS-2 is required for asynchronous cholinergic release in an activity-dependent manner and dampens excitability of inhibitory neurons non-cell autonomously. The function of NCS-2 requires its Ca 2+ binding and membrane association domains. These results reveal a synaptic mechanism implicating asynchronous release in regulation of excitation-inhibition balance. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

High-Throughput Bit-Serial LDPC Decoder LSI Based on Multiple-Valued Asynchronous Interleaving

NASA Astrophysics Data System (ADS)

Onizawa, Naoya; Hanyu, Takahiro; Gaudet, Vincent C.

This paper presents a high-throughput bit-serial low-density parity-check (LDPC) decoder that uses an asynchronous interleaver. Since consecutive log-likelihood message values on the interleaver are similar, node computations are continuously performed by using the most recently arrived messages without significantly affecting bit-error rate (BER) performance. In the asynchronous interleaver, each message's arrival rate is based on the delay due to the wire length, so that the decoding throughput is not restricted by the worst-case latency, which results in a higher average rate of computation. Moreover, the use of a multiple-valued data representation makes it possible to multiplex control signals and data from mutual nodes, thus minimizing the number of handshaking steps in the asynchronous interleaver and eliminating the clock signal entirely. As a result, the decoding throughput becomes 1.3 times faster than that of a bit-serial synchronous decoder under a 90nm CMOS technology, at a comparable BER.

AP-IO: Asynchronous Pipeline I/O for Hiding Periodic Output Cost in CFD Simulation

PubMed Central

Xiaoguang, Ren; Xinhai, Xu

2014-01-01

Computational fluid dynamics (CFD) simulation often needs to periodically output intermediate results to files in the form of snapshots for visualization or restart, which seriously impacts the performance. In this paper, we present asynchronous pipeline I/O (AP-IO) optimization scheme for the periodically snapshot output on the basis of asynchronous I/O and CFD application characteristics. In AP-IO, dedicated background I/O processes or threads are in charge of handling the file write in pipeline mode, therefore the write overhead can be hidden with more calculation than classic asynchronous I/O. We design the framework of AP-IO and implement it in OpenFOAM, providing CFD users with a user-friendly interface. Experimental results on the Tianhe-2 supercomputer demonstrate that AP-IO can achieve a good optimization effect for the periodical snapshot output in CFD application, and the effect is especially better for massively parallel CFD simulations, which can reduce the total execution time up to about 40%. PMID:24955390

Asynchronous and synchronous dual-wavelength pulse generation in a passively mode-locked fiber laser with a mode-locker.

PubMed

Hu, Guoqing; Pan, Yingling; Zhao, Xin; Yin, Siyao; Zhang, Meng; Zheng, Zheng

2017-12-01

The evolution from asynchronous to synchronous dual-wavelength pulse generation in a passively mode-locked fiber laser is experimentally investigated by tailoring the intracavity dispersion. Through tuning the intracavity-loss-dependent gain profile and the birefringence-induced filter effect, asynchronous dual-wavelength soliton pulses can be generated until the intracavity anomalous dispersion is reduced to ∼8  fs/nm. The transition from asynchronous to synchronous pulse generation is then observed at an elevated pump power in the presence of residual anomalous dispersion, and it is shown that pulses are temporally synchronized at the mode-locker in the cavity. Spectral sidelobes are observed and could be attributed to the four-wave-mixing effect between dual-wavelength pulses at the carbon nanotube mode-locker. These results could provide further insight into the design and realization of such dual-wavelength ultrafast lasers for different applications such as dual-comb metrology as well as better understanding of the inter-pulse interactions in such dual-comb lasers.

An efficient and secure dynamic ID-based authentication scheme for telecare medical information systems.

PubMed

Chen, Hung-Ming; Lo, Jung-Wen; Yeh, Chang-Kuo

2012-12-01

The rapidly increased availability of always-on broadband telecommunication environments and lower-cost vital signs monitoring devices bring the advantages of telemedicine directly into the patient's home. Hence, the control of access to remote medical servers' resources has become a crucial challenge. A secure authentication scheme between the medical server and remote users is therefore needed to safeguard data integrity, confidentiality and to ensure availability. Recently, many authentication schemes that use low-cost mobile devices have been proposed to meet these requirements. In contrast to previous schemes, Khan et al. proposed a dynamic ID-based remote user authentication scheme that reduces computational complexity and includes features such as a provision for the revocation of lost or stolen smart cards and a time expiry check for the authentication process. However, Khan et al.'s scheme has some security drawbacks. To remedy theses, this study proposes an enhanced authentication scheme that overcomes the weaknesses inherent in Khan et al.'s scheme and demonstrated this scheme is more secure and robust for use in a telecare medical information system.

An eight-year study of internet-based remote medical counselling.

PubMed

Labiris, G; Coertzen, I; Katsikas, A; Karydis, A; Petounis, A

2002-01-01

We carried out a prospective study of an Internet-based remote counselling service. A total of 15456 Internet users visited the Website over eight years. From these, 1500 users were randomly selected for analysis. Medical counselling had been granted to 901 of the people requesting it (60%). One hundred and sixty-four physicians formed project groups to process the requests and responded using email. The distribution of patients using the service was similar to the availability of the Internet: 78% were from the European Union, North America and Australia. Sixty-seven per cent of the patients lived in urban areas and the remainder were residents of remote rural areas with limited local medical coverage. Sixty-five per cent of the requests were about problems of internal medicine and 30% of the requests concerned surgical issues. The remaining 5% of the patients sought information about recent developments, such molecular medicine or aviation medicine. During the project, our portal became inaccessible five times, and counselling was not possible on 44 days. There was no hacking of the Website. Internet-based medical counselling is a helpful addition to conventional practice.

[Design and Implementation of Intelligent Mobile ECG].

PubMed

Cao, Shaoping; Liu, Jian

2016-05-01

This paper introduces the development of intelligent mobile ECG, and internet big data sharing resources to further improve the remote diagnosis of medical service platform , to enhance the level of mobile medical standard and control medical risks.

Integration of remote blood glucose meter upload technology into a clinical pharmacist medication therapy management service.

PubMed

Schenk, Robert J; Schenk, Jenna

2011-01-01

A pharmacist-delivered, outpatient-focused medication therapy management (MTM) program is using a remote blood glucose (BG) meter upload device to provide better care and to improve outcomes for its patients with diabetes. Sharing uploaded BG meter data, presented in easily comprehensible graphs and charts, enables patients, caregivers, and the medical team to better understand how the patients' diabetes care is progressing. Pharmacists are becoming increasingly more active in helping to manage patients' complex medication regimens in an effort to help detect and avoid medication-related problems. Working together with patients and their physicians as part of an interdisciplinary health care team, pharmacists are helping to improve medication outcomes. This article focuses on two case studies highlighting the Diabetes Monitoring Program, one component of the Meridian Pharmacology Institute MTM service, and discusses the clinical application of a unique BG meter upload device. © 2010 Diabetes Technology Society.

A secure EHR system based on hybrid clouds.

PubMed

Chen, Yu-Yi; Lu, Jun-Chao; Jan, Jinn-Ke

2012-10-01

Consequently, application services rendering remote medical services and electronic health record (EHR) have become a hot topic and stimulating increased interest in studying this subject in recent years. Information and communication technologies have been applied to the medical services and healthcare area for a number of years to resolve problems in medical management. Sharing EHR information can provide professional medical programs with consultancy, evaluation, and tracing services can certainly improve accessibility to the public receiving medical services or medical information at remote sites. With the widespread use of EHR, building a secure EHR sharing environment has attracted a lot of attention in both healthcare industry and academic community. Cloud computing paradigm is one of the popular healthIT infrastructures for facilitating EHR sharing and EHR integration. In this paper, we propose an EHR sharing and integration system in healthcare clouds and analyze the arising security and privacy issues in access and management of EHRs.

An implementation of wireless medical image transmission system on mobile devices.

PubMed

Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

2008-12-01

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

Integrated Clinical Training for Space Flight Using a High-Fidelity Patient Simulator in a Simulated Microgravity Environment

NASA Technical Reports Server (NTRS)

Hurst, Victor; Doerr, Harold K.; Polk, J. D.; Schmid, Josef; Parazynksi, Scott; Kelly, Scott

2007-01-01

This viewgraph presentation reviews the use of telemedicine in a simulated microgravity environment using a patient simulator. For decades, telemedicine techniques have been used in terrestrial environments by many cohorts with varied clinical experience. The success of these techniques has been recently expanded to include microgravity environments aboard the International Space Station (ISS). In order to investigate how an astronaut crew medical officer will execute medical tasks in a microgravity environment, while being remotely guided by a flight surgeon, the Medical Operation Support Team (MOST) used the simulated microgravity environment provided aboard DC-9 aircraft teams of crew medical officers, and remote flight surgeons performed several tasks on a patient simulator.

Asynchronous updates can promote the evolution of cooperation on multiplex networks

NASA Astrophysics Data System (ADS)

Allen, James M.; Hoyle, Rebecca B.

2017-04-01

We study the importance to the frequency of cooperation of the choice of updating strategies in a game played asynchronously or synchronously across layers in a multiplex network. Updating asynchronously in the public goods game leads to higher frequencies of cooperation compared to synchronous updates. How large this effect is depends on the sensitivity of the game dynamics to changes in the number of cooperators surrounding a player, with the largest effect observed when players payoffs are small. The discovery of this effect enhances understanding of cooperation on multiplex networks, and demonstrates a new way to maintain cooperation in these systems.

Control strategy for a variable-speed wind energy conversion system

NASA Technical Reports Server (NTRS)

Jacob, A.; Veillette, D.; Rajagopalan, V.

1979-01-01

A control concept for a variable-speed wind energy conversion system is proposed, for which a self-exited asynchronous cage generator is used along with a system of thyristor converters. The control loops are the following: (1) regulation of the entrainment speed as function of available mechanical energy by acting on the resistance couple of the asynchronous generator; (2) control of electric power delivered to the asynchronous machine, functioning as a motor, for start-up of the vertical axis wind converter; and (3) limitation of the slip value, and by consequence, of the induction currents in the presence of sudden variations of input parameters.

Asynchronous versus Synchronous Learning in Pharmacy Education

ERIC Educational Resources Information Center

Motycka, Carol A.; St. Onge, Erin L.; Williams, Jennifer

2013-01-01

Objective: To better understand the technology being used today in pharmacy education through a review of the current methodologies being employed at various institutions. Also, to discuss the benefits and difficulties of asynchronous and synchronous methodologies, which are being utilized at both traditional and distance education campuses.…

Knowledge Building in Asynchronous Discussion Groups: Going Beyond Quantitative Analysis

ERIC Educational Resources Information Center

Schrire, Sarah

2006-01-01

This contribution examines the methodological challenges involved in defining the collaborative knowledge-building processes occurring in asynchronous discussion and proposes an approach that could advance understanding of these processes. The written protocols that are available to the analyst provide an exact record of the instructional…

Creating and Nurturing Distributed Asynchronous Learning Environments.

ERIC Educational Resources Information Center

Kochtanek, Thomas R.; Hein, Karen K.

2000-01-01

Describes the evolution of a university course from a face-to-face experience to a Web-based asynchronous learning environment. Topics include cognition and learning; distance learning and distributed learning; student learning communities and the traditional classroom; the future as it relates to education and technology; collaborative student…

Learning about the Literacy Development of English Language Learners in Asynchronous Online Discussions

ERIC Educational Resources Information Center

De Oliveira, Luciana C.; Olesova, Larisa

2013-01-01

This study examined asynchronous online discussions in the online course "English Language Development" to identify themes related to participants' learning about the language and literacy development of English Language Learners when they facilitated online discussions to determine whether the participants developed sufficient…

Creating Asynchronous Online Learning Communities

ERIC Educational Resources Information Center

Kerr, Crystal

2009-01-01

This research project examined how to develop and sustain online, asynchronous learning communities in continuous intake, distance education environments for learners in grades 7 through 10. The study is an action research project that is based upon in-depth, qualitative data. Interviews were conducted with distance education teachers,…

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

PubMed

Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

2006-08-24

Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology.

Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success?

PubMed Central

Gagnon, Marie-Pierre; Duplantie, Julie; Fortin, Jean-Paul; Landry, Réjean

2006-01-01

Background Telehealth, as other information and communication technologies (ICTs) introduced to support the delivery of health care services, is considered as a means to answer many of the imperatives currently challenging health care systems. In Canada, many telehealth projects are taking place, mostly targeting rural, remote or isolated populations. So far, various telehealth applications have been implemented and have shown promising outcomes. However, telehealth utilisation remains limited in many settings, despite increased availability of technology and telecommunication infrastructure. Methods A qualitative field study was conducted in four remote regions of Quebec (Canada) to explore perceptions of physicians and managers regarding the impact of telehealth on clinical practice and the organisation of health care services, as well as the conditions for improving telehealth implementation. A total of 54 respondents were interviewed either individually or in small groups. Content analysis of interviews was performed and identified several effects of telehealth on remote medical practice as well as key conditions to ensure the success of telehealth implementation. Results According to physicians and managers, telehealth benefits include better access to specialised services in remote regions, improved continuity of care, and increased availability of information. Telehealth also improves physicians' practice by facilitating continuing medical education, contacts with peers, and access to a second opinion. At the hospital and health region levels, telehealth has the potential to support the development of regional reference centres, favour retention of local expertise, and save costs. Conditions for successful implementation of telehealth networks include the participation of clinicians in decision-making, the availability of dedicated human and material resources, and a planned diffusion strategy. Interviews with physicians and managers also highlighted the importance of considering telehealth within the broader organisation of health care services in remote and rural regions. Conclusion This study identified core elements that should be considered when implementing telehealth applications with the purpose of supporting medical practice in rural and remote regions. Decision-makers need to be aware of the specific conditions that could influence telehealth integration into clinical practices and health care organisations. Thus, strategies addressing the identified conditions for telehealth success would facilitate the optimal implementation of this technology. PMID:16930484

Improvement of a Privacy Authentication Scheme Based on Cloud for Medical Environment.

PubMed

Chiou, Shin-Yan; Ying, Zhaoqin; Liu, Junqiang

2016-04-01

Medical systems allow patients to receive care at different hospitals. However, this entails considerable inconvenience through the need to transport patients and their medical records between hospitals. The development of Telecare Medicine Information Systems (TMIS) makes it easier for patients to seek medical treatment and to store and access medical records. However, medical data stored in TMIS is not encrypted, leaving patients' private data vulnerable to external leaks. In 2014, scholars proposed a new cloud-based medical information model and authentication scheme which would not only allow patients to remotely access medical services but also protects patient privacy. However, this scheme still fails to provide patient anonymity and message authentication. Furthermore, this scheme only stores patient medical data, without allowing patients to directly access medical advice. Therefore, we propose a new authentication scheme, which provides anonymity, unlinkability, and message authentication, and allows patients to directly and remotely consult with doctors. In addition, our proposed scheme is more efficient in terms of computation cost. The proposed system was implemented in Android system to demonstrate its workability.

Evidence for the acceptability and academic success of an innovative remote and rural extended placement.

PubMed

Wilson, Morven; Cleland, Jennifer

2008-01-01

Time spent in remote medicine as an undergraduate is influential in career choice in Australia and Northern America. However, its influence is not known in smaller countries, where recruitment into rural medicine is also problematic. Differences across countries mean work is required to explore determinants of success of remote and rural undergraduate training locally. The objectives of this pilot study were to identify why 4th year medical students chose an extended remote and rural option within a degree program which includes a short compulsory period of remote and rural practice. Because this was a novel option the study also looks at the academic performance of the first cohort of students to ensure quality control of teaching and learning. This was a mixed methods (questionnaire, focus group, assessment data) pilot study exploring student views and performance outcomes in 4th year medical undergraduate students (n = 14), University of Aberdeen, who completed an innovative, one-year remote and rural placement. Fourteen students took part in the pilot. Questionnaire data indicated they viewed remote and rural medicine positively. This interest was maintained over the placement. Most had no definite career plans, but did have a slight preference towards general practice. Focus group data indicated four main themes relating to the decision to select the remote and rural placement: (1) teaching reputation; (2) to experience remote and rural medicine; (3) a change from Aberdeen; and (4) lifestyle factors. Assessment data indicated that student performances at the end of the year placement were consistent with their 3rd year performance on all assessments: OSCEs (p = 0.79), written exams (p = 0.10; p = 0.49), special study module/ Ethics (p = 0.10) and year mark averages (p = 0.48). The results indicate that the extended remote and rural placement was a valuable and academically successful experience for the students. Important outcomes include that: the students who chose to undertake the remote and rural option did not suffer academically; and the cohort maintained their enthusiasm for long-term remote and rural practice. This pilot study represents only the short-term results of a remote and rural extended option offered by one university medical school. We plan further follow up on these students and their successors to look at both short- and long-term outcomes in terms of post selection and choosing to live and work within rural communities.

Risk of Herpes Zoster and Disseminated Varicella Zoster in Patients Taking Immunosuppressant Drugs at the Time of Zoster Vaccination.

PubMed

Cheetham, T Craig; Marcy, S Michael; Tseng, Hung-Fu; Sy, Lina S; Liu, In-Lu Amy; Bixler, Felicia; Baxter, Roger; Donahue, James G; Naleway, Allison L; Jacobsen, Steven J

2015-07-01

To determine the risks associated with zoster vaccine when administered to patients taking immunosuppressant medications. Patients enrolled in 1 of 7 managed care organizations affiliated with the Vaccine Safety Datalink between January 1, 2006, and December 31, 2009, were eligible. The exposure of interest was zoster vaccination in patients with current or remote immunosuppressant drug use. The primary outcomes were disseminated varicella zoster virus (VZV) and herpes zoster in the 42 days after vaccination. Automated data were collected on immunosuppressant drugs and baseline medical conditions. A logistic regression model using inverse probability treatment weights was used to estimate the odds of developing VZV or herpes zoster. A total of 14,554 individuals had an immunosuppressant medication dispensed around the time of vaccination, including 4826 with current use and 9728 with remote use. Most patients were taking low-dose corticosteroids. No cases of disseminated VZV were found in the current or remote users. The risk of herpes zoster was elevated in the 42 days after vaccination in current vs remote users (adjusted odds ratio, 2.99; 95% CI, 1.58-5.70). We found that patients taking immunosuppressant medications at the time of vaccination had a modest increased risk of herpes zoster in the 42 days after vaccination. The development of herpes zoster within 42 days after vaccination suggests that this is more likely due to reactivation of latent zoster virus than dissemination of the vaccine-derived varicella virus. These findings support the current zoster vaccination guidelines. Copyright © 2015 Mayo Foundation for Medical Education and Research. All rights reserved.

Medical Screening for Individuals Supporting Spacecraft Launch and Landing Activities in Remote Locations

NASA Technical Reports Server (NTRS)

Powers. W. Edward

2010-01-01

This viewgraph presentation reviews the medical screening process and spacecraft launch and landing mission activities for astronauts. The topics include: 1) Launch and Landing Mission Overview; 2) Available Resources; and 3) Medical Screening Process.

The future of remote ECG monitoring systems.

PubMed

Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

2016-09-01

Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring.

Improving proton therapy accessibility through seamless electronic integration of remote treatment planning sites.

PubMed

Belard, Arnaud; Dolney, Derek; Zelig, Tochner; McDonough, James; O'Connell, John

2011-06-01

Proton radiotherapy is a relatively scarce treatment modality in radiation oncology, with only nine centers currently operating in the United States. Funded by Public Law 107-248, the University of Pennsylvania and the Walter Reed Army Medical Center have developed a remote proton radiation therapy solution with the goals of improving access to proton radiation therapy for Department of Defense (DoD) beneficiaries while minimizing treatment delays and time spent away from home/work (time savings of up to 3 weeks per patient). To meet both Health Insurance Portability and Accountability Act guidelines and the more stringent security restrictions imposed by the DoD, our program developed a hybrid remote proton radiation therapy solution merging a CITRIX server with a JITIC-certified (Joint Interoperability Test Command) desktop videoconferencing unit. This conduit, thoroughly tested over a period of 6 months, integrates both institutions' radiation oncology treatment planning infrastructures into a single entity for DoD patients' treatment planning and delivery. This telemedicine solution enables DoD radiation oncologists and medical physicists the ability to (1) remotely access a proton therapy treatment planning platform, (2) transfer patient plans securely to the University of Pennsylvania patient database, and (3) initiate ad-hoc point-to-point and multipoint videoconferences to dynamically optimize and validate treatment plans. Our robust and secure remote treatment planning solution grants DoD patients not only access to a state-of-the-art treatment modality, but also participation in the treatment planning process by Walter Reed Army Medical Center radiation oncologists and medical physicists. This telemedicine system has the potential to lead to a greater integration of military treatment facilities and/or satellite clinics into regional proton therapy centers.

The Necessity of Real-Time: Fact and Fiction in Digital Reference Systems.

ERIC Educational Resources Information Center

Lankes, R. David; Shostack, Pauline

2002-01-01

Discussion of digital reference services and the use of real-time versus asynchronous services such as email focuses on data from the AskERIC digital reference service to demonstrate that asynchronous services are not only useful but may have greater utility than real-time systems. (Author/LRW)

Positioning (Mis)Aligned: The (Un)Making of Intercultural Asynchronous Computer-Mediated Communication

ERIC Educational Resources Information Center

Wu, Zhiwei

2018-01-01

Framed from positioning theory and dynamic systems theory, the paper reports on a naturalistic study involving four Chinese participants and their American peers in an intercultural asynchronous computer-mediated communication (ACMC) activity. Based on the moment-by-moment analysis and triangulation of forum posts, reflective essays, and…

Automated Feedback as a Convergence Tool

ERIC Educational Resources Information Center

Chenoweth, Tim; Corral, Karen; Scott, Kit

2016-01-01

This study evaluates two content delivery options for teaching a programming language to determine whether an asynchronous format can achieve the same learning efficacy as a traditional lecture (face-to-face) format. We use media synchronicity theory as a guide to choose media capabilities to incorporate into an asynchronous tutorial used…

Designing a Web-Based Asynchronous Innovation/Entrepreneurism Course

ERIC Educational Resources Information Center

Ghandforoush, Parviz

2017-01-01

Teaching an online fully asynchronous information technology course that requires students to ideate, build an e-commerce website, and develop an effective business plan involves a well-developed and highly engaging course design. This paper describes the design, development, and implementation of such a course and presents information on…

Asynchronous Assessment in a Large Lecture Marketing Course

ERIC Educational Resources Information Center

Downey, W. Scott; Schetzsle, Stacey

2012-01-01

Asynchronous assessment, which includes quizzes or exams online or outside class, offers marketing educators an opportunity to make more efficient use of class time and to enhance students' learning experiences by giving them more flexibility and choice in their assessment environment. In this paper, we examine the performance difference between…

Principles for Effective Asynchronous Online Instruction in Religious Studies

ERIC Educational Resources Information Center

McGuire, Beverley

2017-01-01

Asynchronous online instruction has become increasingly popular in the field of religious studies. However, despite voluminous research on online learning in general and numerous articles on online theological instruction, there has been little discussion of how to effectively design and deliver online undergraduate courses in religious studies.…

Investigating Asynchronous Online Communication: A Connected Stance Revealed

ERIC Educational Resources Information Center

Wegmann, Susan J.; McCauley, Joyce K.

2014-01-01

This research project explores the effects of altering the structure of discussion board formats to increase students' engagement and participation. This paper will present the findings of a two-university, two-class research project in which asynchronous discussion board entries were analyzed for substance. By using oral discourse analysis…

Theoretically Based Pedagogical Strategies Leading to Deep Learning in Asynchronous Online Gerontology Courses

ERIC Educational Resources Information Center

Majeski, Robin; Stover, Merrily

2007-01-01

Online learning has enjoyed increasing popularity in gerontology. This paper presents instructional strategies grounded in Fink's (2003) theory of significant learning designed for the completely asynchronous online gerontology classroom. It links these components with the development of mastery learning goals and provides specific guidelines for…

Developing a Successful Asynchronous Online Extension Program for Forest Landowners

ERIC Educational Resources Information Center

Zobrist, Kevin W.

2014-01-01

Asynchronous online Extension classes can reach a wide audience, is convenient for the learner, and minimizes ongoing demands on instructor time. However, producing such classes takes significant effort up front. Advance planning and good communication with contributors are essential to success. Considerations include delivery platforms, content…

Cultural Influences on Chinese Students' Asynchronous Online Learning in a Canadian University

ERIC Educational Resources Information Center

Zhao, Naxin; McDougall, Douglas

2008-01-01

This study explored six Chinese graduate students' asynchronous online learning in a large urban Canadian university. Individual interviews in Mandarin elicited their perceptions of online learning, their participation in it, and the cultural factors that influenced their experiences. In general, the participants had a positive attitude towards…

Language Use in Asynchronous Computer-Mediated Communication in Taiwan

ERIC Educational Resources Information Center

Huang, Daphne Li-jung

2009-01-01

This paper describes how Chinese-English bilinguals in Taiwan use their languages in asynchronous computer-mediated communication, specifically, via Bulletin Board System (BBS) and email. The main data includes two types: emails collected from a social network and postings collected from two BBS websites. By examining patterns of language choice…

Students' Use of Asynchronous Discussions for Academic Discourse Socialization

ERIC Educational Resources Information Center

Beckett, Gulbahar H.; Amaro-Jimenez, Carla; Beckett, Kelvin S.

2010-01-01

Our universities are becoming increasingly diverse at the same time as online asynchronous discussions (OADs) are emerging as the most important forum for computer mediated communication (CMC) in distance education. But there is shortage of studies that explore how graduate students from different ethnic, linguistic and cultural backgrounds use…

Effects of Belongingness and Synchronicity on Face-to-Face and Computer-Mediated Online Cooperative Pedagogy

ERIC Educational Resources Information Center

Saltarelli, Andrew John

2012-01-01

Previous research suggests asynchronous online computer-mediated communication (CMC) has deleterious effects on certain cooperative learning pedagogies (e.g., constructive controversy), but the processes underlying this effect and how it may be ameliorated remain unclear. This study tests whether asynchronous CMC thwarts belongingness needs…

Synchronous versus Asynchronous CMC and Transfer to Japanese Oral Performance

ERIC Educational Resources Information Center

Hirotani, Maki

2009-01-01

This study investigated the effects of synchronous and asynchronous CMC (computer-mediated communication)on the development of linguistic features of learners' speech in Japanese. Using learners from fourth-semester Japanese classes, the following research questions were examined: (a) Does CMC have positive effects on the development of oral…

A Group Intelligence-Based Asynchronous Argumentation Learning-Assistance Platform

ERIC Educational Resources Information Center

Huang, Chenn-Jung; Chang, Shun-Chih; Chen, Heng-Ming; Tseng, Jhe-Hao; Chien, Sheng-Yuan

2016-01-01

Structured argumentation support environments have been built and used in scientific discourse in the literature. However, to the best our knowledge, there is no research work in the literature examining whether student's knowledge has grown during learning activities with asynchronous argumentation. In this work, an intelligent computer-supported…

Participation, Interaction and Social Presence: An Exploratory Study of Collaboration in Online Peer Review Groups

ERIC Educational Resources Information Center

Zhao, Huahui; Sullivan, Kirk P. H.; Mellenius, Ingmarie

2014-01-01

A key reason for using asynchronous computer conferencing in instruction is its potential for supporting collaborative learning. However, few studies have examined collaboration in computer conferencing. This study examined collaboration in six peer review groups within an asynchronous computer conferencing. Eighteen tertiary students participated…

Asynchronous Group Review of EFL Writing: Interactions and Text Revisions

ERIC Educational Resources Information Center

Saeed, Murad Abdu; Ghazali, Kamila

2017-01-01

The current paper reports an empirical study of asynchronous online group review of argumentative essays among nine English as foreign language (EFL) Arab university learners joining English in their first, second, and third years at the institution. In investigating online interactions, commenting patterns, and how the students facilitate text…

The Role of Beliefs and Motivation in Asynchronous Online Learning in College-Level Classes

ERIC Educational Resources Information Center

Xie, Kui; Huang, Kun

2014-01-01

Epistemic and learning beliefs were found to affect college students' cognitive engagement and study strategies, as well as motivation in classroom settings. However, the relationships between epistemic and learning beliefs, motivation, learning perception, and students' actual learning participation in asynchronous online settings have been…

A Coding Scheme to Analyse the Online Asynchronous Discussion Forums of University Students

ERIC Educational Resources Information Center

Biasutti, Michele

2017-01-01

The current study describes the development of a content analysis coding scheme to examine transcripts of online asynchronous discussion groups in higher education. The theoretical framework comprises the theories regarding knowledge construction in computer-supported collaborative learning (CSCL) based on a sociocultural perspective. The coding…

Relationship of Metacognitive Monitoring with Interaction in an Asynchronous Online Discussion Forum

ERIC Educational Resources Information Center

Topcu, Abdullah

2010-01-01

Monitoring one's own performance accurately is essential for information-processing and self-regulation, which are indispensable in an online learning environment. In this article, the effect of metacognitive monitoring (MM) on interaction in an asynchronous online discussion forum was investigated. Transcripts of this forum, which was integrated…

Using Computer-Mediated Communication to Establish Social and Supportive Environments in Teacher Education

ERIC Educational Resources Information Center

Arnold, Nike; Ducate, Lara; Lomicka, Lara; Lord, Gillian

2005-01-01

This article examines social presence in virtual asynchronous learning communities among foreign language teachers. We present the findings of two studies investigating cross-institutional asynchronous forums created to engage participants in online dialogues regarding their foreign language teacher preparation experiences in and out of the…

The Effect of Synchronous and Asynchronous Participation on Students' Performance in Online Accounting Courses

ERIC Educational Resources Information Center

Duncan, Keith; Kenworthy, Amy; McNamara, Ray

2012-01-01

This article examines the relationship between MBA students' performance and participation in two online environments: a synchronous forum (chat room) and an asynchronous forum (discussion board) at an Australian university. The "quality" and "quantity" of students' participation is used to predict their final examination and…

Adding the Human Touch to Asynchronous Online Learning

ERIC Educational Resources Information Center

Glenn, Cynthia Wheatley

2018-01-01

For learners to actively accept responsibility in a virtual classroom platform, it is necessary to provide special motivation extending across the traditional classroom setting into asynchronous online learning. This article explores specific ways to do this that bridge the gap between ground and online students' learning experiences, and how…

Increasing Student Engagement Using Asynchronous Learning

ERIC Educational Resources Information Center

Northey, Gavin; Bucic, Tania; Chylinski, Mathew; Govind, Rahul

2015-01-01

Student engagement is an ongoing concern for educators because of its positive association with deep learning and educational outcomes. This article tests the use of a social networking site (Facebook) as a tool to facilitate asynchronous learning opportunities that complement face-to-face interactions and thereby enable a stronger learning…

A model for a drug distribution system in remote Australia as a social determinant of health using event structure analysis.

PubMed

Rovers, John P; Mages, Michelle D

2017-09-25

The social determinants of health include the health systems under which people live and utilize health services. One social determinant, for which pharmacists are responsible, is designing drug distribution systems that ensure patients have safe and convenient access to medications. This is critical for settings with poor access to health care. Rural and remote Australia is one example of a setting where the pharmacy profession, schools of pharmacy, and regulatory agencies require pharmacists to assure medication access. Studies of drug distribution systems in such settings are uncommon. This study describes a model for a drug distribution system in an Aboriginal Health Service in remote Australia. The results may be useful for policy setting, pharmacy system design, health professions education, benchmarking, or quality assurance efforts for health system managers in similarly remote locations. The results also suggest that pharmacists can promote access to medications as a social determinant of health. The primary objective of this study was to propose a model for a drug procurement, storage, and distribution system in a remote region of Australia. The secondary objective was to learn the opinions and experiences of healthcare workers under the model. Qualitative research methods were used. Semi-structured interviews were performed with a convenience sample of 11 individuals employed by an Aboriginal health service. Transcripts were analyzed using Event Structure Analysis (ESA) to develop the model. Transcripts were also analyzed to determine the opinions and experiences of health care workers. The model was comprised of 24 unique steps with seven distinct components: choosing a supplier; creating a list of preferred medications; budgeting and ordering; supply and shipping; receipt and storage in the clinic; prescribing process; dispensing and patient counseling. Interviewees described opportunities for quality improvement in choosing suppliers, legal issues and staffing, cold chain integrity, medication shortages and wastage, and adherence to policies. The model illustrates how pharmacists address medication access as a social determinant of health, and may be helpful for policy setting, system design, benchmarking, and quality assurance by health system designers. ESA is an effective and novel method of developing such models.

Implementation of body area networks based on MICS/WMTS medical bands for healthcare systems.

PubMed

Yuce, Mehmet R; Ho, Chee Keong

2008-01-01

A multi-hoping sensor network system has been implemented to monitor physiological parameters from multiple patient bodies by means of medical communication standards MICS (Medical Implant Communication Service) and WMTS (Wireless Medical Telemetry Service). Unlike the other medical sensor networks (they usually use 2.4 GHz ISM band), we used the two medical standards occupying the frequency bands that are mainly assigned to medical applications. The prototype system uses the MICS band (402-405 MHz) between the sensor nodes and a remote central control unit (CCU). And WMTS frequencies (608-614MHz) are used between the CCUs and the remote base stations allowing for a much larger range acting as an intermediate node. The sensor nodes in the prototype can measure up to four body signals (i.e. 4-channel) where one is dedicated to a continuous physiological signal such as ECC/EEG. The system includes firmware and software designs that can provide a long distance data transfer through the internet or a mobile network.

A Remote Medication Monitoring System for Chronic Heart Failure Patients to Reduce Readmissions: A Two-Arm Randomized Pilot Study.

PubMed

Hale, Timothy M; Jethwani, Kamal; Kandola, Manjinder Singh; Saldana, Fidencio; Kvedar, Joseph C

2016-04-17

Heart failure (HF) is a chronic condition affecting nearly 5.7 million Americans and is a leading cause of morbidity and mortality. With an aging population, the cost associated with managing HF is expected to more than double from US $31 billion in 2012 to US $70 billion by 2030. Readmission rates for HF patients are high-25% are readmitted at 30 days and nearly 50% at 6 months. Low medication adherence contributes to poor HF management and higher readmission rates. Remote telehealth monitoring programs aimed at improved medication management and adherence may improve HF management and reduce readmissions. The primary goal of this randomized controlled pilot study is to compare the MedSentry remote medication monitoring system versus usual care in older HF adult patients who recently completed a HF telemonitoring program. We hypothesized that remote medication monitoring would be associated with fewer unplanned hospitalizations and emergency department (ED) visits, increased medication adherence, and improved health-related quality of life (HRQoL) compared to usual care. Participants were randomized to usual care or use of the remote medication monitoring system for 90 days. Twenty-nine participants were enrolled and the final analytic sample consisted of 25 participants. Participants completed questionnaires at enrollment and closeout to gather data on medication adherence, health status, and HRQoL. Electronic medical records were reviewed for data on baseline classification of heart function and the number of unplanned hospitalizations and ED visits during the study period. Use of the medication monitoring system was associated with an 80% reduction in the risk of all-cause hospitalization and a significant decrease in the number of all-cause hospitalization length of stay in the intervention arm compared to usual care. Objective device data indicated high adherence rates (95%-99%) among intervention group participants despite finding no significant difference in self-reported adherence between study arms. The intervention group had poorer heart function and HRQoL at baseline, and HRQoL declined significantly in the intervention group compared to controls. The MedSentry medication monitoring system is a promising technology that merits continued development and evaluation. The MedSentry medication monitoring system may be useful both as a standalone system for patients with complex medication regimens or used to complement existing HF telemonitoring interventions. We found significant reductions in risk of all-cause hospitalization and the number of all-cause length of stay in the intervention group compared to controls. Although HRQoL deteriorated significantly in the intervention group, this may have been due to the poorer HF-functioning at baseline in the intervention group compared to controls. Telehealth medication adherence technologies, such as the MedSentry medication monitoring system, are a promising method to improve patient self-management,the quality of patient care, and reduce health care utilization and expenditure for patients with HF and other chronic diseases that require complex medication regimens. ClinicalTrials.gov NCT01814696; https://clinicaltrials.gov/ct2/show/study/NCT01814696 (Archived by WebCite® at http://www.webcitation.org/6giqAVhno).

10 CFR 35.600 - Use of a sealed source in a remote afterloader unit, teletherapy unit, or gamma stereotactic...

Code of Federal Regulations, 2010 CFR

2010-01-01

... COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and..., teletherapy unit, or gamma stereotactic radiosurgery unit. A licensee shall use sealed sources in photon...

10 CFR 35.600 - Use of a sealed source in a remote afterloader unit, teletherapy unit, or gamma stereotactic...

Code of Federal Regulations, 2011 CFR

2011-01-01

... COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and..., teletherapy unit, or gamma stereotactic radiosurgery unit. A licensee shall use sealed sources in photon...

10 CFR 35.600 - Use of a sealed source in a remote afterloader unit, teletherapy unit, or gamma stereotactic...

Code of Federal Regulations, 2014 CFR

2014-01-01

... COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and..., teletherapy unit, or gamma stereotactic radiosurgery unit. A licensee shall use sealed sources in photon...

10 CFR 35.600 - Use of a sealed source in a remote afterloader unit, teletherapy unit, or gamma stereotactic...

Code of Federal Regulations, 2013 CFR

2013-01-01

... COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and..., teletherapy unit, or gamma stereotactic radiosurgery unit. A licensee shall use sealed sources in photon...

10 CFR 35.600 - Use of a sealed source in a remote afterloader unit, teletherapy unit, or gamma stereotactic...

Code of Federal Regulations, 2012 CFR

2012-01-01

... COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Photon Emitting Remote Afterloader Units, Teletherapy Units, and..., teletherapy unit, or gamma stereotactic radiosurgery unit. A licensee shall use sealed sources in photon...

Study of working experience in remote rural areas after medical graduation.

PubMed

Thapa, K R; Shrestha, B K; Bhattarai, M D

2014-01-01

Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation. A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country. The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments' postings. Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around. The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.

Real-Time, Interactive Echocardiography Over High-Speed Networks: Feasibility and Functional Requirements

NASA Technical Reports Server (NTRS)

Bobinsky, Eric A.

1998-01-01

Real-time, Interactive Echocardiography Over High Speed Networks: Feasibility and Functional Requirements is an experiment in advanced telemedicine being conducted jointly by the NASA Lewis Research Center, the NASA Ames Research Center, and the Cleveland Clinic Foundation. In this project, a patient undergoes an echocardiographic examination in Cleveland while being diagnosed remotely by a cardiologist in California viewing a real-time display of echocardiographic video images transmitted over the broadband NASA Research and Education Network (NREN). The remote cardiologist interactively guides the sonographer administering the procedure through a two-way voice link between the two sites. Echocardiography is a noninvasive medical technique that applies ultrasound imaging to the heart, providing a "motion picture" of the heart in action. Normally, echocardiographic examinations are performed by a sonographer and cardiologist who are located in the same medical facility as the patient. The goal of telemedicine is to allow medical specialists to examine patients located elsewhere, typically in remote or medically underserved geographic areas. For example, a small, rural clinic might have access to an echocardiograph machine but not a cardiologist. By connecting this clinic to a major metropolitan medical facility through a communications network, a minimally trained technician would be able to carry out the procedure under the supervision and guidance of a qualified cardiologist.

Improving collaborative learning in online software engineering education

NASA Astrophysics Data System (ADS)

Neill, Colin J.; DeFranco, Joanna F.; Sangwan, Raghvinder S.

2017-11-01

Team projects are commonplace in software engineering education. They address a key educational objective, provide students critical experience relevant to their future careers, allow instructors to set problems of greater scale and complexity than could be tackled individually, and are a vehicle for socially constructed learning. While all student teams experience challenges, those in fully online programmes must also deal with remote working, asynchronous coordination, and computer-mediated communications all of which contribute to greater social distance between team members. We have developed a facilitation framework to aid team collaboration and have demonstrated its efficacy, in prior research, with respect to team performance and outcomes. Those studies indicated, however, that despite experiencing improved project outcomes, students working in effective software engineering teams did not experience significantly improved individual achievement. To address this deficiency we implemented theoretically grounded refinements to the collaboration model based upon peer-tutoring research. Our results indicate a modest, but statistically significant (p = .08), improvement in individual achievement using this refined model.

Communication library for run-time visualization of distributed, asynchronous data

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

Rowlan, J.; Wightman, B.T.

1994-04-01

In this paper we present a method for collecting and visualizing data generated by a parallel computational simulation during run time. Data distributed across multiple processes is sent across parallel communication lines to a remote workstation, which sorts and queues the data for visualization. We have implemented our method in a set of tools called PORTAL (for Parallel aRchitecture data-TrAnsfer Library). The tools comprise generic routines for sending data from a parallel program (callable from either C or FORTRAN), a semi-parallel communication scheme currently built upon Unix Sockets, and a real-time connection to the scientific visualization program AVS. Our methodmore » is most valuable when used to examine large datasets that can be efficiently generated and do not need to be stored on disk. The PORTAL source libraries, detailed documentation, and a working example can be obtained by anonymous ftp from info.mcs.anl.gov from the file portal.tar.Z from the directory pub/portal.« less

CMS distributed data analysis with CRAB3

NASA Astrophysics Data System (ADS)

Mascheroni, M.; Balcas, J.; Belforte, S.; Bockelman, B. P.; Hernandez, J. M.; Ciangottini, D.; Konstantinov, P. B.; Silva, J. M. D.; Ali, M. A. B. M.; Melo, A. M.; Riahi, H.; Tanasijczuk, A. J.; Yusli, M. N. B.; Wolf, M.; Woodard, A. E.; Vaandering, E.

2015-12-01

The CMS Remote Analysis Builder (CRAB) is a distributed workflow management tool which facilitates analysis tasks by isolating users from the technical details of the Grid infrastructure. Throughout LHC Run 1, CRAB has been successfully employed by an average of 350 distinct users each week executing about 200,000 jobs per day. CRAB has been significantly upgraded in order to face the new challenges posed by LHC Run 2. Components of the new system include 1) a lightweight client, 2) a central primary server which communicates with the clients through a REST interface, 3) secondary servers which manage user analysis tasks and submit jobs to the CMS resource provisioning system, and 4) a central service to asynchronously move user data from temporary storage in the execution site to the desired storage location. The new system improves the robustness, scalability and sustainability of the service. Here we provide an overview of the new system, operation, and user support, report on its current status, and identify lessons learned from the commissioning phase and production roll-out.

High-speed asynchronous optical sampling for high-sensitivity detection of coherent phonons

NASA Astrophysics Data System (ADS)

Dekorsy, T.; Taubert, R.; Hudert, F.; Schrenk, G.; Bartels, A.; Cerna, R.; Kotaidis, V.; Plech, A.; Köhler, K.; Schmitz, J.; Wagner, J.

2007-12-01

A new optical pump-probe technique is implemented for the investigation of coherent acoustic phonon dynamics in the GHz to THz frequency range which is based on two asynchronously linked femtosecond lasers. Asynchronous optical sampling (ASOPS) provides the performance of on all-optical oscilloscope and allows us to record optically induced lattice dynamics over nanosecond times with femtosecond resolution at scan rates of 10 kHz without any moving part in the set-up. Within 1 minute of data acquisition time signal-to-noise ratios better than 107 are achieved. We present examples of the high-sensitivity detection of coherent phonons in superlattices and of the coherent acoustic vibration of metallic nanoparticles.

Dual stator winding variable speed asynchronous generator: optimal design and experiments

NASA Astrophysics Data System (ADS)

Tutelea, L. N.; Deaconu, S. I.; Popa, G. N.

2015-06-01

In the present paper is carried out a theoretical and experimental study of dual stator winding squirrel cage asynchronous generator (DSWA) behavior in the presence of saturation regime (non-sinusoidal) due to the variable speed operation. The main aims are the determination of the relations of calculating the equivalent parameters of the machine windings to optimal design using a Matlab code. Issue is limited to three phase range of double stator winding cage-induction generator of small sized powers, the most currently used in the small adjustable speed wind or hydro power plants. The tests were carried out using three-phase asynchronous generator having rated power of 6 [kVA].

Emotional first aid for a suicide crisis: comparison between Telephonic hotline and internet.

PubMed

Gilat, Itzhak; Shahar, Golan

2007-01-01

The telephone and the internet have become popular sources of psychological help in various types of distress, including a suicide crisis. To gain more insight into the unique features of these media, we compared characteristics of calls to three technologically mediated sources of help that are part of the volunteer-based Israeli Association for Emotional First Aid (ERAN): Telephonic hotline (n = 4426), personal chat (n = 373) and an asynchronous online support group (n = 954). Threats of suicide were much more frequent among participants in the asynchronous support group than the telephone and personal chat. These findings encourage further research into suicide-related interpersonal exchanges in asynchronous online support groups.

Asynchronous emergence by loggerhead turtle (Caretta caretta) hatchlings

NASA Astrophysics Data System (ADS)

Houghton, J. D. R.; Hays, G. C.

2001-03-01

For many decades it has been accepted that marine turtle hatchlings from the same nest generally emerge from the sand together. However, for loggerhead turtles (Caretta caretta) nesting on the Greek Island of Kefalonia, a more asynchronous pattern of emergence has been documented. By placing temperature loggers at the top and bottom of nests laid on Kefalonia during 1998, we examined whether this asynchronous emergence was related to the thermal conditions within nests. Pronounced thermal variation existed not only between, but also within, individual nests. These within-nest temperature differences were related to the patterns of hatchling emergence, with hatchlings from nests displaying large thermal ranges emerging over a longer time-scale than those characterised by more uniform temperatures.

Asynchronous, macrotasked relaxation strategies for the solution of viscous, hypersonic flows

NASA Technical Reports Server (NTRS)

Gnoffo, Peter A.

1991-01-01

A point-implicit, asynchronous macrotasked relaxation of the steady, thin-layer, Navier-Stokes equations is presented. The method employs multidirectional, single-level storage Gauss-Seidel relaxation sweeps, which effectively communicate perturbations across the entire domain in 2n sweeps, where n is the dimension of the domain. In order to enhance convergence the application of relaxation factors to specific components of the Jacobian is examined using a stability analysis of the advection and diffusion equations. Attention is also given to the complications associated with asynchronous multitasking. Solutions are generated for hypersonic flows over blunt bodies in two and three dimensions with chemical reactions, utilizing single-tasked and multitasked relaxation strategies.

Management of ATM-based networks supporting multimedia medical information systems

NASA Astrophysics Data System (ADS)

Whitman, Robert A.; Blaine, G. James; Fritz, Kevin; Goodgold, Ken; Heisinger, Patrick

1997-05-01

Medical information systems are acquiring the ability to collect and deliver many different types of medical information. In support of the increased network demands necessitated by these expanded capabilities, asynchronous transfer mode (ATM) based networks are being deployed in medical care systems. While ATM supplies a much greater line rate than currently deployed networks, the management and standards surrounding ATM are yet to mature. This paper explores the management and control issues surrounding an ATM network supporting medical information systems, and examines how management impacts network performance and robustness. A multivendor ATM network at the BJC Health System/Washington University and the applications using the network are discussed. Performance information for specific applications is presented and analyzed. Network management's influence on application reliability is outlined. The information collected is used to show how ATM network standards and management tools influence network reliability and performance. Performance of current applications using the ATM network is discussed. Special attention is given to issues encountered in implementation of hypertext transfer protocol over ATM internet protocol (IP) communications. A classical IP ATM implementation yields greater than twenty percent higher network performance over LANE. Maximum performance for a host's suite of applications can be obtained by establishing multiple individually engineered IP links through its ATM network connection.

Is Fly in/Fly out (FIFO) a viable interim solution to address remote medical workforce shortages?

PubMed

Margolis, Stephen A

2012-01-01

Geographically remote regions of Australia experience a higher degree of socioeconomic inequality and health inequity, amid poor resourcing and extreme climatic conditions, when compared with their more urban counterparts. Doctors with the knowledge, skills and interest in remote work remain a scarce resource, with only 58 practitioners per 100,000 people versus 196/100,000 in metropolitan areas. Pending the arrival of the full complement of long-term remote medical workforce, an alternative solution that has so far received little attention but could provide near equivalence to resident doctors is the 'fly in/fly out' (FIFO) model. Specifically, where one doctor has a continuous relationship with one town or community, albeit spending their rostered time off away from this location, rather than continuity of service with different doctors each time. In this model, doctors spend a fixed number of days at work geographically remote from their home and families, with logistical support (eg housing, transport) provided, followed by a fixed number of days back at home not working. This provides a the doctor with the benefits of remote clinical work plus guaranteed time off at home, a more acceptable roster than in many remote locations at present. This also avoids the complex issue of experienced doctors having to leave remote areas mid-career for the well-documented reasons of spouse employment and children's education, as well as providing easier access to professional development activities. The author followed this path and remains a FIFO doctor after 7 years of continuous service. For FIFO to be effective, there needs to be a commitment from the sponsoring organisation for short, balanced, flexible, family friendly rosters and a positive organizational structure with effective communication between management and front line staff. Evidence shows that families and children with healthy family functioning, who are able to balance separateness and togetherness and are able to readily adjust when circumstances move from stability through change, and have strong communication skills, cope well with FIFO work. The author's employer actively supports his FIFO work arrangements. Although FIFO presents challenges and is not for everyone, it may be time for organisations providing medical care to remote Australia to further consider this option. Allowing mid-career doctors experienced in remote medicine to continue remote clinical practice when they move to the city for family reasons would provide an immediate benefit to remote communities. Notwithstanding the challenges, perhaps it is time to consider the option of FIFO to address ongoing workforce shortages?

Student Outcomes Associated with Use of Asynchronous Online Discussion Forums in Gross Anatomy Teaching

ERIC Educational Resources Information Center

Green, Rodney A.; Hughes, Diane L.

2013-01-01

Asynchronous online discussion forums are increasingly common in blended learning environments but the relationship to student learning outcomes has not been reported for anatomy teaching. Forums were monitored in two multicampus anatomy courses; an introductory first year course and a second year physiotherapy-specific course. The forums are…

At a Distance: A Comparative Study of Distance Delivery Modalities for PhD Nursing Students

ERIC Educational Resources Information Center

Black, Andrew G.

2010-01-01

This study sought to ascertain and compare the attitudes and perceptions of PhD nursing students attending their coursework through synchronous and asynchronous means at two different universities. Many studies have been performed comparing both synchronous videoconferencing and asynchronous online education with the traditional classroom, but no…

Students' Desired and Experienced Levels of Connectivity to an Asynchronous, Online, Distance Degree Program

ERIC Educational Resources Information Center

Schroeder, Shawnda; Baker, Mary; Terras, Katherine; Mahar, Patti; Chiasson, Kari

2016-01-01

This study examined graduate students' desired and experienced levels of connectivity in an online, asynchronous distance degree program. Connectivity was conceptualized as the students' feelings of community and involvement, not their level of access to the Internet. Graduate students enrolled in a distance degree program were surveyed on both…

Three Interaction Patterns on Asynchronous Online Discussion Behaviours: A Methodological Comparison

ERIC Educational Resources Information Center

Jo, I.; Park, Y.; Lee, H.

2017-01-01

An asynchronous online discussion (AOD) is one format of instructional methods that facilitate student-centered learning. In the wealth of AOD research, this study evaluated how students' behavior on AOD influences their academic outcomes. This case study compared the differential analytic methods including web log mining, social network analysis…

Microbial infection affects egg viability and incubation behavior in a tropical passerine.

Treesearch

Mark I. Cook; Steven R. Beissinger; Gary A. Toranzos; Roberto A. Arendt Rodriguez

2004-01-01

Many avian species initiate incubation before clutch completion, which causes eggs to hatch asynchronously. This influences brood competitive dynamics and often results in nestling mortality. The prevailing hypotheses contend that parents incubate early because asynchronous hatching provides fitness benefits to parents or surviving offspring. An alternative idea is...

FIFO Buffer for Asynchronous Data Streams

NASA Technical Reports Server (NTRS)

Bascle, K. P.

1985-01-01

Variable-rate, asynchronous data signals from up to four measuring instruments or other sources combined in first-in/first-out (FIFO) buffer for transmission on single channel. Constructed in complementary metal-oxide-semiconductor (CMOS) logic, buffer consumes low power (only 125 mW at 5V) and conforms to aerospace standards of reliability and maintainability.

Critical Thinking in Asynchronous Online Discussion: An Investigation of Student Facilitation Techniques

ERIC Educational Resources Information Center

Lim, Sze Chung Raymond; Cheung, Wing Sum; Hew, Khe Foon

2011-01-01

Background: In the last decade, asynchronous online discussion forums have become a primary focus of many educational researchers. Some advocates believed that the process of typing out messages in itself can promote in-depth critical thinking skills. Nevertheless, empirical research has not provided much support for this claim in natural…

Interaction and Cognition in Asynchronous Computer Conferencing

ERIC Educational Resources Information Center

Schrire, Sarah

2004-01-01

This paper is based on a multiple-case study of the learning process in three asynchronous computer conferences. The conferences were part of the distance learning component in doctoral degree courses in computing technology in education offered at an American university. The conferences were analyzed from a number of perspectives, the emphasis in…

Socially Shared Metacognitive Regulation in Asynchronous CSCL in Science: Functions, Evolution and Participation

ERIC Educational Resources Information Center

Iiskala, Tuike; Volet, Simone; Lehtinen, Erno; Vauras, Marja

2015-01-01

The significance of socially shared metacognitive regulation (SSMR) in collaborative learning is gaining momentum. To date, however, there is still a paucity of research of how SSMR is manifested in asynchronous computer-supported collaborative learning (CSCL), and hardly any systematic investigation of SSMR's functions and evolution across…

The Effects of Self-Generated Synchronous and Asynchronous Visual Speech Feedback on Overt Stuttering Frequency

ERIC Educational Resources Information Center

Snyder, Gregory J.; Hough, Monica Strauss; Blanchet, Paul; Ivy, Lennette J.; Waddell, Dwight

2009-01-01

Purpose: Relatively recent research documents that visual choral speech, which represents an externally generated form of synchronous visual speech feedback, significantly enhanced fluency in those who stutter. As a consequence, it was hypothesized that self-generated synchronous and asynchronous visual speech feedback would likewise enhance…

Cooperative Learning in Graduate Student Projects: Comparing Synchronous versus Asynchronous Collaboration

ERIC Educational Resources Information Center

Strang, Kenneth

2013-01-01

Cooperative learning was applied in a graduate project management course to compare the effectiveness of asynchronous versus synchronous online team meetings. An experiment was constructed to allocate students to project teams while ensuring there was a balance of requisite skills, namely systems analysis and design along with HTML/Javascript…

Asynchronous Education: A Blueprint for the Future of Adult Learning.

ERIC Educational Resources Information Center

Krueger, Lyle L.; Porter, Cyndi Wilson; Burke, Daniel

While the distance learning curriculum at Lakeland College (Wisconsin) began 20 years ago, the idea for Lakeland Online was conceived about two and one-half years ago. A variety of delivery modes were considered before discovering Convene software. Since the communication process enabled by the Convene software is asynchronous and requires only a…

Synchronous and Asynchronous Communication in Distance Learning: A Review of the Literature

ERIC Educational Resources Information Center

Watts, Lynette

2016-01-01

Distance learning is commonplace in higher education, with increasing numbers of students enjoying the flexibility e-learning provides. Keeping students connected with peers and instructors has been a challenge with e-learning, but as technology has advanced, the methods by which educators keep students engaged, synchronously and asynchronously,…

Evaluating the Quality of Interaction in Asynchronous Discussion Forums in Fully Online Courses

ERIC Educational Resources Information Center

Nandi, Dip; Hamilton, Margaret; Harland, James

2012-01-01

Fully online courses are becoming progressively more popular because of their "anytime anywhere" learning flexibility. One of the ways students interact with each other and with the instructors within fully online learning environments is via asynchronous discussion forums. However, student engagement in online discussion forums does not…

Real-Time Implementation of an Asynchronous Vision-Based Target Tracking System for an Unmanned Aerial Vehicle

DTIC Science & Technology

2007-06-01

Chin Khoon Quek. “Vision Based Control and Target Range Estimation for Small Unmanned Aerial Vehicle.” Master’s Thesis, Naval Postgraduate School...December 2005. [6] Kwee Chye Yap. “Incorporating Target Mensuration System for Target Motion Estimation Along a Road Using Asynchronous Filter

Reflections of Students in Their Use of Asynchronous Online Seminars

ERIC Educational Resources Information Center

Groves, Mark; O'Donoghue, John

2009-01-01

This paper reports on research that has been carried out into the use, process, and effectiveness of an asynchronous online seminar within an undergraduate sports studies degree programme. Contemporary sources are used to justify the use of technology supported learning (TSL) in higher education and to inform a reflective and critical account of…

Using Asynchronous Electronic Surveys to Help In-Class Revision: A Case Study

ERIC Educational Resources Information Center

Tong, Vincent C. H.

2012-01-01

Synchronous e-voting systems (commonly known as "clickers") have become increasingly popular as they can be used to enhance interactivity in lectures. Asynchronous electronic surveys (AESs), unlike these voting system, usually serve as a method of gathering feedback before or after teaching sessions. This paper describes and evaluates a project…

Argumentation in a Multi Party Asynchronous Computer Mediated Conference: A Generic Analysis

ERIC Educational Resources Information Center

Coffin, Caroline; Painter, Clare; Hewings, Ann

2005-01-01

This paper draws on systemic functional linguistic genre analysis to illuminate the way in which post graduate applied linguistics students structure their argumentation within a multi party asynchronous computer mediated conference. Two conference discussions within the same postgraduate course are compared in order to reveal the way in which…

The Socratic Dialogue in Asynchronous Online Discussions: Is Constructivism Redundant?

ERIC Educational Resources Information Center

Kingsley, Paul

2011-01-01

Purpose: This paper aims to examine Socratic dialogue in asynchronous online discussions in relation to constructivism. The links between theory and practice in teaching are to be discussed whilst tracing the origins of Socratic dialogue and recent trends and use of seminar in research based institutions. Design/methodology/approach: Many online…

Asynchronous Online Peer Assistance: Telephone Messages of Encouragement in Post Licensure Nursing Programs

ERIC Educational Resources Information Center

Melrose, Sherri; Swettenham, Steve

2012-01-01

Peer assistance activities can strengthen online learning environments. And yet, like other professional adult learners, working post licensure nurses attending university part time to upgrade their credentials may have limited interest in student-to-student interaction. Some intentionally choose asynchronous self-paced courses so they can work on…

Thematic Analysis of the "Games" Students Play in Asynchronous Learning Environments

ERIC Educational Resources Information Center

MacMillan, Thalia; Forte, Michele; Grant, Cynthia

2014-01-01

The dynamics of the student-student relationship within the asynchronous online classroom, as evidenced by conversations in an online discussion board, is a balancing act potentially more complex than those occurring in real-time. In order for learning to truly be considered effective, a collaborative, safe environment needs to exist among…

Scaffolding Collaborative Argumentation in Asynchronous Discussions with Message Constraints and Message Labels

ERIC Educational Resources Information Center

Jeong, Allan; Joung, Sunyoung

2007-01-01

This study examined the effects of message constraints and labels on collaborative argumentation in asynchronous online discussions. Thirty-eight undergraduate students in an introductory educational technology course were assigned to one of three groups. In one group, students posted specific types of messages using a prescribed set of message…

Flipping the Online Classroom with Web 2.0: The Asynchronous Workshop

ERIC Educational Resources Information Center

Cummings, Lance

2016-01-01

This article examines how Web 2.0 technologies can be used to "flip" the online classroom by creating asynchronous workshops in social environments where immediacy and social presence can be maximized. Using experience teaching several communication and writing classes in Google Apps (Google+, Google Hangouts, Google Drive, etc.), I…

Peer Moderation of Asynchronous Online Discussions: An Exploratory Study of Peer E-Moderating Behaviour

ERIC Educational Resources Information Center

Ghadirian, Hajar; Ayub, Ahmad Fauzi Mohd

2017-01-01

This study explored patterns of e-moderating behaviour students performed when they were assigned as peer moderators of asynchronous online discussions in a reciprocal manner. Eighty-four students from an undergraduate blended course were observed during a 7-week-long online discussions. Using quantitative content analysis peer moderators'…

Asynchronous CMC, Collaboration and the Development of Critical Thinking in a Graduate Seminar in Applied Linguistics

ERIC Educational Resources Information Center

Abrams, Zsuzsanna I.

2005-01-01

A primary objective of graduate education, and often promoted by peer collaboration tasks, is the development of critical thinking skills. The present study compares how graduate students enrolled in a qualitative research design course in applied linguistics utilized asynchronous computer-mediated communication (ACMC) and face-to-face…

Asynchronous Computer-Mediated Corrective Feedback and the Correct Use of Prepositions: Is It Really Effective?

ERIC Educational Resources Information Center

Hosseini, Seyyed Behrooz

2012-01-01

An area that has recently attracted increasing attention is providing feedback on learners' writing accuracy through the Internet. However, research in this area has largely focused on synchronous communication, i.e., chatting, with fewer studies assessing asynchronous technologies, i.e., e-mailing. Therefore, this study investigates the…

The Role of Technology-Based Scaffolding in Problem-Based Online Asynchronous Discussion

ERIC Educational Resources Information Center

Ak, Serife

2016-01-01

This study examined the effects of technology-based scaffolds that were composed through the use of the seven-stage, problem-based learning strategy on knowledge construction in a problem-based online asynchronous discussion. In a quasi-experimental setting, 60 students in an undergraduate Instructional Technology and Material Design course were…

Superconducting magnetic energy storage for asynchronous electrical systems

DOEpatents

Boenig, H.J.

1984-05-16

It is an object of the present invention to provide superconducting magnetic energy storage for a plurality of asynchronous electrical systems. It is a further object of the present invention to provide load leveling and stability improvement in a plurality of independent ac systems using a single superconducting magnetic energy storage coil.

Factors Affecting Pre-Service Teachers' Participation in Asynchronous Discussion: The Case of Iran

ERIC Educational Resources Information Center

Ebrahimi, Alice; Faghih, Esmail; Marandi, Seyyedeh Susan

2016-01-01

This study reports on a qualitative small-scale exploratory study which examined the factors influencing 32 Iranian pre-service language teachers' participation in online asynchronous text-based discussion forums. By adopting a multiple case study design and analysing data gathered through semi-structured interviews and participants' online…

A Dynamic Analysis of the Interplay between Asynchronous and Synchronous Communication in Online Learning: The Impact of Motivation

ERIC Educational Resources Information Center

Giesbers, B.; Rienties, B.; Tempelaar, D.; Gijselaers, W.

2014-01-01

With the increased affordances of synchronous communication tools, more opportunities for online learning to resemble face-to-face settings have recently become available. However, synchronous communication does not afford as much time for reflection as asynchronous communication. Therefore, a combination of synchronous and asynchronous…

An Investigation of Assessment and Feedback Practices in Fully Asynchronous Online Undergraduate Mathematics Courses

ERIC Educational Resources Information Center

Trenholm, Sven; Alcock, Lara; Robinson, Carol

2015-01-01

Research suggests it is difficult to learn mathematics in the fully asynchronous online (FAO) instructional modality, yet little is known about associated teaching and assessment practices. In this study, we investigate FAO mathematics assessment and feedback practices in particular consideration of both claims and findings that these practices…

An Integrated Approach to Preempt Cheating on Asynchronous, Objective, Online Assessments in Graduate Business Classes

ERIC Educational Resources Information Center

Sullivan, Daniel P.

2016-01-01

Cheating, left untended, erodes the validity of evaluation and, ultimately, corrupts the legitimacy of a course. We profile an approach to manage, with an eye toward preempting, cheating on asynchronous, objective, online quizzes. This approach taps various technological and social solutions to academic dishonesty, integrating them into a…

An Examination of Computer Engineering Students' Perceptions about Asynchronous Discussion Forums

ERIC Educational Resources Information Center

Ozyurt, Ozcan; Ozyurt, Hacer

2013-01-01

This study was conducted in order to reveal the usage profiles and perceptions of Asynchronous Discussion Forums (ADFs) of 126 computer engineering students from the Computer Engineering Department in a university in Turkey. By using a mixed methods research design both quantitative and qualitative data were collected and analyzed. Research…

Students' Learning in Asynchronous Discussion Forums: A Meta-Analysis

ERIC Educational Resources Information Center

Martono, Fkipuntan; Salam, Urai

2017-01-01

Asynchronous discussion forums are among the most preferred tools chosen to foster learning opportunities and knowledge construction. To reveal the cognitive engagement evidenced in the transcripts of the discussion forums, this study presents 51 papers. 17 papers reported research on students' attitude toward the use of ICT for learning, 16…

Student Moderators in Asynchronous Online Discussion: A Question of Questions

ERIC Educational Resources Information Center

Zingaro, Daniel

2012-01-01

Much current research exalts the benefits of having students facilitate weekly discussions in asynchronous online courses. This study seeks to add to what is known about student moderation through an analysis of the types of questions students use to spur each discussion. Prior experimental work has demonstrated that the types of questions posed…

Content Analysis Coding Schemes for Online Asynchronous Discussion

ERIC Educational Resources Information Center

Weltzer-Ward, Lisa

2011-01-01

Purpose: Researchers commonly utilize coding-based analysis of classroom asynchronous discussion contributions as part of studies of online learning and instruction. However, this analysis is inconsistent from study to study with over 50 coding schemes and procedures applied in the last eight years. The aim of this article is to provide a basis…

Does the Medium Dictate the Message? Cultivating E-Communication in an Asynchronous Environment.

ERIC Educational Resources Information Center

Kiernan, Mary; Thomas, Pete; Woodroffe, Mark

Virtual learning environments (VLEs) are often perceived by education establishments as an opportunity to widen access without traditional overheads. An integral part of most VLEs is asynchronous computer conferencing and on-line moderators must help students migrate quickly to the new virtual environment to minimize learning disruption. This…

An Investigation of Student Practices in Asynchronous Computer Conferencing Courses

ERIC Educational Resources Information Center

Peters, Vanessa L.; Hewitt, Jim

2010-01-01

This study investigated the online practices of students enrolled in graduate-level distance education courses. Using interviews and a questionnaire as data sources, the study sought to: (a) identify common practices that students adopt in asynchronous discussions, and (b) gain an understanding of why students adopt them. An analysis of the data…

Asynchronous Replication and Autosome-Pair Non-Equivalence in Human Embryonic Stem Cells

PubMed Central

Dutta, Devkanya; Ensminger, Alexander W.; Zucker, Jacob P.; Chess, Andrew

2009-01-01

A number of mammalian genes exhibit the unusual properties of random monoallelic expression and random asynchronous replication. Such exceptional genes include genes subject to X inactivation and autosomal genes including odorant receptors, immunoglobulins, interleukins, pheromone receptors, and p120 catenin. In differentiated cells, random asynchronous replication of interspersed autosomal genes is coordinated at the whole chromosome level, indicative of chromosome-pair non-equivalence. Here we have investigated the replication pattern of the random asynchronously replicating genes in undifferentiated human embryonic stem cells, using fluorescence in situ hybridization based assay. We show that allele-specific replication of X-linked genes and random monoallelic autosomal genes occur in human embryonic stem cells. The direction of replication is coordinated at the whole chromosome level and can cross the centromere, indicating the existence of autosome-pair non-equivalence in human embryonic stem cells. These results suggest that epigenetic mechanism(s) that randomly distinguish between two parental alleles are emerging in the cells of the inner cell mass, the source of human embryonic stem cells. PMID:19325893

Air Temperature Distribution Measurement Using Asynchronous-Type Sound Probe

NASA Astrophysics Data System (ADS)

Katano, Yosuke; Wakatsuki, Naoto; Mizutani, Koichi

2009-07-01

In conventional temperature measurement using a sound probe, the operation beginnings of two acoustic sensors must be completely synchronized to measure time of flight (TOF), tf, because the precision of synchronization determines TOF measurement accuracy. A wireless local area network (LAN) is convenient for constructing a sensing grid; however, it causes a fluctuation in the delay of millisecond order. Therefore, it cannot provide sufficient precision for synchronizing acoustic sensors. In previous studies, synchronization was achieved by a trigger line using a coaxial cable; however, the cable reduces the flexibility of a wireless sensing grid especially in larger-scale measurement. In this study, an asynchronous-type sound probe is devised to compensate for the effect of the delay of millisecond order caused by the network. The validity of the probe was examined, and the air temperature distribution was measured using this means. A matrix method is employed to obtain the distribution. Similar results were observed using both asynchronous-type sound probes and thermocouples. This shows the validity of the use of a sensing grid with an asynchronous-type sound probe for temperature distribution measurement even if the trigger line is omitted.

Research on navigation of satellite constellation based on an asynchronous observation model using X-ray pulsar

NASA Astrophysics Data System (ADS)

Guo, Pengbin; Sun, Jian; Hu, Shuling; Xue, Ju

2018-02-01

Pulsar navigation is a promising navigation method for high-altitude orbit space tasks or deep space exploration. At present, an important reason for restricting the development of pulsar navigation is that navigation accuracy is not high due to the slow update of the measurements. In order to improve the accuracy of pulsar navigation, an asynchronous observation model which can improve the update rate of the measurements is proposed on the basis of satellite constellation which has a broad space for development because of its visibility and reliability. The simulation results show that the asynchronous observation model improves the positioning accuracy by 31.48% and velocity accuracy by 24.75% than that of the synchronous observation model. With the new Doppler effects compensation method in the asynchronous observation model proposed in this paper, the positioning accuracy is improved by 32.27%, and the velocity accuracy is improved by 34.07% than that of the traditional method. The simulation results show that without considering the clock error will result in a filtering divergence.

Asynchronous hatching and food limitation: A test of Lack's hypothesis

USGS Publications Warehouse

Skagen, Susan Knight

1988-01-01

Lack's (1954, 1968) hypothesis that asynchronous hatching of altricial birds is an adaptive response to unpredictable food shortages during the breeding season was examined in the highly granivorous Zebra Finch (Poephila guttata). I compared growth and survival of nestlings in asynchronous and artificially created synchronous broods reared under food-limited and food-abundant conditions in an aviary. I also examined the role of parental experience on survival and growth of nestlings.There was no differential mortality of Zebra Finch nestlings due to either asynchrony or food abundance. Young in abundant food treatments grew more rapidly, however, than those in food-restricted treatments. Heaviest Zebra Finch nestlings in a brood grew more quickly than their lightest siblings when food was limited, supporting Lack's hypothesis. Further, differential survival of light and heavy siblings occurred when food was abundant, suggesting that asynchronous hatching can be maladaptive under some ecological conditions. Nestlings reared by inexperienced parents suffered greater mortality and slower growth when food was abundant than nestlings raised by experienced parents. Prefledging mass was correlated with size at adulthood

Neighbor Discovery Algorithm in Wireless Local Area Networks Using Multi-beam Directional Antennas

NASA Astrophysics Data System (ADS)

Wang, Jin; Peng, Wei; Liu, Song

2017-10-01

Neighbor discovery is an important step for Wireless Local Area Networks (WLAN) and the use of multi-beam directional antennas can greatly improve the network performance. However, most neighbor discovery algorithms in WLAN, based on multi-beam directional antennas, can only work effectively in synchronous system but not in asynchro-nous system. And collisions at AP remain a bottleneck for neighbor discovery. In this paper, we propose two asynchrono-us neighbor discovery algorithms: asynchronous hierarchical scanning (AHS) and asynchronous directional scanning (ADS) algorithm. Both of them are based on three-way handshaking mechanism. AHS and ADS reduce collisions at AP to have a good performance in a hierarchical way and directional way respectively. In the end, the performance of the AHS and ADS are tested on OMNeT++. Moreover, it is analyzed that different application scenarios and the factors how to affect the performance of these algorithms. The simulation results show that AHS is suitable for the densely populated scenes around AP while ADS is suitable for that most of the neighborhood nodes are far from AP.

A formal model of asynchronous communication and its use in mechanically verifying a biphase mark protocol

NASA Technical Reports Server (NTRS)

Moore, J. Strother

1992-01-01

In this paper we present a formal model of asynchronous communication as a function in the Boyer-Moore logic. The function transforms the signal stream generated by one processor into the signal stream consumed by an independently clocked processor. This transformation 'blurs' edges and 'dilates' time due to differences in the phases and rates of the two clocks and the communications delay. The model can be used quantitatively to derive concrete performance bounds on asynchronous communications at ISO protocol level 1 (physical level). We develop part of the reusable formal theory that permits the convenient application of the model. We use the theory to show that a biphase mark protocol can be used to send messages of arbitrary length between two asynchronous processors. We study two versions of the protocol, a conventional one which uses cells of size 32 cycles and an unconventional one which uses cells of size 18. We conjecture that the protocol can be proved to work under our model for smaller cell sizes and more divergent clock rates but the proofs would be harder.

Quasi-perfect FIFO: Synchronous or asynchronous with application in controller design for the UNICON laser memory. [digital memory and buffer storage

NASA Technical Reports Server (NTRS)

Lim, R. S.

1974-01-01

The first-in-first-out memory buffer (FIFO), is an elastic digital memory whose main application is in data buffering between devices operating at different rates. Data written into the top is moved autonomously down toward the bottom of the FIFO to the lowest unoccupied location, and data read from the bottom of the FIFO will cause data from the top to move autonomously down toward the bottom. The FIFO is available in MOS LSI asynchronous form with data rate in the 1 MHz region. The FIFO described yields a simple high-speed iterative implementation, either synchronous of asynchronous. Because of this simple iterative structure, the FIFO is expandable in both number of words and bits per word, and it is attractive from the viewpoint of integrated-circuit production. For the synchronous FIFO, a model was built and successfully used in the controller for the UNICON laser memory. For the asynchronous FIFO, a model was built and also successfully used in a high-performance magnetic tape controller.

Secure Authentication for Remote Patient Monitoring with Wireless Medical Sensor Networks †

PubMed Central

Hayajneh, Thaier; Mohd, Bassam J; Imran, Muhammad; Almashaqbeh, Ghada; Vasilakos, Athanasios V.

2016-01-01

There is broad consensus that remote health monitoring will benefit all stakeholders in the healthcare system and that it has the potential to save billions of dollars. Among the major concerns that are preventing the patients from widely adopting this technology are data privacy and security. Wireless Medical Sensor Networks (MSNs) are the building blocks for remote health monitoring systems. This paper helps to identify the most challenging security issues in the existing authentication protocols for remote patient monitoring and presents a lightweight public-key-based authentication protocol for MSNs. In MSNs, the nodes are classified into sensors that report measurements about the human body and actuators that receive commands from the medical staff and perform actions. Authenticating these commands is a critical security issue, as any alteration may lead to serious consequences. The proposed protocol is based on the Rabin authentication algorithm, which is modified in this paper to improve its signature signing process, making it suitable for delay-sensitive MSN applications. To prove the efficiency of the Rabin algorithm, we implemented the algorithm with different hardware settings using Tmote Sky motes and also programmed the algorithm on an FPGA to evaluate its design and performance. Furthermore, the proposed protocol is implemented and tested using the MIRACL (Multiprecision Integer and Rational Arithmetic C/C++) library. The results show that secure, direct, instant and authenticated commands can be delivered from the medical staff to the MSN nodes. PMID:27023540

Augmented Reality as a Telemedicine Platform for Remote Procedural Training.

PubMed

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-10-10

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor's hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers' perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

Augmented Reality as a Telemedicine Platform for Remote Procedural Training

PubMed Central

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-01-01

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform. PMID:28994720

Secure Authentication for Remote Patient Monitoring with Wireless Medical Sensor Networks.

PubMed

Hayajneh, Thaier; Mohd, Bassam J; Imran, Muhammad; Almashaqbeh, Ghada; Vasilakos, Athanasios V

2016-03-24

There is broad consensus that remote health monitoring will benefit all stakeholders in the healthcare system and that it has the potential to save billions of dollars. Among the major concerns that are preventing the patients from widely adopting this technology are data privacy and security. Wireless Medical Sensor Networks (MSNs) are the building blocks for remote health monitoring systems. This paper helps to identify the most challenging security issues in the existing authentication protocols for remote patient monitoring and presents a lightweight public-key-based authentication protocol for MSNs. In MSNs, the nodes are classified into sensors that report measurements about the human body and actuators that receive commands from the medical staff and perform actions. Authenticating these commands is a critical security issue, as any alteration may lead to serious consequences. The proposed protocol is based on the Rabin authentication algorithm, which is modified in this paper to improve its signature signing process, making it suitable for delay-sensitive MSN applications. To prove the efficiency of the Rabin algorithm, we implemented the algorithm with different hardware settings using Tmote Sky motes and also programmed the algorithm on an FPGA to evaluate its design and performance. Furthermore, the proposed protocol is implemented and tested using the MIRACL (Multiprecision Integer and Rational Arithmetic C/C++) library. The results show that secure, direct, instant and authenticated commands can be delivered from the medical staff to the MSN nodes.

An efficient biometric and password-based remote user authentication using smart card for Telecare Medical Information Systems in multi-server environment.

PubMed

Maitra, Tanmoy; Giri, Debasis

2014-12-01

The medical organizations have introduced Telecare Medical Information System (TMIS) to provide a reliable facility by which a patient who is unable to go to a doctor in critical or urgent period, can communicate to a doctor through a medical server via internet from home. An authentication mechanism is needed in TMIS to hide the secret information of both parties, namely a server and a patient. Recent research includes patient's biometric information as well as password to design a remote user authentication scheme that enhances the security level. In a single server environment, one server is responsible for providing services to all the authorized remote patients. However, the problem arises if a patient wishes to access several branch servers, he/she needs to register to the branch servers individually. In 2014, Chuang and Chen proposed an remote user authentication scheme for multi-server environment. In this paper, we have shown that in their scheme, an non-register adversary can successfully logged-in into the system as a valid patient. To resist the weaknesses, we have proposed an authentication scheme for TMIS in multi-server environment where the patients can register to a root telecare server called registration center (RC) in one time to get services from all the telecare branch servers through their registered smart card. Security analysis and comparison shows that our proposed scheme provides better security with low computational and communication cost.

Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit.

PubMed

Lazaryan, Moran; Abu-Kishk, Ibrahim; Rosenfeld-Yehoshua, Noa; Berkovitch, Sofia; Toledano, Michal; Reshef, Iris; Kanari, Tal; Ziv-Baran, Tomer; Berkovitch, Matitiahu

2016-01-01

One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available. To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU). A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded. The review time for one medical record was 8.9 (95% CI, 6.9-10.9) min. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11) min. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8) and 12 (9-15) min, respectively, for patients with psychiatric-neurologic disorders compared to those without (p = 0.032). Usually, a daily workload of 240 min was needed for the pharmacist accompanying the round in contrast to 108 min per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9%, and made no comment on 36.9% of the recommendations. Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit

PubMed Central

Lazaryan, Moran; Abu-Kishk, Ibrahim; Rosenfeld-Yehoshua, Noa; Berkovitch, Sofia; Toledano, Michal; Reshef, Iris; Kanari, Tal; Ziv-Baran, Tomer; Berkovitch, Matitiahu

2016-01-01

Background: One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available. Objective: To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU). Methods: A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded. Results: The review time for one medical record was 8.9 (95% CI, 6.9–10.9) min. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45–1.11) min. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8–18.8) and 12 (9–15) min, respectively, for patients with psychiatric-neurologic disorders compared to those without (p = 0.032). Usually, a daily workload of 240 min was needed for the pharmacist accompanying the round in contrast to 108 min per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9%, and made no comment on 36.9% of the recommendations. Conclusion: Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist. PMID:27555821

Hatching behavior of eastern long-necked turtles (Chelodina longicollis): The influence of asynchronous environments on embryonic heart rate and phenotype.

PubMed

McGlashan, Jessica K; Loudon, Fiona K; Thompson, Michael B; Spencer, Ricky-John

2015-10-01

Variable temperatures within a nest cause asynchronous development within clutches of freshwater turtle embryos, yet synchronous hatching occurs and is thought to be an important survival strategy for hatchlings. Metabolic compensation and circadian rhythms in heart rates of embryonic turtles indicate the potential of communication between embryos in a nest. Heart rates were used to identify metabolic circadian rhythms in clutches of an Australian freshwater turtle (Chelodina longicollis) and determine whether embryos metabolically compensate and hatch synchronously when incubated in asynchronous environments. The effects of a group environment during incubation on egg development and incubation period were also investigated during the final 3 weeks of development. Chelodina longicollis hatch synchronously and metabolically compensate so that less advanced embryos catch up to more advanced clutch-mates. Heart rates of embryos remained stable from week 4-7 in asynchronous (M=89 bpm) and synchronous (M=92 bpm) groups and declined in the final 2 weeks of incubation (M=72 and 77 bpm). Circadian rhythms were present throughout development and diel heart rates of embryos in asynchronous groups showed less deviation from the mean (M=-0.5 bpm) than synchronous groups (M=-4 bpm). Eggs incubated in groups had a significantly shorter incubation period than eggs incubated individually. Phenotypic traits including size, performance, and growth of all hatchlings were not affected. Egg position within a turtle nest is important for coordinating development throughout incubation and facilitating synchronous hatching. Copyright © 2015 Elsevier Inc. All rights reserved.

Community-based clinical education increases motivation of medical students to medicine of remote area: comparison between lecture and practice.

PubMed

Tani, Kenji; Yamaguchi, Harutaka; Tada, Saaya; Kondo, Saki; Tabata, Ryo; Yuasa, Shino; Kawaminami, Shingo; Nakanishi, Yoshinori; Ito, Jun; Shimizu, Nobuhiko; Obata, Fumiaki; Shin, Teruki; Bando, Hiroyasu; Kohno, Mitsuhiro

2014-01-01

In this study, we administered a questionnaire to medical students to evaluate the effect of community-based clinical education on their attitudes to community medicine and medicine in remote area. Questionnaires were given 4 times to all the students from first-year to sixth-year. Of 95 students, 65 students (68.4%) who completed all questionnaires, were used in this study. The intensity of students' attitudes was estimated by using visual analogue scale. The intensity of interest, a sense of fulfillment and passion in medicine of remote area was significantly increased after the community-based practice. On the other hand, the level of understanding in medicine in remote area was increased by the lecture not by the practice. The intensity of desire both to become a generalist and a specialist was significantly increased when the grade went up. Most of sixth-year students desired to have abilities of a generalist and a specialist simultaneously. This study shows that the community-based practice is more meaningful in increasing motivation in medicine in remote area than the lecture, and suggests that it is important to prepare more courses to experience community medicine to increase the number of physicians who desire to work in remote area.

Digitizing Medicines for Remote Capture of Oral Medication Adherence Using Co‐encapsulation

PubMed Central

Peloquin, C; Santillo, F; Haubrich, R; Muttera, L; Moser, K; Savage, GM; Benson, CA; Blaschke, TF

2017-01-01

High‐resolution measurement of medication adherence is essential to personalized drug therapy. A US Food and Drug Administration (FDA)‐cleared device, using an edible ingestion sensor (IS), external wearable patch, and paired mobile device can detect and record ingestion events. Oral medications must be combined with an IS to generate precise “digitized‐medication” ingestion records. We developed a Good Manufacturing Practice protocol to repackage oral medications with the IS within certified Capsugel capsules, termed co‐encapsulation (CoE). A randomized bioequivalence study of CoE‐IS‐Rifamate (Isoniazid/Rifampin 150/300 mg) vs. native‐Rifamate was conducted in 12 patients with active Mycobacterium tuberculosis and demonstrated bioequivalence using the population method ratio test (95% confidence interval). Subsequently, CoE‐IS‐medications across all biopharmaceutical classes underwent in vitro dissolution testing utilizing USP and FDA guidelines. CoE‐IS medications tested met USP dissolution specifications and were equivalent to their native formulations. CoE combines oral medications with the IS without altering the quality of the native formulation, generating “digitized” medications for remote capture of dosing histories. PMID:28597911

An investigation of the questions posted on medical consultation websites.

PubMed

Chiu, Ming-Hsin Phoebe

2016-12-01

Online medical consultation has recently become a more and more popular alternative venue for healthcare. It allows patients and caregivers to discuss their health problems and symptoms with qualified medical health professionals via the Internet. This study investigates the questions posted on an asynchronous online medical consultation website, Taiwan eDoctor. Five research themes are explored: (1) length of questions, (2) moment of seeking consultation, (3) strategies of communicating chief complaints, (4) purpose of seeking consultation and (5) identity disclosure. Data collection was conducted by randomly selecting 50 resolved consultation Q&As for each of 24 medical specialties, resulting in a total of 1200 entries in the primary data set. Data analysis was conducted qualitatively and quantitatively. Average length of questions was 161.21 words. Online medical consultation was sought when healthy, healthy but not robust, when suspicious of illness, when diagnosed as ill and during treatment/recovery. In communicating chief complaints, consultation seekers were engaged in contextual, focal or emotional communication styles. Nine distinct purposes to seek online consultation were identified and can be broadly interpreted as intellectual, social and emotional. The finding also suggests that more than two-third of questions were asked for by the patients themselves. Through content analysis of questions posted on an online medical consultation website, this study characterises communication patterns during the health information seeking process. These findings can help guide the design of more effective patient-centred online medical consultation services. © 2016 Health Libraries Group.

Practical lessons in remote connectivity.

PubMed Central

Kouroubali, A.; Starren, J.; Barrows, R. C.; Clayton, P. D.

1997-01-01

Community Health Information Networks (CHINs) require the ability to provide computer network connections to many remote sites. During the implementation of the Washington Heights and Inwood Community Health Management Information System (WHICHIS) at the Columbia-Presbyterian Medical Center (CPMC), a number of remote connectivity issues have been encountered. Both technical and non-technical issues were significant during the installation. We developed a work-flow model for this process which may be helpful to any health care institution attempting to provide seamless remote connectivity. This model is presented and implementation lessons are discussed. PMID:9357643

Area/latency optimized early output asynchronous full adders and relative-timed ripple carry adders.

PubMed

Balasubramanian, P; Yamashita, S

2016-01-01

This article presents two area/latency optimized gate level asynchronous full adder designs which correspond to early output logic. The proposed full adders are constructed using the delay-insensitive dual-rail code and adhere to the four-phase return-to-zero handshaking. For an asynchronous ripple carry adder (RCA) constructed using the proposed early output full adders, the relative-timing assumption becomes necessary and the inherent advantages of the relative-timed RCA are: (1) computation with valid inputs, i.e., forward latency is data-dependent, and (2) computation with spacer inputs involves a bare minimum constant reverse latency of just one full adder delay, thus resulting in the optimal cycle time. With respect to different 32-bit RCA implementations, and in comparison with the optimized strong-indication, weak-indication, and early output full adder designs, one of the proposed early output full adders achieves respective reductions in latency by 67.8, 12.3 and 6.1 %, while the other proposed early output full adder achieves corresponding reductions in area by 32.6, 24.6 and 6.9 %, with practically no power penalty. Further, the proposed early output full adders based asynchronous RCAs enable minimum reductions in cycle time by 83.4, 15, and 8.8 % when considering carry-propagation over the entire RCA width of 32-bits, and maximum reductions in cycle time by 97.5, 27.4, and 22.4 % for the consideration of a typical carry chain length of 4 full adder stages, when compared to the least of the cycle time estimates of various strong-indication, weak-indication, and early output asynchronous RCAs of similar size. All the asynchronous full adders and RCAs were realized using standard cells in a semi-custom design fashion based on a 32/28 nm CMOS process technology.

e-Learning system ERM for medical radiation physics education.

PubMed

Stoeva, Magdalena; Cvetkov, Asen

2005-09-01

The objective of this paper is to present the Education for Radiation in Medicine (ERM) e-Learning System. The system was developed, tested and piloted in the Inter-University Medical Physics Centre, Plovdiv, Bulgaria. It was based on the results of EU Project TEMPUS S-JEP 09826. The ERM e-Learning System is an integrated on-line system for remote education covering aspects of Medical Radiation Physics education (M.Sc. level). It provides user-friendly interface and optimised functionality with three different access levels: trainee, professor and administrator. The minimum server requirements and the standard client side working environment turn the system into a good, cost effective and easy to support solution for remote education.

A Multimodal Database for a Home Remote Medical Care Application

NASA Astrophysics Data System (ADS)

Medjahed, Hamid; Istrate, Dan; Boudy, Jerome; Steenkeste, François; Baldinger, Jean-Louis; Dorizzi, Bernadette

The home remote monitoring systems aim to make a protective contribution to the well being of individuals (patients, elderly persons) requiring moderate amounts of support for independent living spaces, and improving their everyday life. Existing researches of these systems suffer from lack of experimental data and a standard medical database intended for their validation and improvement. This paper presents a multi-sensors environment for acquiring and recording a multimodal medical database, which includes physiological data (cardiac frequency, activity or agitation, posture, fall), environment sounds and localization data. It provides graphical interface functions to manage, process and index these data. The paper focuses on the system implementation, its usage and it points out possibilities for future work.

Rapid Feedforward Inhibition and Asynchronous Excitation Regulate Granule Cell Activity in the Mammalian Main Olfactory Bulb

PubMed Central

Burton, Shawn D.

2015-01-01

Granule cell-mediated inhibition is critical to patterning principal neuron activity in the olfactory bulb, and perturbation of synaptic input to granule cells significantly alters olfactory-guided behavior. Despite the critical role of granule cells in olfaction, little is known about how sensory input recruits granule cells. Here, we combined whole-cell patch-clamp electrophysiology in acute mouse olfactory bulb slices with biophysical multicompartmental modeling to investigate the synaptic basis of granule cell recruitment. Physiological activation of sensory afferents within single glomeruli evoked diverse modes of granule cell activity, including subthreshold depolarization, spikelets, and suprathreshold responses with widely distributed spike latencies. The generation of these diverse activity modes depended, in part, on the asynchronous time course of synaptic excitation onto granule cells, which lasted several hundred milliseconds. In addition to asynchronous excitation, each granule cell also received synchronous feedforward inhibition. This inhibition targeted both proximal somatodendritic and distal apical dendritic domains of granule cells, was reliably recruited across sniff rhythms, and scaled in strength with excitation as more glomeruli were activated. Feedforward inhibition onto granule cells originated from deep short-axon cells, which responded to glomerular activation with highly reliable, short-latency firing consistent with tufted cell-mediated excitation. Simulations showed that feedforward inhibition interacts with asynchronous excitation to broaden granule cell spike latency distributions and significantly attenuates granule cell depolarization within local subcellular compartments. Collectively, our results thus identify feedforward inhibition onto granule cells as a core feature of olfactory bulb circuitry and establish asynchronous excitation and feedforward inhibition as critical regulators of granule cell activity. SIGNIFICANCE STATEMENT Inhibitory granule cells are involved critically in shaping odor-evoked principal neuron activity in the mammalian olfactory bulb, yet little is known about how sensory input activates granule cells. Here, we show that sensory input to the olfactory bulb evokes a barrage of asynchronous synaptic excitation and highly reliable, short-latency synaptic inhibition onto granule cells via a disynaptic feedforward inhibitory circuit involving deep short-axon cells. Feedforward inhibition attenuates local depolarization within granule cell dendritic branches, interacts with asynchronous excitation to suppress granule cell spike-timing precision, and scales in strength with excitation across different levels of sensory input to normalize granule cell firing rates. PMID:26490853

A comparative evaluation of the effect of internet-based CME delivery format on satisfaction, knowledge and confidence

PubMed Central

2010-01-01

Background Internet-based instruction in continuing medical education (CME) has been associated with favorable outcomes. However, more direct comparative studies of different Internet-based interventions, instructional methods, presentation formats, and approaches to implementation are needed. The purpose of this study was to conduct a comparative evaluation of two Internet-based CME delivery formats and the effect on satisfaction, knowledge and confidence outcomes. Methods Evaluative outcomes of two differing formats of an Internet-based CME course with identical subject matter were compared. A Scheduled Group Learning format involved case-based asynchronous discussions with peers and a facilitator over a scheduled 3-week delivery period. An eCME On Demand format did not include facilitated discussion and was not based on a schedule; participants could start and finish at any time. A retrospective, pre-post evaluation study design comparing identical satisfaction, knowledge and confidence outcome measures was conducted. Results Participants in the Scheduled Group Learning format reported significantly higher mean satisfaction ratings in some areas, performed significantly higher on a post-knowledge assessment and reported significantly higher post-confidence scores than participants in the eCME On Demand format that was not scheduled and did not include facilitated discussion activity. Conclusions The findings support the instructional benefits of a scheduled delivery format and facilitated asynchronous discussion in Internet-based CME. PMID:20113493

42 CFR 456.522 - Content of request for variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time... travel time between the remote facility and each facility listed in paragraph (e) of this section; (f...

Remote Adaptive Motor Resistance Training Exercise Apparatus and Method of Use Thereof

NASA Technical Reports Server (NTRS)

Reich, Alton (Inventor); Shaw, James (Inventor)

2017-01-01

The invention comprises a method and/or an apparatus using a computer configured exercise system equipped with an electric motor to provide physical resistance to user motion in conjunction with means for sharing exercise system related data and/or user performance data with a secondary user, such as a medical professional, a physical therapist, a trainer, a computer generated competitor, and/or a human competitor. For example, the exercise system is used with a remote trainer to enhance exercise performance, with a remote medical professional for rehabilitation, and/or with a competitor in a competition, such as in a power/weightlifting competition or in a video game. The exercise system is optionally configured with an intelligent software assistant and knowledge navigator functioning as a personal assistant application.

Remote Adaptive Motor Resistance Training Exercise Apparatus and Method of Use Thereof

NASA Technical Reports Server (NTRS)

Shaw, James (Inventor); Reich, Alton (Inventor)

2016-01-01

The invention comprises a method and/or an apparatus using a computer configured exercise system equipped with an electric motor to provide physical resistance to user motion in conjunction with means for sharing exercise system related data and/or user performance data with a secondary user, such as a medical professional, a physical therapist, a trainer, a computer generated competitor, and/or a human competitor. For example, the exercise system is used with a remote trainer to enhance exercise performance, with a remote medical professional for rehabilitation, and/or with a competitor in a competition, such as in a power/weightlifting competition or in a video game. The exercise system is optionally configured with an intelligent software assistant and knowledge navigator functioning as a personal assistant application.

Comparative case study of two biomedical research collaboratories.

PubMed

Schleyer, Titus K L; Teasley, Stephanie D; Bhatnagar, Rishi

2005-10-25

Working together efficiently and effectively presents a significant challenge in large-scale, complex, interdisciplinary research projects. Collaboratories are a nascent method to help meet this challenge. However, formal collaboratories in biomedical research centers are the exception rather than the rule. The main purpose of this paper is to compare and describe two collaboratories that used off-the-shelf tools and relatively modest resources to support the scientific activity of two biomedical research centers. The two centers were the Great Lakes Regional Center for AIDS Research (HIV/AIDS Center) and the New York University Oral Cancer Research for Adolescent and Adult Health Promotion Center (Oral Cancer Center). In each collaboratory, we used semistructured interviews, surveys, and contextual inquiry to assess user needs and define the technology requirements. We evaluated and selected commercial software applications by comparing their feature sets with requirements and then pilot-testing the applications. Local and remote support staff cooperated in the implementation and end user training for the collaborative tools. Collaboratory staff evaluated each implementation by analyzing utilization data, administering user surveys, and functioning as participant observers. The HIV/AIDS Center primarily required real-time interaction for developing projects and attracting new participants to the center; the Oral Cancer Center, on the other hand, mainly needed tools to support distributed and asynchronous work in small research groups. The HIV/AIDS Center's collaboratory included a center-wide website that also served as the launch point for collaboratory applications, such as NetMeeting, Timbuktu Conference, PlaceWare Auditorium, and iVisit. The collaboratory of the Oral Cancer Center used Groove and Genesys Web conferencing. The HIV/AIDS Center was successful in attracting new scientists to HIV/AIDS research, and members used the collaboratory for developing and implementing new research studies. The Oral Cancer Center successfully supported highly distributed and asynchronous research, and the collaboratory facilitated real-time interaction for analyzing data and preparing publications. The two collaboratory implementations demonstrated the feasibility of supporting biomedical research centers using off-the-shelf commercial tools, but they also identified several barriers to successful collaboration. These barriers included computing platform incompatibilities, network infrastructure complexity, variable availability of local versus remote IT support, low computer and collaborative software literacy, and insufficient maturity of available collaborative software. Factors enabling collaboratory use included collaboration incentives through funding mechanism, a collaborative versus competitive relationship of researchers, leadership by example, and tools well matched to tasks and technical progress. Integrating electronic collaborative tools into routine scientific practice can be successful but requires further research on the technical, social, and behavioral factors influencing the adoption and use of collaboratories.

Participation in Asynchronous Online Discussion Forums Does Improve Student Learning of Gross Anatomy

ERIC Educational Resources Information Center

Green, Rodney A.; Farchione, Davide; Hughes, Diane L.; Chan, Siew-Pang

2014-01-01

Asynchronous online discussion forums are common in blended learning models and are popular with students. A previous report has suggested that participation in these forums may assist student learning in a gross anatomy subject but it was unclear as to whether more academically able students post more often or whether participation led to…

Online-BSEE (Online Bachelor of Science in Electrical Engineering): An Asynchronous Online Electrical Engineering Degree Program with Laboratory

ERIC Educational Resources Information Center

Tang, Wendy; Westgate, Charles; Liu, Pao-Lo; Gouzman, Michael

2014-01-01

The Online Bachelor of Science in Electrical Engineering is a collaborative effort among three University Centers at SUNY (State University of New York), namely Stony Brook, Binghamton, and Buffalo. The program delivers the complete electrical engineering curriculum at the bachelor level to students online and asynchronously. Students, however,…

Reversible logic gates on Physarum Polycephalum

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

Schumann, Andrew

2015-03-10

In this paper, we consider possibilities how to implement asynchronous sequential logic gates and quantum-style reversible logic gates on Physarum polycephalum motions. We show that in asynchronous sequential logic gates we can erase information because of uncertainty in the direction of plasmodium propagation. Therefore quantum-style reversible logic gates are more preferable for designing logic circuits on Physarum polycephalum.

A Comparison of Asynchronous Online Text-Based Lectures and Synchronous Interactive Web Conferencing Lectures

ERIC Educational Resources Information Center

Skylar, Ashley Ann

2009-01-01

Online learning environments are more prevalent in teacher education than ever before. In 2009, many instructors are attempting to emulate traditional instructional methods in the online learning environment as much as possible. Online courses are separated into two categories, (1) asynchronous; and (2) synchronous, depending on the nature of the…

Educational Outcomes of Synchronous and Asynchronous High School Students: A Quantitative Causal-Comparative Study of Online Algebra 1

ERIC Educational Resources Information Center

Berry, Sharon

2017-01-01

This study used a quantitative, causal-comparative design. It compared educational outcome data from online Algebra 1 courses to determine if a significant difference existed between synchronous and asynchronous students for end-of-course grades, state assessments scores, and student perceptions of their course. The study found that synchronous…

The Effectiveness of Synchronous and Asynchronous Written Corrective Feedback on Grammatical Accuracy in a Computer-Mediated Environment

ERIC Educational Resources Information Center

Shintani, Natsuko; Aubrey, Scott

2016-01-01

This study extends research on written corrective feedback (CF) by investigating how timing of CF affects grammar acquisition. Specifically, it examined the relative effects of synchronous and asynchronous CF on the accurate use of the hypothetical conditional structure. Participants were 68 intermediate-level students of English at a university…

Microanalytic Case studies of Individual Participation Patterns in an Asynchronous Online Discussion in an Undergraduate Blended Course

ERIC Educational Resources Information Center

Wise, Alyssa Friend; Perera, Nishan; Hsiao, Ying-Ting; Speer, Jennifer; Marbouti, Farshid

2012-01-01

This study presents three case studies of students' participation patterns in an online discussion to address the gap in our current understanding of how "individuals" experience asynchronous learning environments. Cases were constructed via microanalysis of log-file data, post contents, and the evolving discussion structure. The first student was…

Collaborative Learning Processes in an Asynchronous Environment: An Analysis through Discourse and Social Networks

ERIC Educational Resources Information Center

Tirado, Ramon; Aguaded, Ignacio; Hernando, Angel

2011-01-01

This article analyses an experience in collaborative learning in an asynchronous writing environment through discussion forums on a WebCt platform of the University of Huelva's virtual campus, and was part of an innovative teaching project in 2007-08. The main objectives are to describe the processes of collaborative knowledge construction and the…

Asynchronous Online Access as an Accommodation on Students with Learning Disabilities and/or Attention-Deficit Hyperactivity Disorders in Postsecondary STEM Courses

ERIC Educational Resources Information Center

Graves, Laura; Asunda, Paul A.; Plant, Stacey J.; Goad, Chester

2011-01-01

The purpose of this study was to investigate whether asynchronous online access of course recordings was beneficial to students with learning disabilities (LD) and/or Attention Deficit/Hyperactivity Disorder (ADHD) enrolled in science, technology, engineering, and mathematics (STEM) courses. Data were collected through semi-structured interviews…

Digging beneath the Surface: Analyzing the Complexity of Instructors' Participation in Asynchronous Discussion

ERIC Educational Resources Information Center

Clarke, Lane Whitney; Bartholomew, Audrey

2014-01-01

The purpose of this study was to investigate instructor participation in asynchronous discussions through an in-depth content analysis of instructors' postings and comments through the Community of Inquiry (COI) framework (Garrison et. al, 2001). We developed an analytical tool based on this framework in order to better understand what instructors…

Writer L1/L2 Status and Asynchronous Online Writing Center Feedback: Consultant Response Patterns

ERIC Educational Resources Information Center

Weirick, Joshua; Davis, Tracy; Lawson, Daniel

2017-01-01

This case study examines the differences in comments offered by asynchronous online writing center consultants to L1 and L2 speakers and examines the potential disconnects in consultant perceptions of their practice. The researchers collected and coded sample papers and interviewed participants to contextualize data from the quantitative portion…

Reconceptualising Moderation in Asynchronous Online Discussions Using Grounded Theory

ERIC Educational Resources Information Center

Vlachopoulos, Panos; Cowan, John

2010-01-01

This article reports a grounded theory study of the moderation of asynchronous online discussions, to explore the processes by which tutors in higher education decide when and how to moderate. It aims to construct a theory of e-moderation based on some key factors which appear to influence e-moderation. It discusses previous research on the…

Exploring Singapore Primary School Students' Perceptions of Chinese Asynchronous Online Discussions

ERIC Educational Resources Information Center

Chin, Wong Wan; Sum, Cheung Wing; Foon, Hew Khe

2008-01-01

Background: Asynchronous online discussion (AOD) has found widespread use in tertiary education and adult learning environment; however, there has been little research on its use in elementary school, especially in the context of the teaching of the Chinese Language. This study explores the use of AOD in a Chinese Language class in a primary…

Synchronous and Asynchronous Text-Based CMC in Educational Contexts: A Review of Recent Research

ERIC Educational Resources Information Center

Johnson, Genevieve, Marie

2006-01-01

This paper presents a review of recent research that examines the relative instructional utility of text-based synchronous and asynchronous computer-mediated communication (CMC). As a mechanism for limiting the number of studies reviewed as well as controlling for emergent technologies, only research published since 2000 was reviewed. The goal was…

Asynchronous Knowledge Sharing and Conversation Interaction Impact on Grade in an Online Business Course

ERIC Educational Resources Information Center

Strang, Kenneth David

2011-01-01

Student knowledge sharing and conversation theory interactions were coded from asynchronous discussion forums to measure the effect of learning-oriented utterances on academic performance. The sample was 3 terms of an online business course (in an accredited MBA program) at a U.S.-based university. Correlation, stepwise regression, and multiple…

A Study of Synchronous versus Asynchronous Collaboration in an Online Business Writing Class

ERIC Educational Resources Information Center

Mabrito, Mark

2006-01-01

A case study examined the collaborative experiences of students in an online business writing classroom. The purpose was to examine the same groups of students working on collaborative writing assignments in both a synchronous (real-time) and an asynchronous (non-real-time) discussion forum. This study focused on examining the amount, pattern, and…

Interaction and Critical Inquiry in Asynchronous Computer-Mediated Conferencing: A Research Agenda

ERIC Educational Resources Information Center

Hopkins, Joseph; Gibson, Will; Ros i. Sole, Cristina; Savvides, Nicola; Starkey, Hugh

2008-01-01

This paper reviews research on learner and tutor interaction in asynchronous computer-mediated (ACM) conferences used in distance learning. The authors note claims made for the potential of ACM conferences to promote higher-order critical inquiry and the social construction of knowledge, and argue that there is a general lack of evidence regarding…

Analysis of an Asynchronous Online Discussion as a Supportive Model for Peer Collaboration and Reflection in Teacher Education

ERIC Educational Resources Information Center

Plešec Gasparic, Romina; Pecar, Mojca

2016-01-01

Professional development of future teachers is based on connecting theory and practice with the aim of supporting and developing critical, independent, responsible decision-making and active teaching. With this aim we designed a blended learning environment with an asynchronous online discussion, enabling collaboration and reflection even when…

Comparing Face-To-Face and Asynchronous Online Communication as Mechanisms for Critical Reflective Dialogue

ERIC Educational Resources Information Center

Salter, Susan; Douglas, Tracy; Kember, David

2017-01-01

Two mechanisms for engaging in critical reflective dialogue are discussed and compared: face-to-face meetings and asynchronous online discussion. The context is an umbrella action research project, with over 20 participants, which aimed to improve practices in online teaching and contribute to the development of graduate attributes. The article…

Using Asynchronous Video to Achieve Instructor Immediacy and Closeness in Online Classes: Experiences from Three Cases

ERIC Educational Resources Information Center

Griffiths, Michael; Graham, Charles

2010-01-01

This research sought to understand the experiences of students and instructors with asynchronous video (video-mail) using webcams in three online sections of teacher education classes at Brigham Young University. We examined the experiences of students through scores and comments posted in student ratings surveys, and the experiences of…

Toward Personal and Emotional Connectivity in Mobile Higher Education through Asynchronous Formative Audio Feedback

ERIC Educational Resources Information Center

Rasi, Päivi; Vuojärvi, Hanna

2018-01-01

This study aims to develop asynchronous formative audio feedback practices for mobile learning in higher education settings. The development was conducted in keeping with the principles of design-based research. The research activities focused on an inter-university online course, within which the use of instructor audio feedback was tested,…

Asynchronous online foresight panels: the case of wildfire management

Treesearch

David N. Bengston; Robert L. Olson

2015-01-01

Text-based asynchronous online conferencing involves structured online discussion and deliberation among multiple participants from multiple sites in which there is a delay in interaction between contributors. This method has been widely used for a variety of purposes in higher education and other settings, but has not been commonly used in futures research. This paper...

Effects of Synchronous and Asynchronous Computer-Mediated Communication (CMC) Oral Conversations on English Language Learners' Discourse Functions

ERIC Educational Resources Information Center

AbuSeileek, Ali Farhan; Qatawneh, Khaleel

2013-01-01

This study aimed to explore the effects of synchronous and asynchronous computer mediated communication (CMC) oral discussions on question types and strategies used by English as a Foreign Language (EFL) learners. The participants were randomly assigned to two treatment conditions/groups; the first group used synchronous CMC, while the second…

Introducing Group-Based Asynchronous Learning to Business Education. Reflections on Effective Course Design and Delivery

ERIC Educational Resources Information Center

Walker, Richard; Arnold, Ivo

2004-01-01

This paper explores the contribution of virtual tools to student learning within full-time management programmes. More specifically, the paper focuses on asynchronous communication tools, considering the scope they offer for group-based collaborative learning outside the classroom. We report on the effectiveness of this approach for an economics…

Student Perceptions of Asynchronous Multimodal Instructor Feedback: A Multiple Case Study

ERIC Educational Resources Information Center

Lenards, Nishele Dyan

2017-01-01

Student dissatisfaction has been a problem in higher education with regard to the provision of assessment-related feedback. Due to the distant nature of online learning, instructors are faced with many challenges in delivering quality feedback because the communication is asynchronous and lacks social cues that are present in a F2F environment.…

Students' Perceptions of Online Discussions, Participation and E-Moderation Behaviours in Peer-Moderated Asynchronous Online Discussions

ERIC Educational Resources Information Center

Ghadirian, Hajar; Fauzi Mohd Ayub, Ahmad; Salehi, Keyvan

2018-01-01

The aim of this study was to investigate the relationships between students' perceptions of online discussions, participation and e-moderation behaviours in peer-moderated asynchronous online discussions. Using survey data, the learning system's activity log and discussion transcripts, the authors analysed how 84 learners' perceptions of online…

Three-Dimensional Temperature Field Simulation for the Rotor of an Asynchronous Motor

ERIC Educational Resources Information Center

Wang, Yanwu; Fan, Chunli; Yang, Li; Sun, Fengrui

2010-01-01

A three-dimensional heat transfer model is built according to the rotor structure of an asynchronous motor, and three-dimensional temperature fields of the rotor under different working conditions, such as the unloaded, rated loaded and that with broken rotor bars, are studied based on the finite element numerical method and experiments. The…

Bully Proofing Your Twice-Exceptional Child

ERIC Educational Resources Information Center

Mohammed, Amra

2018-01-01

Twice-exceptional (2E) students are those who demonstrate a gift or talent in one or more areas and have a disability in another area. One identifying characteristic of 2E children is asynchronous development, or the display of unusual talent or maturity in one or more areas alongside a struggle to develop in other areas. Asynchronous development…

The Effect of Asynchronous/Synchronous Approaches on English Vocabulary Achievement: A Study of Iranian EFL Learners

ERIC Educational Resources Information Center

Khodaparast, Fatemeh; Ghafournia, Narjes

2015-01-01

The contribution of computer-assisted instructional programs to language learning process has been the focus of researchers for about two decades. However, the effect of synchronous and asynchronous computer-assisted approaches of language teaching on improving L2 vocabulary has been scarcely investigated. This study explored whether synchronous,…

Effects of Asynchronous Music on Students' Lesson Satisfaction and Motivation at the Situational Level

ERIC Educational Resources Information Center

Digelidis, Nikolaos; Karageorghis, Costas I.; Papapavlou, Anastasia; Papaioannou, Athanasios G.

2014-01-01

The aim of this study was to examine the effects of asynchronous (background) music on senior students' motivation and lesson satisfaction at the situational level. A counterbalanced mixed-model design was employed with two factors comprising condition (three levels) and gender (two levels). Two hundred students (82 boys, 118 girls; M [subscript…

Synchronous and Asynchronous E-Language Learning: A Case Study of Virtual University of Pakistan

ERIC Educational Resources Information Center

Perveen, Ayesha

2016-01-01

This case study evaluated the impact of synchronous and asynchronous E-Language Learning activities (ELL-ivities) in an E-Language Learning Environment (ELLE) at Virtual University of Pakistan. The purpose of the study was to assess e-language learning analytics based on the constructivist approach of collaborative construction of knowledge. The…

Computer-Mediated Synchronous and Asynchronous Corrective Feedback Provided by Trainee Teachers to Learners of French: A Preliminary Study

ERIC Educational Resources Information Center

Vidal, Julie; Thouësny, Sylvie

2015-01-01

In this paper, we investigate whether trainee teachers' practices, with respect to multimodal feedback, differ from current research, and to what extent it may affect students' language development. More specifically, the goal of the present study is threefold: (1) it observes how trainee teachers responded, whether synchronously, asynchronously,…

Beyond Social Presence: Facelessness and the Ethics of Asynchronous Online Education

ERIC Educational Resources Information Center

Rose, Ellen

2017-01-01

In this position paper, I argue that a focus on achieving and increasing social presence in online courses tends to derail a consideration of the ethical implications and dimensions of the essential facelessness of asynchronous education. Drawing upon the work of Emmanuel Levinas and Nel Noddings, who contended that the face is the basis of…

Exploring Change in Graduate Students' Perceptions of Web-Based Education throughout an Asynchronous Course

ERIC Educational Resources Information Center

Timotheou, Maria Mama

2017-01-01

This paper presents the main findings of a UK study exploring graduate students' perceptions of web-based education, with a specific focus on their change over time, throughout an asynchronous course. Data were collected through online messages and interviews, and analyzed qualitatively, following content and thematic analyses. Participant pre-…

Distributed Teaching Presence and Communicative Patterns in Asynchronous Learning: Name versus Reply Networks

ERIC Educational Resources Information Center

Engel, Anna; Coll, Cesar; Bustos, Alfonso

2013-01-01

This work explores some methodological challenges in the application of Social Network Analysis (SNA) to the study of "Asynchronous Learning Networks" (ALN). Our interest in the SNA is situated within the framework of the study of Distributed Teaching Presence (DTP), understood as the exercise of educational influence, through a multi-method…

Cyber Asynchronous versus Blended Cyber Approach in Distance English Learning

ERIC Educational Resources Information Center

Ge, Zi-Gang

2012-01-01

This study aims to compare the single cyber asynchronous learning approach with the blended cyber learning approach in distance English education. Two classes of 70 students participated in this study, which lasted one semester of about four months, with one class using the blended approach for their English study and the other only using the…

Using the Community of Inquiry Model to Investigate Students' Knowledge Construction in Asynchronous Online Discussions

ERIC Educational Resources Information Center

Liu, Chien-Jen; Yang, Shu Ching

2014-01-01

This study used the Community of Inquiry (CoI) model proposed by Garrison to investigate students' level of knowledge construction in asynchronous discussions. The participants included 36 senior students (27 males) majoring in information management. The students attended 18 weeks of an online information ethics course. In this study, four types…

Comparing the Social Knowledge Construction Behavioral Patterns of Problem-Based Online Asynchronous Discussion in E/M-Learning Environments

ERIC Educational Resources Information Center

Lan, Yu-Feng; Tsai, Pei-Wei; Yang, Shih-Hsien; Hung, Chun-Ling

2012-01-01

In recent years, researchers have conducted various studies on applying wireless networking technology and mobile devices in education settings. However, research on behavioral patterns in learners' online asynchronous discussions with mobile devices is limited. The purposes of this study are to develop a mobile learning system, mobile interactive…

A Survey of Factors Contributing to Learners' "Listening" Behaviors in Asynchronous Online Discussions

ERIC Educational Resources Information Center

Wise, Alyssa Friend; Marbouti, Farshid; Hsiao, Ying-Ting; Hausknecht, Simone

2012-01-01

Sixty-seven undergraduates taking either a Blended Business Course (BBC) or an Online Education Course (OEC) were surveyed about factors influencing their "listening" behaviors in asynchronous online course discussions. These are the ways they attend to the posts made by others: which posts they open, how they engage with open posts, and…