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

PubMed

Baiguini, Alessandro; Colletta, Stefano; Rebella, Valentina

2011-01-01

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

Early Flood Warning in Africa: Results of a Feasibility study in the JUBA, SHABELLE and ZAMBEZI

NASA Astrophysics Data System (ADS)

Pappenberger, F. P.; de Roo, A. D.; Buizza, Roberto; Bodis, Katalin; Thiemig, Vera

2009-04-01

Building on the experiences gained with the European Flood Alert System (EFAS), pilot studies are carried out in three river basins in Africa. The European Flood Alert System, pre-operational since 2003, provides early flood alerts for European rivers. At present, the experiences with the European EFAS system are used to evaluate the feasibility of flood early warning for Africa. Three case studies are carried in the Juba and Shabelle rivers (Somalia and Ethiopia), and in the Zambesi river (Southern Africa). Predictions in these data scarce regions are extremely difficult to make as records of observations are scarce and often unreliable. Meteorological and Discharge observations are used to calibrate and test the model, as well as soils, landuse and topographic data available within the JRC African Observatory. ECMWF ERA-40, ERA-Interim data and re-forecasts of flood events from January to March 1978, and in March 2001 are evaluated to examine the feasibility for early flood warning. First results will be presented.

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

ERIC Educational Resources Information Center

Gammon, J. B.

2017-01-01

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

ElarmS Earthquake Early Warning System 2016 Performance and New Research

NASA Astrophysics Data System (ADS)

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

2016-12-01

The ElarmS earthquake early warning system has been detecting earthquakes throughout California since 2007. It is one of the algorithms that contributes to the West Coast ShakeAlert, a prototype earthquake early warning system being developed for the US West Coast. ElarmS is also running in the Pacific Northwest, and in Israel, Chile, Turkey, and Peru in test mode. We summarize the performance of the ElarmS system over the past year and review some of the more problematic events that the system has encountered. During the first half of 2016 (2016-01-01 through 2016-07-21), ElarmS successfully alerted on all events with ANSS catalog magnitudes M>3 in the Los Angeles area. The mean alert time for these 9 events was just 4.84 seconds. In the San Francisco Bay Area, ElarmS detected 26 events with ANSS catalog magnitudes M>3. The alert times for these events is 9.12 seconds. The alert times are longer in the Bay Area than in the Los Angeles area due to the sparser network of stations in the Bay Area. 7 Bay Area events were not detected by ElarmS. These events occurred in areas where there is less dense station coverage. In addition, ElarmS sent alerts for 13 of the 16 moderately-sized (ANSS catalog magnitudes M>4) events that occurred throughout the state of California. One of those missed events was a M4.5 that occurred far offshore in the northernmost part of the state. The other two missed events occurred inland in regions with sparse station coverage. Over the past year, we have worked towards the implementation of a new filterbank teleseismic filter algorithm, which we will discuss. Other than teleseismic events, a significant cause of false alerts and severely mislocated events is spurious triggers being associated with triggers from a real earthquake. Here, we address new approaches to filtering out problematic triggers.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

Early warning of active fire hotspots through NASA FIRMS fire information system

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Murphy, K. J.

2014-12-01

Forest fires and wildfires can threaten ecosystems, wildlife, property, and often, large swaths of populations. Early warning of active fire hotspots plays a crucial role in planning, managing, and mitigating the damaging effects of wildfires. The NASA Fire Information for Resource Management System (FIRMS) has been providing active fire location information to users in easy-to-use formats for the better part of last decade, with a view to improving the alerting mechanisms and response times to fight forest and wildfires. FIRMS utilizes fires flagged as hotspots by the MODIS instrument flying aboard the Aqua and Terra satellites and sends early warning of detected hotspots via email in near real-time or as daily and weekly summaries. The email alerts can also be customized to send alerts for a particular region of interest, a country, or a specific protected area or park. In addition, a web mapping component, named "Web Fire Mapper" helps query and visualize hotspots. A newer version of Web Fire Mapper is being developed to enhance the existing visualization and alerting capabilities. Plans include supporting near real-time imagery from Aqua and Terra satellites to provide a more helpful context while viewing fires. Plans are also underway to upgrade the email alerts system to provide mobile-formatted messages and short text messages (SMS). The newer version of FIRMS will also allow users to obtain geo-located image snapshots, which can be imported into local GIS software by stakeholders to help further analyses. This talk will discuss the FIRMS system, its enhancements and its role in helping map, alert, and monitor fire hotspots by providing quick data visualization, querying, and download capabilities.

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

PubMed Central

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

2014-01-01

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

Context-Sensitive Clinical Alert Packages Written in Arden Syntax.

PubMed

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

2017-01-01

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

Automated Health Alerts Using In-Home Sensor Data for Embedded Health Assessment

PubMed Central

Guevara, Rainer Dane; Rantz, Marilyn

2015-01-01

We present an example of unobtrusive, continuous monitoring in the home for the purpose of assessing early health changes. Sensors embedded in the environment capture behavior and activity patterns. Changes in patterns are detected as potential signs of changing health. We first present results of a preliminary study investigating 22 features extracted from in-home sensor data. A 1-D alert algorithm was then implemented to generate health alerts to clinicians in a senior housing facility. Clinicians analyze each alert and provide a rating on the clinical relevance. These ratings are then used as ground truth for training and testing classifiers. Here, we present the methodology for four classification approaches that fuse multisensor data. Results are shown using embedded sensor data and health alert ratings collected on 21 seniors over nine months. The best results show similar performance for two techniques, where one approach uses only domain knowledge and the second uses supervised learning for training. Finally, we propose a health change detection model based on these results and clinical expertise. The system of in-home sensors and algorithms for automated health alerts provides a method for detecting health problems very early so that early treatment is possible. This method of passive in-home sensing alleviates compliance issues. PMID:27170900

Using Heuristic Evaluation to Improve Sepsis Alert Usability.

PubMed

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

2018-06-01

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

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

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

ElarmS Earthquake Early Warning System: 2017 Performance and New ElarmS Version 3.0 (E3)

NASA Astrophysics Data System (ADS)

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

2017-12-01

The ElarmS earthquake early warning (EEW) system has been successfully detecting earthquakes throughout California since 2007. ElarmS version 2.0 (E2) is one of the three algorithms contributing alerts to ShakeAlert, a public EEW system being developed by the USGS in collaboration with UC Berkeley, Caltech, University of Washington, and University of Oregon. E2 began operating in test mode in the Pacific Northwest in 2013, and since April of this year E2 has been contributing real-time alerts from Oregon and Washington to the ShakeAlert production prototype system as part of the ShakeAlert roll-out throughout the West Coast. Since it began operating west-coast-wide, E2 has correctly alerted on 5 events that matched ANSS catalog events with M≥4, missed 1 event with M≥4, and incorrectly created alerts for 5 false events with M≥4. The most recent version of the algorithm, ElarmS version 3.0 (E3), is a significant improvement over E2. It addresses some of the most problematic causes of false events for which E2 produced alerts, without impacting reliability in terms of matched and missed events. Of the 5 false events that were generated by E2 since April, 4 would have been suppressed by E3. In E3, we have added a filterbank teleseismic filter. By analyzing the amplitude of the waveform filtered in various passbands, it is possible to distinguish between local and teleseismic events. We have also added a series of checks to validate triggers and filter out spurious and S-wave triggers. Additional improvements to the waveform associator also improve detections. In this presentation, we describe the improvements and compare the performance of the current production (E2) and development (E3) versions of ElarmS over the past year. The ShakeAlert project is now working through a streamlining process to identify the best components of various algorithms and merge them. The ElarmS team is participating in this effort and we anticipate that much of E3 will continue in the final system.

USGS earthquake hazards program (EHP) GPS use case : earthquake early warning (EEW) and shake alert

DOT National Transportation Integrated Search

2017-03-30

GPS Adjacent Band Workshop VI RTCA Inc., Washington D.C., 30 March 2017. USGS GPS receiver use case - Real-Time GPS for EEW -Continued: CRITICAL EFFECT - The GNSS component of the Shake Alert system augments the inertial sensors and is especial...

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

NASA Astrophysics Data System (ADS)

Espinosa Aranda, J.

2013-05-01

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

Geodetic Finite-Fault-based Earthquake Early Warning Performance for Great Earthquakes Worldwide

NASA Astrophysics Data System (ADS)

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

2017-12-01

GNSS-based earthquake early warning (EEW) algorithms estimate fault-finiteness and unsaturated moment magnitude for the largest, most damaging earthquakes. Because large events are infrequent, algorithms are not regularly exercised and insufficiently tested on few available datasets. The Geodetic Alarm System (G-larmS) is a GNSS-based finite-fault algorithm developed as part of the ShakeAlert EEW system in the western US. Performance evaluations using synthetic earthquakes offshore Cascadia showed that G-larmS satisfactorily recovers magnitude and fault length, providing useful alerts 30-40 s after origin time and timely warnings of ground motion for onshore urban areas. An end-to-end test of the ShakeAlert system demonstrated the need for GNSS data to accurately estimate ground motions in real-time. We replay real data from several subduction-zone earthquakes worldwide to demonstrate the value of GNSS-based EEW for the largest, most damaging events. We compare predicted ground acceleration (PGA) from first-alert-solutions with those recorded in major urban areas. In addition, where applicable, we compare observed tsunami heights to those predicted from the G-larmS solutions. We show that finite-fault inversion based on GNSS-data is essential to achieving the goals of EEW.

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

NASA Astrophysics Data System (ADS)

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

2015-12-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-12-05

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

[Ecological security early-warning in Zhoushan Islands based on variable weight model].

PubMed

Zhou, Bin; Zhong, Lin-sheng; Chen, Tian; Zhou, Rui

2015-06-01

Ecological security early warning, as an important content of ecological security research, is of indicating significance in maintaining regional ecological security. Based on driving force, pressure, state, impact and response (D-P-S-I-R) framework model, this paper took Zhoushan Islands in Zhejiang Province as an example to construct the ecological security early warning index system, test degrees of ecological security early warning of Zhoushan Islands from 2000 to 2012 by using the method of variable weight model, and forecast ecological security state of 2013-2018 by Markov prediction method. The results showed that the variable weight model could meet the study needs of ecological security early warning of Zhoushan Islands. There was a fluctuant rising ecological security early warning index from 0.286 to 0.484 in Zhoushan Islands between year 2000 and 2012, in which the security grade turned from "serious alert" into " medium alert" and the indicator light turned from "orange" to "yellow". The degree of ecological security warning was "medium alert" with the light of "yellow" for Zhoushan Islands from 2013 to 2018. These findings could provide a reference for ecological security maintenance of Zhoushan Islands.

Pi-EEWS: a low cost prototype for on-site earthquake early warning system

NASA Astrophysics Data System (ADS)

Pazos, Antonio; Vera, Angel; Morgado, Arturo; Rioja, Carlos; Davila, Jose Martin; Cabieces, Roberto

2017-04-01

The Royal Spanish Navy Observatory (ROA), with the participation of the Cadiz University (UCA), have been developed the ALERTES-SC3 EEWS (regional approach) based on the SeisComP3 software package. This development has been done in the frame of the Spanish ALERT-ES (2011-2013) and ALERTES-RIM (2014-2016) projects, and now a days it is being tested in real time for south Iberia. Additionally, the ALERTES-SC3 system integrates an on-site EEWS software, developed by ROA-UCA, which is running for testing in real time in some seismic broad band stations of the WM network. Regional EEWS are not able to provide alerts in the area closet to the epicentre (blind zone), so a dense on-site EEWS is necessary. As it was mentioned, ALERTES-SC3 inludes the on-site software running on several WM stations but a more dense on-site stations are necessary to cover the blind zones. In order to densify this areas, inside of the "blind zones", a low cost on-site prototype "Pi-EEWS", based on a Raspberry Pi card and low cost acelerometers. In this work the main design ideas, the components and its capabilities will be shown.

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

ERIC Educational Resources Information Center

Donnelly, John E.

2010-01-01

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

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

PubMed

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

2014-01-01

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

Future Earth: Reducing Loss By Automating Response to Earthquake Shaking

NASA Astrophysics Data System (ADS)

Allen, R. M.

2014-12-01

Earthquakes pose a significant threat to society in the U.S. and around the world. The risk is easily forgotten given the infrequent recurrence of major damaging events, yet the likelihood of a major earthquake in California in the next 30 years is greater than 99%. As our societal infrastructure becomes ever more interconnected, the potential impacts of these future events are difficult to predict. Yet, the same inter-connected infrastructure also allows us to rapidly detect earthquakes as they begin, and provide seconds, tens or seconds, or a few minutes warning. A demonstration earthquake early warning system is now operating in California and is being expanded to the west coast (www.ShakeAlert.org). In recent earthquakes in the Los Angeles region, alerts were generated that could have provided warning to the vast majority of Los Angelinos who experienced the shaking. Efforts are underway to build a public system. Smartphone technology will be used not only to issue that alerts, but could also be used to collect data, and improve the warnings. The MyShake project at UC Berkeley is currently testing an app that attempts to turn millions of smartphones into earthquake-detectors. As our development of the technology continues, we can anticipate ever-more automated response to earthquake alerts. Already, the BART system in the San Francisco Bay Area automatically stops trains based on the alerts. In the future, elevators will stop, machinery will pause, hazardous materials will be isolated, and self-driving cars will pull-over to the side of the road. In this presentation we will review the current status of the earthquake early warning system in the US. We will illustrate how smartphones can contribute to the system. Finally, we will review applications of the information to reduce future losses.

Alertness and cognitive control: Testing the early onset hypothesis.

PubMed

Schneider, Darryl W

2018-05-01

Previous research has revealed a peculiar interaction between alertness and cognitive control in selective-attention tasks: Congruency effects are larger on alert trials (on which an alerting cue is presented briefly in advance of the imperative stimulus) than on no-alert trials, despite shorter response times (RTs) on alert trials. One explanation for this finding is the early onset hypothesis, which is based on the assumptions that increased alertness shortens stimulus-encoding time and that cognitive control involves gradually focusing attention during a trial. The author tested the hypothesis in 3 experiments by manipulating alertness and stimulus quality (which were intended to shorten and lengthen stimulus-encoding time, respectively) in an arrow-based flanker task involving congruent and incongruent stimuli. Replicating past findings, the alerting manipulation led to shorter RTs but larger congruency effects on alert trials than on no-alert trials. The stimulus-quality manipulation led to longer RTs and larger congruency effects for degraded stimuli than for intact stimuli. These results provide mixed support for the early onset hypothesis, but the author discusses how data and theory might be reconciled if stimulus quality affects stimulus-encoding time and the rate of evidence accumulation in the decision process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Dynamic malware containment under an epidemic model with alert

NASA Astrophysics Data System (ADS)

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

2017-03-01

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

Earthquake Early Warning: User Education and Designing Effective Messages

NASA Astrophysics Data System (ADS)

Burkett, E. R.; Sellnow, D. D.; Jones, L.; Sellnow, T. L.

2014-12-01

The U.S. Geological Survey (USGS) and partners are transitioning from test-user trials of a demonstration earthquake early warning system (ShakeAlert) to deciding and preparing how to implement the release of earthquake early warning information, alert messages, and products to the public and other stakeholders. An earthquake early warning system uses seismic station networks to rapidly gather information about an occurring earthquake and send notifications to user devices ahead of the arrival of potentially damaging ground shaking at their locations. Earthquake early warning alerts can thereby allow time for actions to protect lives and property before arrival of damaging shaking, if users are properly educated on how to use and react to such notifications. A collaboration team of risk communications researchers and earth scientists is researching the effectiveness of a chosen subset of potential earthquake early warning interface designs and messages, which could be displayed on a device such as a smartphone. Preliminary results indicate, for instance, that users prefer alerts that include 1) a map to relate their location to the earthquake and 2) instructions for what to do in response to the expected level of shaking. A number of important factors must be considered to design a message that will promote appropriate self-protective behavior. While users prefer to see a map, how much information can be processed in limited time? Are graphical representations of wavefronts helpful or confusing? The most important factor to promote a helpful response is the predicted earthquake intensity, or how strong the expected shaking will be at the user's location. Unlike Japanese users of early warning, few Californians are familiar with the earthquake intensity scale, so we are exploring how differentiating instructions between intensity levels (e.g., "Be aware" for lower shaking levels and "Drop, cover, hold on" at high levels) can be paired with self-directed supplemental information to increase the public's understanding of earthquake shaking and protective behaviors.

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

PubMed Central

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

2017-01-01

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

Establishing an early warning alert and response network following the Solomon Islands tsunami in 2013.

PubMed

Bilve, Augustine; Nogareda, Francisco; Joshua, Cynthia; Ross, Lester; Betcha, Christopher; Durski, Kara; Fleischl, Juliet; Nilles, Eric

2014-11-01

On 6 February 2013, an 8.0 magnitude earthquake generated a tsunami that struck the Santa Cruz Islands, Solomon Islands, killing 10 people and displacing over 4700. A post-disaster assessment of the risk of epidemic disease transmission recommended the implementation of an early warning alert and response network (EWARN) to rapidly detect, assess and respond to potential outbreaks in the aftermath of the tsunami. Almost 40% of the Santa Cruz Islands' population were displaced by the disaster, and living in cramped temporary camps with poor or absent sanitation facilities and insufficient access to clean water. There was no early warning disease surveillance system. By 25 February, an EWARN was operational in five health facilities that served 90% of the displaced population. Eight priority diseases or syndromes were reported weekly; unexpected health events were reported immediately. Between 25 February and 19 May, 1177 target diseases or syndrome cases were reported. Seven alerts were investigated. No sustained transmission or epidemics were identified. Reporting compliance was 85%. The EWARN was then transitioned to the routine four-syndrome early warning disease surveillance system. It was necessary to conduct a detailed assessment to evaluate the risk and potential impact of serious infectious disease outbreaks, to assess whether and how enhanced early warning disease surveillance should be implemented. Local capacities and available resources should be considered in planning EWARN implementation. An EWARN can be an opportunity to establish or strengthen early warning disease surveillance capabilities.

Integrated Land- and Underwater-Based Sensors for a Subduction Zone Earthquake Early Warning System

NASA Astrophysics Data System (ADS)

Pirenne, B.; Rosenberger, A.; Rogers, G. C.; Henton, J.; Lu, Y.; Moore, T.

2016-12-01

Ocean Networks Canada (ONC — oceannetworks.ca/ ) operates cabled ocean observatories off the coast of British Columbia (BC) to support research and operational oceanography. Recently, ONC has been funded by the Province of BC to deliver an earthquake early warning (EEW) system that integrates offshore and land-based sensors to deliver alerts of incoming ground shaking from the Cascadia Subduction Zone. ONC's cabled seismic network has the unique advantage of being located offshore on either side of the surface expression of the subduction zone. The proximity of ONC's sensors to the fault can result in faster, more effective warnings, which translates into more lives saved, injuries avoided and more ability for mitigative actions to take place.ONC delivers near real-time data from various instrument types simultaneously, providing distinct advantages to seismic monitoring and earthquake early warning. The EEW system consists of a network of sensors, located on the ocean floor and on land, that detect and analyze the initial p-wave of an earthquake as well as the crustal deformation on land during the earthquake sequence. Once the p-wave is detected and characterized, software systems correlate the data streams of the various sensors and deliver alerts to clients through a Common Alerting Protocol-compliant data package. This presentation will focus on the development of the earthquake early warning capacity at ONC. It will describe the seismic sensors and their distribution, the p-wave detection algorithms selected and the overall architecture of the system. It will further overview the plan to achieve operational readiness at project completion.

An evaluation of an intelligent home monitoring system.

PubMed

Sixsmith, A J

2000-01-01

A trial was performed of an intelligent monitoring system which used sensors in the home to identify emergencies by detecting deviations from normal activity patterns. The field trial lasted three months. Twenty-two elderly people agreed to participate. Their ages ranged from early 60s to over 85, with two-thirds in the age range 75-84 years. They lived in four different localities within the UK--Ipswich, Northumberland, Merseyside and Nottingham. A total of 61 alerts was recorded, at a mean frequency about one alert per month per client. Of the 61 alerts generated, 46 were classified as false alerts and the other 15 as genuine, although no real emergencies occurred during the study. Many people in the field trial reported enhanced feelings of safety and security, which could help to stimulate independence and help them to remain living in their own homes. The monitoring system increased the care choices available to elderly people and supported and enhanced the carer's role.

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

NASA Astrophysics Data System (ADS)

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

2012-06-01

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

Technical Note: An operational landslide early warning system at regional scale based on space-time-variable rainfall thresholds

NASA Astrophysics Data System (ADS)

Segoni, S.; Battistini, A.; Rossi, G.; Rosi, A.; Lagomarsino, D.; Catani, F.; Moretti, S.; Casagli, N.

2015-04-01

We set up an early warning system for rainfall-induced landslides in Tuscany (23 000 km2). The system is based on a set of state-of-the-art intensity-duration rainfall thresholds (Segoni et al., 2014b) and makes use of LAMI (Limited Area Model Italy) rainfall forecasts and real-time rainfall data provided by an automated network of more than 300 rain gauges. The system was implemented in a WebGIS to ease the operational use in civil protection procedures: it is simple and intuitive to consult, and it provides different outputs. When switching among different views, the system is able to focus both on monitoring of real-time data and on forecasting at different lead times up to 48 h. Moreover, the system can switch between a basic data view where a synoptic scenario of the hazard can be shown all over the region and a more in-depth view were the rainfall path of rain gauges can be displayed and constantly compared with rainfall thresholds. To better account for the variability of the geomorphological and meteorological settings encountered in Tuscany, the region is subdivided into 25 alert zones, each provided with a specific threshold. The warning system reflects this subdivision: using a network of more than 300 rain gauges, it allows for the monitoring of each alert zone separately so that warnings can be issued independently. An important feature of the warning system is that the visualization of the thresholds in the WebGIS interface may vary in time depending on when the starting time of the rainfall event is set. The starting time of the rainfall event is considered as a variable by the early warning system: whenever new rainfall data are available, a recursive algorithm identifies the starting time for which the rainfall path is closest to or overcomes the threshold. This is considered the most hazardous condition, and it is displayed by the WebGIS interface. The early warning system is used to forecast and monitor the landslide hazard in the whole region, providing specific alert levels for 25 distinct alert zones. In addition, the system can be used to gather, analyze, display, explore, interpret and store rainfall data, thus representing a potential support to both decision makers and scientists.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network.

PubMed

Cordes, Kristina M; Cookson, Susan T; Boyd, Andrew T; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad; Husain, Farah

2017-11-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security.

Real-Time Surveillance in Emergencies Using the Early Warning Alert and Response Network

PubMed Central

Cordes, Kristina M.; Cookson, Susan T.; Boyd, Andrew T.; Hardy, Colleen; Malik, Mamunur Rahman; Mala, Peter; El Tahir, Khalid; Everard, Marthe; Jasiem, Mohamad

2017-01-01

Humanitarian emergencies often result in population displacement and increase the risk for transmission of communicable diseases. To address the increased risk for outbreaks during humanitarian emergencies, the World Health Organization developed the Early Warning Alert and Response Network (EWARN) for early detection of epidemic-prone diseases. The US Centers for Disease Control and Prevention has worked with the World Health Organization, ministries of health, and other partners to support EWARN through the implementation and evaluation of these systems and the development of standardized guidance. Although protocols have been developed for the implementation and evaluation of EWARN, a need persists for standardized training and additional guidance on supporting these systems remotely when access to affected areas is restricted. Continued collaboration between partners and the Centers for Disease Control and Prevention for surveillance during emergencies is necessary to strengthen capacity and support global health security. PMID:29155660

Successful ShakeAlert Performance for the Napa Quake

NASA Astrophysics Data System (ADS)

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

2014-12-01

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

Novel online monitoring and alert system for anaerobic digestion reactors.

PubMed

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

2011-10-15

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

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

PubMed

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

2013-06-01

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

The impact of the disease early warning system in responding to natural disasters and conflict crises in Pakistan.

PubMed

Rahim, M; Kazi, B M; Bile, K M; Munir, M; Khan, A R

2010-01-01

The disease early warning system (DEWS) was introduced in the immediate aftermath of the 2005 earthquake in Pakistan, with the objective to undertake prompt investigation and mitigation of disease outbreaks. The DEWS network was replicated successfully during subsequent flood and earthquake disasters as well as during the 2008-09 internally displaced persons' crisis. DEWS-generated alerts, prompt investigations and timely responses had an effective contribution to the control of epidemics. Through DEWS, 1360 reported alerts during 2005-09 averted the risk of disease outbreaks through pre-emptive necessary measures, while the 187 confirmed outbreaks were effectively controlled. In the aftermath of the disasters, DEWS technology also facilitated the development of a disease-surveillance system that became an integral part of the district health system. This study aims to report the DEWS success and substantiate its lead role as a priority emergency health response intervention.

Establishing an early warning alert and response network following the Solomon Islands tsunami in 2013

PubMed Central

Bilve, Augustine; Nogareda, Francisco; Joshua, Cynthia; Ross, Lester; Betcha, Christopher; Durski, Kara; Fleischl, Juliet

2014-01-01

Abstract Problem On 6 February 2013, an 8.0 magnitude earthquake generated a tsunami that struck the Santa Cruz Islands, Solomon Islands, killing 10 people and displacing over 4700. Approach A post-disaster assessment of the risk of epidemic disease transmission recommended the implementation of an early warning alert and response network (EWARN) to rapidly detect, assess and respond to potential outbreaks in the aftermath of the tsunami. Local setting Almost 40% of the Santa Cruz Islands’ population were displaced by the disaster, and living in cramped temporary camps with poor or absent sanitation facilities and insufficient access to clean water. There was no early warning disease surveillance system. Relevant changes By 25 February, an EWARN was operational in five health facilities that served 90% of the displaced population. Eight priority diseases or syndromes were reported weekly; unexpected health events were reported immediately. Between 25 February and 19 May, 1177 target diseases or syndrome cases were reported. Seven alerts were investigated. No sustained transmission or epidemics were identified. Reporting compliance was 85%. The EWARN was then transitioned to the routine four-syndrome early warning disease surveillance system. Lesson learnt It was necessary to conduct a detailed assessment to evaluate the risk and potential impact of serious infectious disease outbreaks, to assess whether and how enhanced early warning disease surveillance should be implemented. Local capacities and available resources should be considered in planning EWARN implementation. An EWARN can be an opportunity to establish or strengthen early warning disease surveillance capabilities. PMID:25378746

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

PubMed

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

2011-08-01

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

Comparison of 'time to detection' values between BacT/ALERT VIRTUO and BacT/ALERT 3D instruments for clinical blood culture samples.

PubMed

Congestrì, Francesco; Pedna, Maria Federica; Fantini, Michela; Samuelli, Michela; Schiavone, Pasqua; Torri, Arianna; Bertini, Stefania; Sambri, Vittorio

2017-09-01

The early detection of bacteraemia and fungemia is of paramount importance to guide antimicrobial therapy in septic patients. In this study the 'time to detection' (TTD) value for the new blood culture system BacT/ALERT VIRTUO (VIRTUO) was evaluated in 1462 positive clinical bottles and compared with the TTD for 1601 positive clinical bottles incubated in the BacT/ALERT 3D system (BTA-3D). The most representative microorganisms isolated from bottles incubated in both blood culture systems were divided into eight categories (in order of frequency): coagulase-negative staphylococci (CoNS), Escherichia coli, Enterobacteriaceae (other than E. coli), Staphylococcus aureus, Enterococcus spp, viridans group streptococci, Pseudomonas aeruginosa, and Candida spp. The comparison of TTD values for the two blood culture systems strongly indicated that growth of the first five groups listed above was detected earlier with VIRTUO than with BTA-3D (p < 0.05). The new VIRTUO blood culture system can reduce the TTD for more than 75% of isolated microorganisms. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

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

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

1995-04-01

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

Evaluating Post-Earthquake Building Safety Using Economical MEMS Seismometers.

PubMed

Hsu, Ting-Yu; Yin, Ren-Cheng; Wu, Yih-Min

2018-05-05

The earthquake early warning (EEW)-research group at National Taiwan University has been developing a microelectromechanical system-based accelerometer called “P-Alert”, designed for issuing EEWs. The main advantage of P-Alert is that it is a relatively economical seismometer. However, because of the expensive nature of commercial hardware for structural health monitoring (SHM) systems, the application of SHM to buildings remains limited. To determine the performance of P-Alert for evaluating post-earthquake building safety, we conducted a series of steel-frame shaking table tests with incremental damage. We used the fragility curves of different damage levels and the interstory drift ratios (calculated by the measured acceleration of each story using double integration and a filter) to gauge the potential damage levels. We concluded that the acceptable detection of damage for an entire building is possible. With improvements to the synchronization of the P-Alert sensors, we also anticipate a damage localization feature for the stories of a building.

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

Earthquake Early Warning Beta Users: Java, Modeling, and Mobile Apps

NASA Astrophysics Data System (ADS)

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

2014-12-01

Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds warning prior to ground shaking at a user's location. The goal and purpose of such a system is to reduce, or minimize, the damage, costs, and casualties resulting from an earthquake. A demonstration earthquake early warning system (ShakeAlert) is undergoing testing in the United States by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, the USGS, and beta users in California and the Pacific Northwest. The beta users receive earthquake information very rapidly in real-time and are providing feedback on their experiences of performance and potential uses within their organization. Beta user interactions allow the ShakeAlert team to discern: which alert delivery options are most effective, what changes would make the UserDisplay more useful in a pre-disaster situation, and most importantly, what actions users plan to take for various scenarios. Actions could include: personal safety approaches, such as drop cover, and hold on; automated processes and procedures, such as opening elevator or fire stations doors; or situational awareness. Users are beginning to determine which policy and technological changes may need to be enacted, and funding requirements to implement their automated controls. The use of models and mobile apps are beginning to augment the basic Java desktop applet. Modeling allows beta users to test their early warning responses against various scenarios without having to wait for a real event. Mobile apps are also changing the possible response landscape, providing other avenues for people to receive information. All of these combine to improve business continuity and resiliency.

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

PubMed

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

2017-10-01

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

RED Alert – Early warning or detection of global re-emerging infectious disease (RED)

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

Deshpande, Alina

This is the PDF of a presentation for a webinar given by Los Alamos National Laboratory (LANL) on the early warning or detection of global re-emerging infectious disease (RED). First, there is an overview of LANL biosurveillance tools. Then, information is given about RED Alert. Next, a demonstration is given of a component prototype. RED Alert is an analysis tool that can provide early warning or detection of the re-emergence of an infectious disease at the global level, but through a local lens.

A-21st-century-approach to firefighting in the Western US: How microwave-based seismic networks can change fire suppression from reactive to proactive

NASA Astrophysics Data System (ADS)

Kent, G. M.; Smith, K. D.; Williams, M. C.; Slater, D. E.; Plank, G.; McCarthy, M.; Rojas-Gonzalez, R.; Vernon, F.; Driscoll, N. W.; Hidley, G.

2015-12-01

The Nevada Seismological Laboratory (NSL) at UNR has recently embarked on a bold technical initiative, installing a high-speed (up to 190 Mb/sec) mountaintop-based Internet Protocol (IP) microwave network, enabling a myriad of sensor systems for Multi-Hazard Early Warning detection and response. In the Tahoe Basin, this system is known as AlertTahoe; a similar network has been deployed in north-central Nevada as part of a 5-year-long grant with BLM. The UNR network mirrors the successful HPWREN multi-hazard network run through UCSD; the UNR "Alert" program (Access to Leverage Emergency information in Real Time) has expanded on the original concept by providing a framework for early fire detection and discovery. Both systems do not rely on open-access public Internet services such as those provided by cellular service providers. Instead, they utilize private wireless communication networks to collect data 24/7 in real-time from multiple sensors throughout the system. Utilizing this restricted-access private communication platform enhances system reliability, capability, capacity and versatility for staff and its community of certified users. Both UNR and UCSD fire camera systems are presently being confederated under a common framework to provide end users (e.g., BLM, USFS, CalFire) a unified interface. Earthquake response has been both organizations' primary mission for decades; high-speed IP microwave fundamentally changes the playing field allowing for rapid early detection of wildfires, earthquakes and other natural disasters, greatly improving local and regional disaster response/recovery. For example, networked cameras can be optimally placed for wildfire detection and are significantly less vulnerable due infrastructure hardening and the ability to avoid extreme demands by the public on cellular and other public networks during a crisis. These systems also provide a backup for emergency responders to use when public access communications become overwhelmed or fail during an event. The crowd-sourced fire cameras can be viewed year round through AlertTahoe and AlertSoCal websites with on-demand time-lapse, an integrated real time lightning map, and other useful features.

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

NASA Astrophysics Data System (ADS)

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

2009-03-01

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

Humanizing Aggregated Data: Developing Personas to Prioritize User Needs for Earthquake Early Warning

NASA Astrophysics Data System (ADS)

Burkett, E. R.; Jayanty, N. K.; Sellnow, D. D.; Given, D. D.; DeGroot, R. M.

2016-12-01

Methods that use storytelling to gather and synthesize data from people can be advantageous in understanding user needs and designing successful communication products. Using a multidisciplinary approach, we research and prioritize user needs for the ShakeAlert Earthquake Early Warning system (http://pubs.usgs.gov/fs/2014/3083/), drawing on best practices from social and behavioral science, risk communication, and human-centered design. We apply quantitative and qualitative human data collection methods including user surveys, interviews, journey maps, personas, and scenarios. Human-centered design methods leverage storytelling (a) in the acquisition of qualitative behavioral data (e.g. with journey mapping), (b) through goal-driven behaviors and needs that are synthesized into a persona as a composite model of the data, and (c) within context scenarios (the story plot or projected circumstances) in which the persona is placed in context to inform the design of relevant and usable products or services. ShakeAlert, operated by the USGS and partners, has transitioned into a production prototype phase in which users are permitted to begin testing pilot implementations to take protective actions in response to an earthquake alert. While a subset of responses will be automated (e.g., opening fire house doors), other applications of the technology will alert individuals by broadcast, public address, or mobile device notifications and require self-protective behavioral decisions (e.g., "Drop, Cover, and Hold On"). To better understand ShakeAlert user decisions and needs, we use human-centered design methods to synthesize aggregated behavioral data into "personas," which model the common behavioral patterns that can be used to guide plans for the ShakeAlert interface, messaging, and training. We present user data, methods, and resulting personas that will inform decisions moving forward to shape ShakeAlert messaging and training that will be most usable by alert recipients.

Machine-learning-based Brokers for Real-time Classification of the LSST Alert Stream

NASA Astrophysics Data System (ADS)

Narayan, Gautham; Zaidi, Tayeb; Soraisam, Monika D.; Wang, Zhe; Lochner, Michelle; Matheson, Thomas; Saha, Abhijit; Yang, Shuo; Zhao, Zhenge; Kececioglu, John; Scheidegger, Carlos; Snodgrass, Richard T.; Axelrod, Tim; Jenness, Tim; Maier, Robert S.; Ridgway, Stephen T.; Seaman, Robert L.; Evans, Eric Michael; Singh, Navdeep; Taylor, Clark; Toeniskoetter, Jackson; Welch, Eric; Zhu, Songzhe; The ANTARES Collaboration

2018-05-01

The unprecedented volume and rate of transient events that will be discovered by the Large Synoptic Survey Telescope (LSST) demand that the astronomical community update its follow-up paradigm. Alert-brokers—automated software system to sift through, characterize, annotate, and prioritize events for follow-up—will be critical tools for managing alert streams in the LSST era. The Arizona-NOAO Temporal Analysis and Response to Events System (ANTARES) is one such broker. In this work, we develop a machine learning pipeline to characterize and classify variable and transient sources only using the available multiband optical photometry. We describe three illustrative stages of the pipeline, serving the three goals of early, intermediate, and retrospective classification of alerts. The first takes the form of variable versus transient categorization, the second a multiclass typing of the combined variable and transient data set, and the third a purity-driven subtyping of a transient class. Although several similar algorithms have proven themselves in simulations, we validate their performance on real observations for the first time. We quantitatively evaluate our pipeline on sparse, unevenly sampled, heteroskedastic data from various existing observational campaigns, and demonstrate very competitive classification performance. We describe our progress toward adapting the pipeline developed in this work into a real-time broker working on live alert streams from time-domain surveys.

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

PubMed

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

2014-01-01

Public health policies are designed for specific subsets of the population. Evidence that a policy is effectively designed should be based on whether it effectively addresses its mission. A critical factor is determining whether utilization patterns reflect the mission and the efficacy of public health policies, particularly during early stages of implementation. We assert that utilization patterns can be effectively assessed using geographic information systems (GIS). This paper uses the Silver Alert program, a recently implemented public health policy, as a case for how and why GIS can be used to examine utilization patterns. GIS are employed to visualize and spatially analyze a new health policy--North Carolina's Silver Alert policy. We use visualized data and spatial statistics to assess utilization patterns and mission adherence. Results show disproportionate utilization patterns of the Silver Alert policy. In particular, an outstanding number of Silver Alerts were used in Wake County and its surrounding counties, which are both the political and media center of North Carolina. Other counties, including populous counties, had few if any alerts. Findings suggest that the North Carolina's Silver Alert policy needs to be adjusted to more effectively address its mission. We identify several factors that need further examination prior to a statewide evaluation. From this case study, we propose ways future programs, particularly the introduction of the Affordable Care Act (ACA) in 2014, might use GIS to examine utilization patterns as a means to better understand whether and in what ways the health care needs of the public are being met with such a policy.

Performance Analysis of a Citywide Real-time Landslide Early Warning System in Korea

NASA Astrophysics Data System (ADS)

Park, Joon-Young; Lee, Seung-Rae; Kang, Sinhang; Lee, Deuk-hwan; Nedumpallile Vasu, Nikhil

2017-04-01

Rainfall-induced landslide has been one of the major disasters in Korea since the beginning of 21st century when the global climate change started to give rise to the growth of the magnitude and frequency of extreme precipitation events. In order to mitigate the increasing damage to properties and loss of lives and to provide an effective tool for public officials to manage the landslide disasters, a real-time landslide early warning system with an advanced concept has been developed by taking into account for Busan, the second largest metropolitan city in Korea, as an operational test-bed. The system provides with warning information based on a five-level alert scheme (Normal, Attention, Watch, Alert, and Emergency) using the forecasted/observed rainfall data or the data obtained from ground monitoring (volumetric water content and matric suction). The alert levels are determined by applying seven different thresholds in a step-wise manner following a decision tree. In the pursuit of improved reliability of an early warning level assigned to a specific area, the system makes assessments repetitively using the thresholds of different theoretical backgrounds including statistical(empirical), physically-based, and mathematical analyses as well as direct measurement-based approaches. By mapping the distribution of the five early warning levels determined independently for each of tens of millions grids covering the entire mountainous area of Busan, the regional-scale system can also provide with the early warning information for a specific local area. The fact that the highest warning level is determined by using a concept of a numerically-modelled potential debris-flow risk is another distinctive feature of the system. This study tested the system performance by applying it for four previous rainy seasons in order to validate the operational applicability. During the rainy seasons of 2009, 2011, and 2014, the number of landslides recorded throughout Busan's territory reached 156, 64, and 37, respectively. In 2016, only three landslides were recorded even though the city experienced a couple of heavy rainfall events during the rainy season. The system performance test results show good agreement with the observation results for the past rainfall events. It seems that the system can also provide with reliable warning information for the future rainfall events.

Surveillance and early warning systems of infectious disease in China: From 2012 to 2014.

PubMed

Zhang, Honglong; Wang, Liping; Lai, Shengjie; Li, Zhongjie; Sun, Qiao; Zhang, Peng

2017-07-01

Appropriate surveillance and early warning of infectious diseases have very useful roles in disease control and prevention. In 2004, China established the National Notifiable Infectious Disease Surveillance System and the Public Health Emergency Event Surveillance System to report disease surveillance and events on the basis of data sources from the National Notifiable Infectious Disease Surveillance System, China Infectious Disease Automated-alert and Response System in this country. This study provided a descriptive summary and a data analysis, from 2012 to 2014, of these 3 key surveillance and early warning systems of infectious disease in China with the intent to provide suggestions for system improvement and perfection. Copyright © 2017 John Wiley & Sons, Ltd.

Community participation in tsunami early warning system in Pangandaran town

NASA Astrophysics Data System (ADS)

Hadian, Sapari D.; Khadijah, Ute Lies Siti; Saepudin, Encang; Budiono, Agung; Yuliawati, Ayu Krishna

2017-07-01

Disaster-resilient communities are communities capable of anticipating and minimizing destructive forces through adaptation. Disaster is an event very close to the people of Indonesia, especially in the small tourism town of Pangadaran located at West Java, Indonesia. On July 17, 2006, the town was hit by a Mw 7.8 earthquake and tsunami that effected over 300 km of the coastline, where the community suffered losses in which more than 600 people were killed, with run up heights exceeding 20 m. The devastation of the tsunami have made the community more alert and together with the local government and other stakeholder develop an Early Warning System for Tsunami. The study is intended to discover issues on tsunami Early Warning System (EWS), disaster risk reduction measures taken and community participation. The research method used is descriptive and explanatory research. The study describe the Tsunami EWS and community based Disaster Risk Reduction in Pangandaran, the implementation of Tsunami alert/EWS in disaster preparedness and observation of community participation in EWS. Data were gathered by secondary data collection, also primary data through interviews, focus group discussions and field observations. Research resulted in a description of EWS implementation, community participation and recommendation to reduce disaster risk in Pangandaran.

The pathway to earthquake early warning in the US

NASA Astrophysics Data System (ADS)

Allen, R. M.; Given, D. D.; Heaton, T. H.; Vidale, J. E.; West Coast Earthquake Early Warning Development Team

2013-05-01

The development of earthquake early warning capabilities in the United States is now accelerating and expanding as the technical capability to provide warning is demonstrated and additional funding resources are making it possible to expand the current testing region to the entire west coast (California, Oregon and Washington). Over the course of the next two years we plan to build a prototype system that will provide a blueprint for a full public system in the US. California currently has a demonstrations warning system, ShakeAlert, that provides alerts to a group of test users from the public and private sector. These include biotech companies, technology companies, the entertainment industry, the transportation sector, and the emergency planning and response community. Most groups are currently in an evaluation mode, receiving the alerts and developing protocols for future response. The Bay Area Rapid Transit (BART) system is the one group who has now implemented an automated response to the warning system. BART now stops trains when an earthquake of sufficient size is detected. Research and development also continues to develop improved early warning algorithms to better predict the distribution of shaking in large earthquakes when the finiteness of the source becomes important. The algorithms under development include the use of both seismic and GPS instrumentation and integration with existing point source algorithms. At the same time, initial testing and development of algorithms in and for the Pacific Northwest is underway. In this presentation we will review the current status of the systems, highlight the new research developments, and lay out a pathway to a full public system for the US west coast. The research and development described is ongoing at Caltech, UC Berkeley, University of Washington, ETH Zurich, Southern California Earthquake Center, and the US Geological Survey, and is funded by the Gordon and Betty Moore Foundation and the US Geological Survey.

Pattern recognition applied to infrared images for early alerts in fog

NASA Astrophysics Data System (ADS)

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

2014-09-01

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

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

PubMed

Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions. The borderline significant improvement of short-term renal outcome in the RIFLE class risk patients needs to be confirmed in a large multicenter trial.

Faculty Intervention as Support for First-Year Students

ERIC Educational Resources Information Center

Naidoo, Ana'dhavelli; Lemmens, Juan-Claude

2015-01-01

The impetus for this study is grounded in a strategic decision by management to measure readiness for university education as part of an early alert and referral system. The motivation for this project is also rooted in literature that points out that the South African higher education system faces challenges with students entering the system…

Design of smart neonatal health monitoring system using SMCC

PubMed Central

Mukherjee, Anwesha; Bhakta, Ishita

2016-01-01

Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors’ system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased. PMID:28261491

Design of smart neonatal health monitoring system using SMCC.

PubMed

De, Debashis; Mukherjee, Anwesha; Sau, Arkaprabha; Bhakta, Ishita

2017-02-01

Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required. In this Letter, an automated neonatal health monitoring system is designed using sensor mobile cloud computing (SMCC). SMCC is based on WSN and MCC. In the authors' system temperature sensor, acceleration sensor and heart rate measurement sensor are used to monitor body temperature, acceleration due to body movement and heart rate of neonates. The sensor data are stored inside the cloud. The health person continuously monitors and accesses these data through the mobile device using an Android Application for neonatal monitoring. When an abnormal situation arises, an alert is generated in the mobile device of the health person. By alerting health professional using such an automated system, early care is provided to the affected babies and the probability of recovery is increased.

A New GRB follow-up Software at TUG

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

Effects of direction of rotation in continuous and discontinuous 8 hour shift systems

PubMed Central

Tucker, P.; Smith, L.; Macdonald, I.; Folkard, S.

2000-01-01

OBJECTIVES—Previous research has produced conflicting evidence on the relative merits of advancing and delaying shift systems. The current study assessed the effects of the direction of shift rotation within 8 hour systems, upon a range of measures including sleep, on shift alertness, physical health, and psychological wellbeing.
METHODS—An abridged version of the standard shiftwork index which included retrospective alertness ratings was completed by four groups of industrial shiftworkers on relatively rapidly rotating 8 hour systems (n=611). Two groups worked continuous systems that were either advancing or delaying; the other two groups worked discontinuous systems that were either advancing or delaying.
RESULTS—Few effects were found of direction of rotation on chronic measures of health and wellbeing, even when the systems incorporated "quick returns" (a break of only 8 hours when changing from one shift to another). This was despite the use of measures previously shown to be sensitive to the effects of a broad range of features of shift systems. However, advancing continuous systems seemed to be associated with marginally steeper declines in alertness across the shift (F (3,1080)=2.87, p<0.05). They were also associated with shorter sleeps between morning shifts (F (1,404)=4.01, p<0.05), but longer sleeps between afternoons (F (1,424)=4.16, p<0.05).
CONCLUSIONS—The absence of negative effects of advancing shifts upon the chronic outcome measures accorded with previous evidence that advancing shifts may not be as harmful as early research indicated. However, this interpretation is tempered by the possibility that difficult shift systems self select those workers most able to cope with their deleterious effects. The presence of quick returns in advancing continuous systems seemed to impact upon some of the acute measures such as duration of sleep, although the associated effects on alertness seemed to be marginal.


Keywords: shift rotation; health; alertness PMID:10984340

G-FAST Early Warning Potential for Great Earthquakes in Chile

NASA Astrophysics Data System (ADS)

Crowell, B.; Schmidt, D. A.; Baker, B. I.; Bodin, P.; Vidale, J. E.

2016-12-01

The importance of GNSS-based earthquake early warning for modeling large earthquakes has been studied extensively over the past decade and several such systems are currently under development. In the Pacific Northwest, we have developed the G-FAST GNSS-based earthquake early warning module for eventual inclusion in the US West-Coast wide ShakeAlert system. We have also created a test system that allows us to replay past and synthetic earthquakes to identify problems with both the network architecture and the algorithms. Between 2010 and 2016, there have been seven M > 8 earthquakes across the globe, of which three struck offshore Chile; the 27 February 2010 Mw 8.8 Maule, the 1 April 2014 Mw 8.2 Iquique, and the 16 September 2015 Mw 8.3 Illapel. Subsequent to these events, the Chilean national GNSS network operated by the Centro Sismologico Nacional (http://www.sismologia.cl/) greatly expanded to over 150 continuous GNSS stations, providing the best recordings of great earthquakes with GNSS outside of Japan. Here we report on retrospective G-FAST performance for those three great earthquakes in Chile. We discuss the interplay of location errors, latency, and data completeness with respect to the precision and timing of G-FAST earthquake source alerts as well as the computational demands of the system.

Assessing the Applicability of Earthquake Early Warning in Nicaragua.

NASA Astrophysics Data System (ADS)

Massin, F.; Clinton, J. F.; Behr, Y.; Strauch, W.; Cauzzi, C.; Boese, M.; Talavera, E.; Tenorio, V.; Ramirez, J.

2016-12-01

Nicaragua, like much of Central America, suffers from frequent damaging earthquakes (6 M7+ earthquakes occurred in the last 100 years). Thrust events occur at the Middle America Trench where the Cocos plate subducts by 72-81 mm/yr eastward beneath the Caribbean plate. Shallow crustal events occur on-shore, with potential extensive damage as demonstrated in 1972 by a M6.2 earthquake, 5 km beneath Managua. This seismotectonic setting is challenging for Earthquake Early Warning (EEW) because the target events derive from both the offshore seismicity, with potentially large lead times but uncertain locations, and shallow seismicity in close proximity to densely urbanized areas, where an early warning would be short if available at all. Nevertheless, EEW could reduce Nicaragua's earthquake exposure. The Swiss Development and Cooperation Fund and the Nicaraguan Government have funded a collaboration between the Swiss Seismological Service (SED) at ETH Zurich and the Nicaraguan Geosciences Institute (INETER) in Managua to investigate and build a prototype EEW system for Nicaragua and the wider region. In this contribution, we present the potential of EEW to effectively alert Nicaragua and the neighbouring regions. We model alert time delays using all available seismic stations (existing and planned) in the region, as well as communication and processing delays (observed and optimal) to estimate current and potential performances of EEW alerts. Theoretical results are verified with the output from the Virtual Seismologist in SeisComP3 (VS(SC3)). VS(SC3) is implemented in the INETER SeisComP3 system for real-time operation and as an offline instance, that simulates real-time operation, to record processing delays of playback events. We compare our results with similar studies for Europe, California and New Zealand. We further highlight current capabilities and challenges for providing EEW alerts in Nicaragua. We also discuss how combining different algorithms, like e.g. VS and FinDer, can lead to a robust approach to EEW.

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

Evaluating Post-Earthquake Building Safety Using Economical MEMS Seismometers

PubMed Central

Yin, Ren-Cheng

2018-01-01

The earthquake early warning (EEW)-research group at National Taiwan University has been developing a microelectromechanical system-based accelerometer called “P-Alert”, designed for issuing EEWs. The main advantage of P-Alert is that it is a relatively economical seismometer. However, because of the expensive nature of commercial hardware for structural health monitoring (SHM) systems, the application of SHM to buildings remains limited. To determine the performance of P-Alert for evaluating post-earthquake building safety, we conducted a series of steel-frame shaking table tests with incremental damage. We used the fragility curves of different damage levels and the interstory drift ratios (calculated by the measured acceleration of each story using double integration and a filter) to gauge the potential damage levels. We concluded that the acceptable detection of damage for an entire building is possible. With improvements to the synchronization of the P-Alert sensors, we also anticipate a damage localization feature for the stories of a building. PMID:29734736

Investigate the Capabilities of Remotely Sensed Crop Indicators for Agricultural Drought Monitoring in Kansas

NASA Astrophysics Data System (ADS)

Zhang, J.; Becker-Reshef, I.; Justice, C. O.

2013-12-01

Although agricultural production has been rising in the past years, drought remains the primary cause of crop failure, leading to food price instability and threatening food security. The recent 'Global Food Crisis' in 2008, 2011 and 2012 has put drought and its impact on crop production at the forefront, highlighting the need for effective agricultural drought monitoring. Satellite observations have proven a practical, cost-effective and dynamic tool for drought monitoring. However, most satellite based methods are not specially developed for agriculture and their performances for agricultural drought monitoring still need further development. Wheat is the most widely grown crop in the world, and the recent droughts highlight the importance of drought monitoring in major wheat producing areas. As the largest wheat producing state in the US, Kansas plays an important role in both global and domestic wheat markets. Thus, the objective of this study is to investigate the capabilities of remotely sensed crop indicators for effective agricultural drought monitoring in Kansas wheat-grown regions using MODIS data and crop yield statistics. First, crop indicators such as NDVI, anomaly and cumulative metrics were calculated. Second, the varying impacts of agricultural drought at different stages were explored by examining the relationship between the derived indicators and yields. Also, the starting date of effective agricultural drought early detection and the key agricultural drought alert period were identified. Finally, the thresholds of these indicators for agricultural drought early warning were derived and the implications of these indicators for agricultural drought monitoring were discussed. The preliminary results indicate that drought shows significant impacts from the mid-growing-season (after Mid-April); NDVI anomaly shows effective drought early detection from Late-April, and Late-April to Early-June can be used as the key alert period for agricultural drought early warning; and drought occurring in Early-May has the most significant agricultural impacts. This research intends to help prototype an agricultural drought alert system, which could alert crop analysts to agricultural drought vulnerable areas/periods and provide tools for assessing crop outlooks in these regions.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

[System construction of early warning for ecological security at cultural and natural heritage mixed sites and its application: a case study of Wuyishan Scenery District].

PubMed

You, Wei-Bin; He, Dong-Jin; Qin, De-Hua; Ji, Zhi-Rong; Wu, Li-Yun; Yu, Jian-An; Chen, Bing-Rong; Tan, Yong

2014-05-01

This paper proposed a new concept of ecological security for protection by a comprehensive analysis of the contents and standards of world heritage sites. A frame concept model named "Pressure-State-Control" for early warning of ecological security at world heritage mixed sites was constructed and evaluation indicators of this frame were also selected. Wuyishan Scenery District was chosen for a case study, which has been severely disturbed by natural and artificial factors. Based on the frame model of "Pressure-State-Control" and by employing extension analysis, the matter-element model was established to assess the ecological security status of this cultural and natural world heritage mixed site. The results showed that the accuracy of ecological security early warning reached 84%. Early warning rank was I level (no alert status) in 1997 and 2009, but that in 2009 had a higher possibility to convert into II level. Likewise, the early-warning indices of sensitive ranks were different between 1997 and 2009. Population density, population growth rate, area index for tea garden, cultivated land owned per capita, level of drought, and investment for ecological and environmental construction were the main limiting factors to hinder the development of ecological security from 2009 to future. In general, the status of Wuyishan Scenery District ecological security was relatively good and considered as no alert level, while risk conditions also existed in terms of a few early-warning indicators. We still need to pay more attention to serious alert indicators and adopt effective prevention and control measures to maintain a good ecological security status of this heritage site.

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

NASA Astrophysics Data System (ADS)

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

2013-05-01

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

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

PubMed

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

2013-05-01

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

A National Study of Student Early Alert Models at Four-Year Institutions of Higher Education

ERIC Educational Resources Information Center

Simons, Jill M.

2011-01-01

The purpose of this study was to explore the state of student early alert models at nonprofit, four-year institutions of higher education through both quantitative and qualitative lenses. The use of these retention initiatives has become a much heralded practice on college campuses (Kuh, 2007a; Kuh 2007b; Seidman, 2005; Tinto, 2008). However,…

EEG quantification of alertness: methods for early identification of individuals most susceptible to sleep deprivation

NASA Astrophysics Data System (ADS)

Berka, Chris; Levendowski, Daniel J.; Westbrook, Philip; Davis, Gene; Lumicao, Michelle N.; Olmstead, Richard E.; Popovic, Miodrag; Zivkovic, Vladimir T.; Ramsey, Caitlin K.

2005-05-01

Electroencephalographic (EEG) and neurocognitive measures were simultaneously acquired to quantify alertness from 24 participants during 44-hours of sleep deprivation. Performance on a three-choice vigilance task (3C-VT), paired-associate learning/memory task (PAL) and modified Maintenance of Wakefulness Test (MWT), and sleep technician-observed drowsiness (eye-closures, head-nods, EEG slowing) were quantified. The B-Alert system automatically classifies each second of EEG on an alertness/drowsiness continuum. B-Alert classifications were significantly correlated with technician-observations, visually scored EEG and performance measures. B-Alert classifications during 3C-VT, and technician observations and performance during the 3C-VT and PAL evidenced progressively increasing drowsiness as a result of sleep deprivation with a stabilizing effect observed at the batteries occurring between 0600 and 1100 suggesting a possible circadian effect similar to those reported in previous sleep deprivation studies. Participants were given an opportunity to take a 40-minute nap approximately 24-hours into the sleep deprivation portion of the study (i.e., 7 PM on Saturday). The nap was followed by a transient period of increased alertness. Approximately 8 hours after the nap, behavioral and physiological measures of drowsiness returned to levels prior to the nap. Cluster analysis was used to stratify individuals into three groups based on their level of impairment as a result of sleep deprivation. The combination of B-Alert and neuro-behavioral measures may identify individuals whose performance is most susceptible to sleep deprivation. These objective measures could be applied in an operational setting to provide a "biobehavioral assay" to determine vulnerability to sleep deprivation.

75 FR 6343 - Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-09

... Independence Ave., SW., Washington, DC 20250-1522. FAX: (202) 720-4120. Title: Weather Radio Transmitter Grant... collection. Abstract: The National Weather Service operates an All Hazards Early Warning System that alerts people in areas covered by its transmissions of approaching dangerous weather and other emergencies. The...

Benefits of Earthquake Early Warning to Large Municipalities (Invited)

NASA Astrophysics Data System (ADS)

Featherstone, J.

2013-12-01

The City of Los Angeles has been involved in the testing of the Cal Tech Shake Alert, Earthquake Early Warning (EQEW) system, since February 2012. This system accesses a network of seismic monitors installed throughout California. The system analyzes and processes seismic information, and transmits a warning (audible and visual) when an earthquake occurs. In late 2011, the City of Los Angeles Emergency Management Department (EMD) was approached by Cal Tech regarding EQEW, and immediately recognized the value of the system. Simultaneously, EMD was in the process of finalizing a report by a multi-discipline team that visited Japan in December 2011, which spoke to the effectiveness of EQEW for the March 11, 2011 earthquake that struck that country. Information collected by the team confirmed that the EQEW systems proved to be very effective in alerting the population of the impending earthquake. The EQEW in Japan is also tied to mechanical safeguards, such as the stopping of high-speed trains. For a city the size and complexity of Los Angeles, the implementation of a reliable EQEW system will save lives, reduce loss, ensure effective and rapid emergency response, and will greatly enhance the ability of the region to recovery from a damaging earthquake. The current Shake Alert system is being tested at several governmental organizations and private businesses in the region. EMD, in cooperation with Cal Tech, identified several locations internal to the City where the system would have an immediate benefit. These include the staff offices within EMD, the Los Angeles Police Department's Real Time Analysis and Critical Response Division (24 hour crime center), and the Los Angeles Fire Department's Metropolitan Fire Communications (911 Dispatch). All three of these agencies routinely manage the collaboration and coordination of citywide emergency information and response during times of crisis. Having these three key public safety offices connected and included in the early testing of an EQEW system will help shape the EQEW policy which will determine the seismic safety of millions of Californians in the years to come.

Providing accurate near real-time fire alerts for Protected Areas through NASA FIRMS: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Wong, M.; Murphy, K. J.

2013-12-01

The NASA Fire Information for Resource Management System (FIRMS) is at the forefront of providing global near real-time (NRT) MODIS thermal anomalies / hotspot location data to end-users . FIRMS serves the data via an interactive Web GIS named Web Fire Mapper, downloads of NRT active fire, archive data downloads for MODIS hotspots dating back to 1999 and a hotspot email alert system The FIRMS Email Alerts system has been successfully alerting users of fires in their area of interest in near real-time and/or via daily and weekly email summaries, with an option to receive MODIS hotspot data as a text file (CSV) attachment. Currently, there are more than 7000 email alert subscriptions from more than 100 countries. Specifically, the email alerts system is designed to generate and send an email alert for any region or area on the globe, with a special focus on providing alerts for protected areas worldwide. For many protected areas, email alerts are particularly useful for early fire detection, monitoring on going fires, as well as allocating resources to protect wildlife and natural resources of particular value. For protected areas, FIRMS uses the World Database on Protected Areas (WDPA) supplied by United Nations Environment Program - World Conservation Monitoring Centre (UNEP-WCMC). Maintaining the most up-to-date, accurate boundary geometry for the protected areas for the email alerts is a challenge as the WDPA is continuously updated due to changing boundaries, merging or delisting of certain protected areas. Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database. To maintain the most up-to-date boundary information for protected areas and to be in compliance with the WDPA terms and conditions, FIRMS needs to constantly update its database of protected areas. Currently, FIRMS strives to keep its database up to date by downloading the most recent WDPA database at regular intervals, processing it, and ingesting it into the FIRMS spatial database. However, due to the large size of database, the process to download, process and ingest the database is quite time consuming. The FIRMS team is currently working on developing a method to update the protected areas database via web at regular intervals or on-demand. Using such a solution, FIRMS will be able access the most up-to-date extents of any protected area and the corresponding spatial geometries in real time. As such, FIRMS can utilize such a service to access the protected areas and their associated geometries to keep users' protected area boundaries in sync with those of the most recent WDPA database, and thus serve a more accurate email alert to the users. Furthermore, any client accessing the WDPA protected areas database could potentially use the solution of real-time access to the protected areas database. This talk primarily focuses on the challenges for FIRMS in sending accurate email alerts for protected areas, along with the solution the FIRMS team is developing. This talk also introduces the FIRMS fire information system and its components, with a special emphasis on the FIRMS email alerts system.

Identification of potentially emerging food safety issues by analysis of reports published by the European Community's Rapid Alert System for Food and Feed (RASFF) during a four-year period.

PubMed

Kleter, G A; Prandini, A; Filippi, L; Marvin, H J P

2009-05-01

The SAFE FOODS project undertakes to design a new approach towards the early identification of emerging food safety hazards. This study explored the utility of notifications filed through RASFF, the European Commission's Rapid Alert System for Food and Feed, to identify emerging trends in food safety issues. RASFF information and alert notifications published in the four-year period of July 2003-June 2007 were assigned to categories of products and hazards. For chronological trend analysis, a basic time unit of three months was chosen. Data within each hazard category were analyzed for chronological trends, relationships between product and hazard categories, regions of origin, and countries filing the notifications. Conspicuous trends that were observed included a rise in the incidence of food contact substances, particularly 2-isopropyl-thioxanthone, as well as of chemical substances migrating from utensils and fraud-related issues. Temporary increases were noted in the incidences of the unauthorized dye Para Red, genetically modified organisms, the pesticide isophenfos-methyl, and herring worm, Anisakis simplex. National and European authorities themselves have signaled these conspicuous trends and taken measures. It is recommended to add complementary data to RASFF data, including safety assessments, risk management measures, background data on hazards and surveillance patterns, for a holistic approach towards early identification of emerging hazards.

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

NASA Astrophysics Data System (ADS)

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

2010-12-01

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

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

PubMed

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

2016-06-01

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

Dose-response relationship for light intensity and ocular and electroencephalographic correlates of human alertness

NASA Technical Reports Server (NTRS)

Cajochen, C.; Zeitzer, J. M.; Czeisler, C. A.; Dijk, D. J.

2000-01-01

Light can elicit both circadian and acute physiological responses in humans. In a dose response protocol men and women were exposed to illuminances ranging from 3 to 9100 lux for 6.5 h during the early biological night after they had been exposed to <3 lux for several hours. Light exerted an acute alerting response as assessed by a reduction in the incidence of slow-eye movements, a reduction of EEG activity in the theta-alpha frequencies (power density in the 5-9 Hz range) as well as a reduction in self-reported sleepiness. This alerting response was positively correlated with the degree of melatonin suppression by light. In accordance with the dose response function for circadian resetting and melatonin suppression, the responses of all three indices of alertness to variations in illuminance were consistent with a logistic dose response curve. Half of the maximum alerting response to bright light of 9100 lux was obtained with room light of approximately 100 lux. This sensitivity to light indicates that variations in illuminance within the range of typical, ambient, room light (90-180 lux) can have a significant impact on subjective alertness and its electrophysiologic concomitants in humans during the early biological night.

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

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

PubMed Central

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

2011-01-01

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

Integrative Approach for a Transformative Freshman-Level STEM Curriculum

ERIC Educational Resources Information Center

D'Souza, Malcolm J.; Curran, Kathleen L.; Olsen, Paul E.; Nwogbaga, Agashi P.; Stotts, Stephanie

2016-01-01

In 2014 Wesley College adopted a unified undergraduate program of evidence-based high-impact teaching practices. Through foundation and federal and state grant support, the college completely revised its academic core curriculum and strengthened its academic support structures by including a comprehensive early alert system for at-risk students.…

76 FR 80780 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

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

Development of a Low Cost Earthquake Early Warning System in Taiwan

NASA Astrophysics Data System (ADS)

Wu, Y. M.

2017-12-01

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

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

PubMed

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

2017-05-01

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

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

NASA Technical Reports Server (NTRS)

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

1997-01-01

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

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

PubMed

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

2016-05-05

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

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

NASA Astrophysics Data System (ADS)

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

2016-06-01

This paper presents a regional extreme rainfall analysis based on 10 years of radar data for the 159 regions adopted for official natural hazard warnings in Switzerland. Moreover, a nowcasting tool aimed at issuing heavy precipitation regional alerts is introduced. The two topics are closely related, since the extreme rainfall analysis provides the thresholds used by the nowcasting system for the alerts. Warm and cold seasons' monthly maxima of several statistical quantities describing regional rainfall are fitted to a generalized extreme value distribution in order to derive the precipitation amounts corresponding to sub-annual return periods for durations of 1, 3, 6, 12, 24 and 48 h. It is shown that regional return levels exhibit a large spatial variability in Switzerland, and that their spatial distribution strongly depends on the duration of the aggregation period: for accumulations of 3 h and shorter, the largest return levels are found over the northerly alpine slopes, whereas for longer durations the southern Alps exhibit the largest values. The inner alpine chain shows the lowest values, in agreement with previous rainfall climatologies. The nowcasting system presented here is aimed to issue heavy rainfall alerts for a large variety of end users, who are interested in different precipitation characteristics and regions, such as, for example, small urban areas, remote alpine catchments or administrative districts. The alerts are issued not only if the rainfall measured in the immediate past or forecast in the near future exceeds some predefined thresholds but also as soon as the sum of past and forecast precipitation is larger than threshold values. This precipitation total, in fact, has primary importance in applications for which antecedent rainfall is as important as predicted one, such as urban floods early warning systems. The rainfall fields, the statistical quantity representing regional rainfall and the frequency of alerts issued in case of continuous threshold exceedance are some of the configurable parameters of the tool. The analysis of the urban flood which occurred in the city of Schaffhausen in May 2013 suggests that this alert tool might have complementary skill with respect to radar-based thunderstorm nowcasting systems for storms which do not show a clear convective signature.

Assessment of early warning system performance and improvements since it is in operational phase in Romania

NASA Astrophysics Data System (ADS)

Ionescu, Constantin; Marmureanu, Alexandru; Marmureanu, Gheorghe; Ortansa Cioflan, Carmen

2017-04-01

Earthquake represents a major natural disaster for Romanian territory. The main goal following the occurrence of a strong earthquake is to minimize the total number of fatalities. A rapid early warning system (REWS) was developed in Romania in order to provide 25-35 seconds warning time to Bucharest facilities for the earthquakes with M>5.0. The system consists of four components: a network of strong motion sensors installed in the epicentral area, a redundant communication network, an automatic analyzing system located in the Romanian Data Centre and an alert distribution system. The detection algorithm is based on the magnitude computation using strong motion data and rapid evaluation and scaling relation between the maximum P-wave acceleration measured in the epicentral area and the higher ground motion amplitude recorded in Bucharest. In order to reduce the damages caused by earthquakes, the exploitation of the up to date technology is very important. The information is the key point in the disaster management, and the internet is one of the most used instrument, implying also low costs. The Rapid Early Warning System was expanded to cover all countries affected by major earthquakes originating in the Vrancea seismic area and reduce their impact on existing installations of national interest in neighbouring Romania and elsewhere. REWS provides an efficient instrument for prevention and reaction based on the integrated system for seismic detection in South-Eastern Europe. REWS has been operational since 2013 and sends alert the authorities, hazardous facilities in Romania and Bulgaria (NPP, emergency response agencies etc.) and to public via twitter and some smartphone applications developed in the house. Also, NIEP is part of the UNESCO initiative case on developing a platform on earthquake early warning systems (IP-MEP) that aims to promote and strengthen the development of earthquake early warning systems in earthquake-prone regions of the world by sharing scientific knowledge, capacity building and international cooperation.

Analysis of Alerting System Failures in Commercial Aviation Accidents

NASA Technical Reports Server (NTRS)

Mumaw, Randall J.

2017-01-01

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

Technical Note: An operational landslide early warning system at regional scale based on space-time variable rainfall thresholds

NASA Astrophysics Data System (ADS)

Segoni, S.; Battistini, A.; Rossi, G.; Rosi, A.; Lagomarsino, D.; Catani, F.; Moretti, S.; Casagli, N.

2014-10-01

We set up an early warning system for rainfall-induced landslides in Tuscany (23 000 km2). The system is based on a set of state-of-the-art intensity-duration rainfall thresholds (Segoni et al., 2014b), makes use of LAMI rainfall forecasts and real-time rainfall data provided by an automated network of more than 300 rain-gauges. The system was implemented in a WebGIS to ease the operational use in civil protection procedures: it is simple and intuitive to consult and it provides different outputs. Switching among different views, the system is able to focus both on monitoring of real time data and on forecasting at different lead times up to 48 h. Moreover, the system can switch between a very straightforward view where a synoptic scenario of the hazard can be shown all over the region and a more in-depth view were the rainfall path of rain-gauges can be displayed and constantly compared with rainfall thresholds. To better account for the high spatial variability of the physical features, which affects the relationship between rainfall and landslides, the region is subdivided into 25 alert zones, each provided with a specific threshold. The warning system reflects this subdivision: using a network of 332 rain gauges, it allows monitoring each alert zone separately and warnings can be issued independently from an alert zone to another. An important feature of the warning system is the use of thresholds that may vary in time adapting at the conditions of the rainfall path recorded by the rain-gauges. Depending on when the starting time of the rainfall event is set, the comparison with the threshold may produce different outcomes. Therefore, a recursive algorithm was developed to check and compare with the thresholds all possible starting times, highlighting the worst scenario and showing in the WebGIS interface at what time and how much the rainfall path has exceeded or will exceed the most critical threshold. Besides forecasting and monitoring the hazard scenario over the whole region with hazard levels differentiated for 25 distinct alert zones, the system can be used to gather, analyze, visualize, explore, interpret and store rainfall data, thus representing a potential support to both decision makers and scientists.

False-positive alarms for bacterial screening of platelet concentrates with BacT/ALERT new-generation plastic bottles: a multicenter pilot study.

PubMed

Hundhausen, T; Müller, T H

2005-08-01

The microbial detection system BacT/ALERT (bioMérieux) is widely used to monitor bacterial contamination of platelet concentrates (PCs). Recently, the manufacturer introduced polycarbonate culture bottles and a modified pH-sensitive liquid emulsion sensor as microbial growth indicator. This reconfigured assay was investigated in a routine setting. In each of eight transfusion centers, samples from 500 consecutive PCs were monitored for 1 week. For all PCs with a positive BacT/ALERT signal, retained samples and, if available, original PC containers and concomitant red blood cell concentrates were analyzed independently. Initially BacT/ALERT-positive PCs without bacterial identification in any sample were defined as false-positive. BacT/ALERT-positive PCs with bacteria in the first sample only were called potentially positive. PCs with bacteria in the first sample and the same strain in at least one additional sample were accepted as positive. Five PCs (0.13%) were positive, 9 PCs (0.23%) were potentially positive, and 35 PCs (0.9%) were false-positive. The rate of false-positive BacT/ALERT results varied substantially between centers (<0.2%-3.2%). Tracings from false-positive cultures lacked an exponential increase of the signal during incubation. Most of these false-positives were due to malfunctioning cells in various BacT/ALERT incubation units. Careful assessment of individual tracings of samples with positive signals helps to identify malfunctioning incubation units. Their early shutdown or replacement minimizes the high rate of unrectifiable product rejects attributed to false-positive alarms and avoids unnecessary concern of doctors and patients after conversion to a reconfigured BacT/ALERT assay.

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

NASA Technical Reports Server (NTRS)

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

2015-01-01

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

77 FR 41331 - Commercial Mobile Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

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

Implementation of a landslide early warning system based on near-real-time monitoring, multisensor mapping and geophysical measurements

NASA Astrophysics Data System (ADS)

Teza, Giordano; Galgaro, Antonio; Francese, Roberto; Ninfo, Andrea; Mariani, Rocco

2017-04-01

An early warning system has been implemented to monitor the Perarolo di Cadore landslide (North-Eastern Italian Alps), which is a slump whose induced risk is fairly high because a slope collapse could form a temporary dam on the underlying torrent and, therefore, could directly threaten the close village. A robotic total station (RTS) measures, with 6h returning time, the positions of 23 retro-reflectors placed on the landslide upper and middle sectors. The landslide's kinematical behavior derived from these near-real-time (NRT) surface displacements is interpreted on the basis of available geomorphological and geological information, geometrical data provided by some laser scanning and photogrammetric surveys, and a landslide model obtained by means of 3D Electrical Resistivity Tomography (3D ERT) measurements. In this way, an analysis of the time series provided by RTS and a pluviometer, which cover several years, allows the definition of some pre-alert and alert kinematical and rainfall thresholds. These thresholds, as well as the corresponding operational recommendations, are currently used for early warning purposes by Authorities involved in risk management for the Perarolo landslide. It should be noted the fact that, as new RTS and pluviometric data are available, the thresholds can be updated and, therefore, a fine tuning of the early warning system can be carried out in order to improve its performance. Although the proposed approach has been implemented in a particular case, it can be used to develop an early warning system based on NRT data in each site where a landslide threatens infrastructures and/or villages that cannot be relocated.

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

PubMed

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

2013-12-01

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

Status of Public Earthquake Early Warning in the U.S

NASA Astrophysics Data System (ADS)

Given, D. D.

2013-12-01

Earthquake Early Warning (EEW) is a proven use of seismological science that can give people and businesses outside the epicentral area of a large earthquake up to a minute to take protective actions before the most destructive shaking hits them. Since 2006 several organizations have been collaborating to create such a system in the United States. These groups include the US Geological Survey, Caltech, UC Berkeley, the University of Washington, the Southern California Earthquake Center, the Swiss Federal Institute of Technology, Zürich, the California Office of Emergency Services, and the California Geological Survey. A demonstration version of the system, called ShakeAlert, began sending test notifications to selected users in California in January 2012. In August 2012 San Francisco's Bay Area Rapid Transit district began slowing and stopping trains in response to strong ground shaking. The next step in the project is to progress to a production prototype for the west coast. The system is built on top of the considerable technical and organizational earthquake monitoring infrastructure of the Advanced National Seismic System (ANSS). While a fully functional, robust, public EEW system will require significant new investment and development in several major areas, modest progress is being made with current resources. First, high-quality sensors must be installed with sufficient density, particularly near source faults. Where possible, we are upgrading and augmenting the existing ANSS networks on the west coast. Second, data telemetry from those sensors must be engineered for speed and reliability. Next, robust central processing infrastructure is being designed and built. Also, computer algorithms to detect and characterize the evolving earthquake must be further developed and tested. Last year the Gordon and Betty Moore Foundation funded USGS, Caltech, UCB and UW to accelerate R&D efforts. Every available means of distributing alerts must be used to insure the system's effectiveness. We have developed an internet-based UserDisplay application and a smartphone app based on Google Cloud Messaging. In addition, USGS has applied for authorization to alert over FEMA's Integrated Pubic Alert and Warning System. We are also working with private companies to develop alert distribution channels and end user implementation capabilities. Finally, because policy makers, institutional users, and the public must be educated about the system, social scientists and communicators are determining how to communicate the alerts most effectively. Progress is also being made in several related areas. Real-time GPS position data is becoming available on a large scale and algorithms are being developed to use these data to rapidly characterize the fault rupture as it propagates. New, advanced seismological and geodetic algorithms for the Cascadia megathrust and San Andreas fault are being developed. We are exploring public-private partnerships to develop commercial EEW applications. And Federal, State and local agencies are working out their roles and responsibilities in building, operating and educating users about the system. There is much more to be done and funding the creation and operation of this new capability is a challenge in the current budget climate. However, our goal is to build an EEW system before the next big earthquake rather than in its aftermath.

Military Interoperable Digital Hospital Testbed (MIDHT)

DTIC Science & Technology

2010-02-01

note build and system setup. There was significant progress in identifying workflows and processes. A sample note for a patient visit can be seen...between EMR systems did not exist when surveys were completed in early 2009. There is a significant opportunity to enhance patient care of military...interpret the provider’s handwriting . Many EHRs have included decision support into their functionality to help alert physicians to medication conflicts

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

PubMed

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

2017-01-01

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

77 FR 33661 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

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

Infant Responsiveness, Alertness, Hemoglobin and Growth in Rural Sidama, Ethiopia

PubMed Central

Aubuchon-Endsley, Nicki L.; Grant, Stephanie L.; Thomas, David G.; Kennedy, Tay S.; Berhanu, Getenesh; Stoecker, Barbara J.; Hubbs-Tait, Laura; Hambidge, K. Michael

2011-01-01

Several recent studies have supported relations between infant behavior (alertness and responsiveness) and nutrition (e.g. Dempsey 2008, Wachs et al 2005) in addition to investigating infant behavior within the context of changes in iron status over time (e.g. Black et al. 2004, Murray-Kolb & Beard 2009). Existing research is typically limited to investigation of the effects of a single vitamin or mineral and no studies have been found that examined the influence that early alertness and responsiveness have on growth in early infancy, despite the fact that relations between behavior and nutritional status may be bidirectional (Hulthén 2003). The current study used a sample of Ethiopian infants and investigated anthropometrics, hemoglobin, the frequency of alertness, and the frequency of responsiveness at 6 and 9 months of age. Six-month weight-for-age predicted 9-month frequency of alertness, while 6-month hemoglobin predicted 9-month frequency of responsiveness. Compared to responsive infants, non-responsive infants at 6 months remained more non-responsive at 9 months, though weight-for-age for both groups converged at 9 months. Results support relations between nutrition and behavior (alertness and responsiveness) and provide evidence of a potentially useful tool (the Laboratory Temperament Assessment Battery [Lab-TAB]) that was adapted to evaluate these relations in Ethiopia. PMID:22233352

Automated Detection of Sepsis Using Electronic Medical Record Data: A Systematic Review.

PubMed

Despins, Laurel A

Severe sepsis and septic shock are global issues with high mortality rates. Early recognition and intervention are essential to optimize patient outcomes. Automated detection using electronic medical record (EMR) data can assist this process. This review describes automated sepsis detection using EMR data. PubMed retrieved publications between January 1, 2005 and January 31, 2015. Thirteen studies met study criteria: described an automated detection approach with the potential to detect sepsis or sepsis-related deterioration in real or near-real time; focused on emergency department and hospitalized neonatal, pediatric, or adult patients; and provided performance measures or results indicating the impact of automated sepsis detection. Detection algorithms incorporated systemic inflammatory response and organ dysfunction criteria. Systems in nine studies generated study or care team alerts. Care team alerts did not consistently lead to earlier interventions. Earlier interventions did not consistently translate to improved patient outcomes. Performance measures were inconsistent. Automated sepsis detection is potentially a means to enable early sepsis-related therapy but current performance variability highlights the need for further research.

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

PubMed

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

2017-11-01

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

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

PubMed Central

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

1996-01-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2012 CFR

2012-04-01

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

21 CFR 26.20 - Alert system.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2013 CFR

2013-10-01

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

Alerting, orienting or executive attention networks: differential patters of pupil dilations

PubMed Central

Geva, Ronny; Zivan, Michal; Warsha, Aviv; Olchik, Dov

2013-01-01

Attention capacities, alerting responses, orienting to sensory stimulation, and executive monitoring of performance are considered independent yet interrelated systems. These operations play integral roles in regulating the behavior of diverse species along the evolutionary ladder. Each of the primary attention constructs—alerting, orienting, and executive monitoring—involves salient autonomic correlates as evidenced by changes in reactive pupil dilation (PD), heart rate, and skin conductance. Recent technological advances that use remote high-resolution recording may allow the discernment of temporo-spatial attributes of autonomic responses that characterize the alerting, orienting, and executive monitoring networks during free viewing, irrespective of voluntary performance. This may deepen the understanding of the roles of autonomic regulation in these mental operations and may deepen our understanding of behavioral changes in verbal as well as in non-verbal species. The aim of this study was to explore differences between psychosensory PD responses in alerting, orienting, and executive conflict monitoring tasks to generate estimates of concurrent locus coeruleus (LC) noradrenergic input trajectories in healthy human adults using the attention networks test (ANT). The analysis revealed a construct-specific pattern of pupil responses: alerting is characterized by an early component (Pa), its acceleration enables covert orienting, and executive control is evidenced by a prominent late component (Pe). PD characteristics seem to be task-sensitive, allowing exploration of mental operations irrespective of conscious voluntary responses. These data may facilitate development of studies designed to assess mental operations in diverse species using autonomic responses. PMID:24133422

Innovations in vital signs measurement for the detection of hypertension and shock in pregnancy.

PubMed

Vousden, Nicola; Nathan, Hannah L; Shennan, Andrew H

2018-06-22

Approximately 820 women die in pregnancy and childbirth every day worldwide, with 99% of these occurring in low-resource settings. The most common causes of maternal mortality are haemorrhage, sepsis and hypertensive disorders. There are established, effective solutions to these complications, however challenges remain in identifying who is at greatest risk and ensuring that interventions are delivered early when they have the greatest potential to benefit. Measuring vital signs is the first step in identifying women at risk. Overstretched or poorly trained staff and inadequate access to accurate, reliable equipment to measure vital signs can potentially result in delayed treatment initiation. Early warning systems may help alert users to identify patients at risk, especially where novel technologies can improve usability by automating calculations and alerting users to abnormalities. This may be of greatest benefit in under-resourced settings where task-sharing is common and early identification of complications can allow for prioritisation of life-saving interventions. This paper highlights the challenges of accurate vital sign measurement in pregnancy and identifies innovations which may improve detection of pregnancy complications.

Development and implementation of sepsis alert systems

PubMed Central

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

2016-01-01

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

Wireless clinical alerts for physiologic, laboratory and medication data.

PubMed Central

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

2000-01-01

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

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

PubMed Central

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

2011-01-01

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

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

PubMed

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

2010-01-01

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

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

PubMed

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

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

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

NASA Astrophysics Data System (ADS)

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

2014-05-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

The Seismic Alert System of Mexico, SASMEX began in 1991, is integrated by the seismic alert system of Mexico City and the seismic alert system of Oaxaca. SASMEX has 97 seismic sensors which are distributed in the seismic regions of the Pacific coast and the South of the Trans-Mexican Volcanic Belt of states of Jalisco, Colima, Michoacán, Guerrero, Oaxaca and Puebla. The alert dissemination covers the cities of: Acapulco, Chilpancingo, Morelia, Puebla, Oaxaca, Toluca and Mexico City, reaching the earthquake warnings to more than 25 millions of people. SASMEX has detected correctly more than 5600 earthquakes and warned 156. Mexico City has different alert dissemination systems like several Radio and Tv commercial broadcasters, dedicated radio receivers, EAS-SAME-SARMEX radio receivers and more tha 6700 public loud speakers. The other cities have only some of those systems. The Mw 8.2 Chiapas earthquake on September 7, despite the epicentral distance far of the first seismic detections (more than 180 km) and the low amplitudes of the P waves, the earthquake warning time gave more than 90 seconds to Mexico City before the arrivals of S waves with minor damages to the city in contrast with high damages in towns in the coast. This earthquake offered an opportunity to show the developments and lacks to reduce the risk, such as the need to increase the seismic detection coverage and the earthquake warning dissemination in towns with high seismic vulnerability. The Mw 7.1 Morelos earthquake on September 19 caused thousands of damages and hundreds of deaths and injuries in Mexico City, this earthquake is the second with the most damages after the Mw 8.1 Michoacán earthquake of September 19 on 1985. The earthquake early warning gave 11 seconds after the arrivals of S waves, however the activation occurred few seconds after the P waves arrives to Mexico City, and due to the seismic focus was near to the city, the P waves were felt for the people. The Accelerographic Network of Mexico City, reported absolute accelerations of 225 cm/s2 in the transition soils , which have never recorded in the Mexico Valley.

Implementing Obstetric Early Warning Systems.

PubMed

Friedman, Alexander M; Campbell, Mary L; Kline, Carolyn R; Wiesner, Suzanne; D'Alton, Mary E; Shields, Laurence E

2018-04-01

Severe maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings. This manuscript reports on key points from this session. While implementation experiences varied based on factors specific to individual sites, common themes relevant to all hospitals presenting were identified. Successful implementation of early warnings systems requires administrative and leadership support, dedication of resources, improved coordination between nurses, providers, and ancillary staff, optimization of information technology, effective education, evaluation of and change in hospital culture and practices, and support in provider decision-making. Evolving data on outcomes on early warning systems suggest that maternal risk may be reduced. To effectively reduce maternal, risk early warning systems that capture deterioration from a broad range of conditions may be required in addition to bundles tailored to specific conditions such as hemorrhage, thromboembolism, and hypertension.

INITIATE: An Intelligent Adaptive Alert Environment.

PubMed

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

2015-01-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

DTIC Science & Technology

2016-03-11

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

Jetliner Alert Systems

NASA Technical Reports Server (NTRS)

1983-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

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

Pixel color feature enhancement for road signs detection

NASA Astrophysics Data System (ADS)

Zhang, Qieshi; Kamata, Sei-ichiro

2010-02-01

Road signs play an important role in our daily life which used to guide drivers to notice variety of road conditions and cautions. They provide important visual information that can help drivers operating their vehicles in a manner for enhancing traffic safety. The occurrence of some accidents can be reduced by using automatic road signs recognition system which can alert the drivers. This research attempts to develop a warning system to alert the drivers to notice the important road signs early enough to refrain road accidents from happening. For solving this, a non-linear weighted color enhancement method by pixels is presented. Due to the advantage of proposed method, different road signs can be detected from videos effectively. With suitably coefficients and operations, the experimental results have proved that the proposed method is robust, accurate and powerful in road signs detection.

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

PubMed

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

2018-01-01

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

Towards eradication of inappropriate therapies for ICD lead failure by combining comprehensive remote monitoring and lead noise alerts.

PubMed

Ploux, Sylvain; Swerdlow, Charles D; Strik, Marc; Welte, Nicolas; Klotz, Nicolas; Ritter, Philippe; Haïssaguerre, Michel; Bordachar, Pierre

2018-06-02

Recognition of implantable cardioverter defibrillator (ICD) lead malfunction before occurrence of life threatening complications is crucial. We aimed to assess the effectiveness of remote monitoring associated or not with a lead noise alert for early detection of ICD lead failure. From October 2013 to April 2017, a median of 1,224 (578-1,958) ICD patients were remotely monitored with comprehensive analysis of all transmitted materials. ICD lead failure and subsequent device interventions were prospectively collected in patients with (RMLN) and without (RM) a lead noise alert (Abbott Secure Sense™ or Medtronic Lead Integrity Alert™) in their remote monitoring system. During a follow-up of 4,457 patient years, 64 lead failures were diagnosed. Sixty-one (95%) of the diagnoses were made before any clinical complication occurred. Inappropriate shocks were delivered in only one patient of each group (3%), with an annual rate of 0.04%. All high voltage conductor failures were identified remotely by a dedicated impedance alert in 10 patients. Pace-sense component failures were correctly identified by a dedicated alert in 77% (17 of 22) of the RMLN group versus 25% (8 of 32) of the RM group (P = 0.002). The absence of a lead noise alert was associated with a 16-fold increase in the likelihood of initiating either a shock or ATP (OR: 16.0, 95% CI 1.8-143.3; P = 0.01). ICD remote monitoring with systematic review of all transmitted data is associated with a very low rate of inappropriate shocks related to lead failure. Dedicated noise alerts further reduce inappropriate detection of ventricular arrhythmias. © 2018 Wiley Periodicals, Inc.

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Motivational Correlates of Academic Success in an Educational Psychology Course

ERIC Educational Resources Information Center

Herman, William E.

2011-01-01

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

Provider acceptance of an automated electronic alert for acute kidney injury

PubMed Central

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

2016-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

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

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

NASA Astrophysics Data System (ADS)

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

2017-10-01

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

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

PubMed

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

2017-08-23

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2013 CFR

2013-10-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

Development and Implementation of Sepsis Alert Systems.

PubMed

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

2016-06-01

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

Pilot Non-Conformance to Alerting System Commands

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1997-01-01

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

Impact of the sitagliptin alert on prescription of oral antihyperglycemic drugs in Japan.

PubMed

Sato, Daisaku; Sato, Yasunori; Masuda, Sachiko; Kimura, Hiromichi

2012-12-01

Sitagliptin, the first of a new class of dipeptidyl peptidase-4 (DPP-4)-inhibitory oral antihyperglycemic drugs (OHDs), was introduced in Japan in December 2009. In April 2010 a safety alert was issued regarding the risk of serious hypoglycemic events when the drug is used in combination with high-dose sulfonylureas (SUs). To investigate trends in prescription of OHDs before and after the launch of sitagliptin, and before and after the safety alert, in order to evaluate changes in the prescribing behavior of various groups of physicians in response to the safety alert. Japan. Prescription data from 6,500 institutions, randomly collected from 300 Japanese pharmacies were used. A cohort of 87,678 patients with 813,374 prescriptions for OHDs, among which 464,079 included SUs (glimepiride: 317,423), was collected from August 2009 to 31 December 2010. Logistic regression analysis was conducted. Prescription trends for sitagliptin and SUs, stratified by age, gender, types of prescribers and institutions. The safety alert recommending a reduction of SU dosing was well reflected in prescriptions issued after the alert (glimepiride dose reduction from 2.78 ± 1.86 mg to 2.32 ± 1.68), especially in prescriptions issued by diabetes specialists (from 2.27 ± 1.81 mg to 1.87 ± 1.47 mg). The dose of background SUs in patients who started sitagliptin early was higher (before alert: 2.70 ± 1.80 mg, after alert: 2.51 ± 1.74 mg) than in patients without experience of sitagliptin (2.12 ± 1.57 mg). This may indicate that patients receiving high-dose SUs were selected for sitagliptin, and this might be a factor in the high frequency of hypoglycemia in the early launch phase of sitagliptin. The sitagliptin safety alert had a clear impact on prescribing behavior, but the impact appeared to depend on prescribers' backgrounds. Our findings should be helpful for developing a safer drug launching strategy for new classes of drugs in established categories.

Incorporation of EGPWS in the NASA Ames Research Center 747-400 Flight Simulator

NASA Technical Reports Server (NTRS)

Sallant, Ghislain; DeGennaro, Robert A.

2001-01-01

The NASA Ames Research Center CAE Boeing 747300 flight simulator is used primarily for the study of human factors in aviation safety. The simulator is constantly upgraded to maintain a configuration match to a specific United Airlines aircraft and maintains the highest level of FAA certification to ensure credibility to the results of research programs. United's 747-400 fleet and hence the simulator are transitioning from the older Ground Proximity Warning System (GPWS) to the state-of-the-art Enhanced Ground Proximity Warning System (EGPWS). GPWS was an early attempt to reduce or eliminate Controlled Flight Into Terrain (CFIT). Basic GPWS alerting modes include: excessive descent rate, excessive terrain closure rate, altitude loss after takeoff, unsafe terrain clearance, excessive deviation below glideslope, advisory callouts and windshear alerting. However, since GPWS uses the radar altimeter which looks straight down, ample warning is not always provided. EGPWS retains all of the basic functions of GPWS but adds the ability to look ahead by comparing the aircraft position to an internal database and provide additional alerting and display capabilities. This paper evaluates three methods of incorporating EGPWS in the simulator and describes the implementation and architecture of the preferred option.

Remote Patient Management in Automated Peritoneal Dialysis: A Promising New Tool.

PubMed

Drepper, Valérie Jotterand; Martin, Pierre-Yves; Chopard, Catherine Stoermann; Sloand, James A

2018-01-01

Remote patient management (RPM) has the potential to help clinicians detect early issues, allowing intervention prior to development of more significant problems. A 23-year-old end-stage kidney disease patient required urgent start of renal replacement therapy. A newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity was implemented in her care. Pre-defined RPM threshold parameters were set to identify clinically relevant issues. Red flag dashboard alerts heralded prolonged drain times leading to clinical evaluation with subsequent diagnosis of and surgical repositioning for catheter displacement, although it took several days for newly-RPM-exposed staff to recognize this issue. Post-PD catheter repositioning, drain times were again normal as indicated by disappearance of flag alerts and unremarkable cycle volume profiles. Identification of < 90% adherence to prescribed PD therapy was then documented with the RPM system, alerting the clinical staff to address this important issue given its association with significant negative clinical outcomes. Healthcare providers face a "learning curve" to effect optimal utilization of the RPM tool. Larger scale observational studies will determine the impact of RPM on APD technique survival and resource utilization. Copyright © 2018 International Society for Peritoneal Dialysis.

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

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

Critical Infrastructure Protection and Resilience Literature Survey: Modeling and Simulation

DTIC Science & Technology

2014-11-01

2013 Page 34 of 63 Below the yellow set is a purple cluster bringing together detection , anomaly , intrusion, sensors, monitoring and alerting (early...hazards and threats to security56 Water ADWICE, PSS®SINCAL ADWICE for real-time anomaly detection in water management systems57 One tool that...Systems. Cybernetics and Information Technologies. 2008;8(4):57-68. 57. Raciti M, Cucurull J, Nadjm-Tehrani S. Anomaly detection in water management

United States Earthquake Early Warning System: How Theory and Analysis Can Save America Before the Big One Happens

DTIC Science & Technology

2017-12-01

integration within the American preparedness culture. Perhaps most importantly, the implementation of ShakeAlert will help prepare the people , businesses...disasters through the use of an earthquake warning system. In general, people have an expectation that authorities will protect society from natural... Society of America, potentially damaging earthquakes may threaten more than 143 million Americans in the next 50 years, and 28 million persons are

Early Detection of Rapidly Developing Cumulus Area using HIMAWARI-8

NASA Astrophysics Data System (ADS)

Yamada, Y.; Kadosaki, G.

2017-12-01

In recent years, many disasters have been occured by influence of meteorological change in Japan. So, it becomes more important to inform rapid weather change caused by cumulus which brings concentrated heavy rain/hail, wind gust, lightning in a short period. These severe events should inclease in the future by global warming. Therefore we are developping the alert system for Rapidly Developing Cumulus Area (RDCA) detection using Japanese new satellite. At July 2015, Japan Meteorological Agency started operation of new geostationary meteorological satellite "Himawari-8". This satellite has optical imager named Advanced Himawari Imager (AHI). It can observe Japan area every 2.5 minutes. The frequently infrared image with high resolution (2km) is the key of our alert system. We took some special functions in the algorithm of this system. One of the points is cloud location which shifts to north from true location around Japan by viewing angle from the satellite above the equator. We moved clouds to the correct position using geometric correction method according to its height and latitude. This algorithm also follows a movement of cloud every 2.5 minutes during several observations. It derives the information about degree of the development of cumulus. The prototype system gives the alert before 30 to 60 minutes in advance to the first lightning in typical cumulus case. However, we understand that there are some difficult cases to alert. For example, winter low cloud over the Japan Sea which brings a winter lightning, and tornado (although it is not cumulus). Now, we are adjusting some parameters of the algorithm. In the near future, our algorithm will be used in weather information delivery service to the customer.

Visual Alert System

NASA Technical Reports Server (NTRS)

1985-01-01

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

Seeing race: N170 responses to race and their relation to automatic racial attitudes and controlled processing.

PubMed

Ofan, Renana H; Rubin, Nava; Amodio, David M

2011-10-01

We examined the relation between neural activity reflecting early face perception processes and automatic and controlled responses to race. Participants completed a sequential evaluative priming task, in which two-tone images of Black faces, White faces, and cars appeared as primes, followed by target words categorized as pleasant or unpleasant, while encephalography was recorded. Half of these participants were alerted that the task assessed racial prejudice and could reveal their personal bias ("alerted" condition). To assess face perception processes, the N170 component of the ERP was examined. For all participants, stronger automatic pro-White bias was associated with larger N170 amplitudes to Black than White faces. For participants in the alerted condition only, larger N170 amplitudes to Black versus White faces were also associated with less controlled processing on the word categorization task. These findings suggest that preexisting racial attitudes affect early face processing and that situational factors moderate the link between early face processing and behavior.

Automated detection of physiologic deterioration in hospitalized patients

PubMed Central

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

2015-01-01

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

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

PubMed

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

2014-01-01

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

77 FR 26701 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

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

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

PubMed

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

2017-09-01

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

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

PubMed

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

2002-12-01

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

Flood and landslide warning based on rainfall thresholds and soil moisture indexes: the HEWS (Hydrohazards Early Warning System) for Sicily

NASA Astrophysics Data System (ADS)

Brigandì, Giuseppina; Tito Aronica, Giuseppe; Bonaccorso, Brunella; Gueli, Roberto; Basile, Giuseppe

2017-09-01

The main focus of the paper is to present a flood and landslide early warning system, named HEWS (Hydrohazards Early Warning System), specifically developed for the Civil Protection Department of Sicily, based on the combined use of rainfall thresholds, soil moisture modelling and quantitative precipitation forecast (QPF). The warning system is referred to 9 different Alert Zones in which Sicily has been divided into and based on a threshold system of three different increasing critical levels: ordinary, moderate and high. In this system, for early flood warning, a Soil Moisture Accounting (SMA) model provides daily soil moisture conditions, which allow to select a specific set of three rainfall thresholds, one for each critical level considered, to be used for issue the alert bulletin. Wetness indexes, representative of the soil moisture conditions of a catchment, are calculated using a simple, spatially-lumped rainfall-streamflow model, based on the SCS-CN method, and on the unit hydrograph approach, that require daily observed and/or predicted rainfall, and temperature data as input. For the calibration of this model daily continuous time series of rainfall, streamflow and air temperature data are used. An event based lumped rainfall-runoff model has been, instead, used for the derivation of the rainfall thresholds for each catchment in Sicily characterised by an area larger than 50 km2. In particular, a Kinematic Instantaneous Unit Hydrograph based lumped rainfall-runoff model with the SCS-CN routine for net rainfall was developed for this purpose. For rainfall-induced shallow landslide warning, empirical rainfall thresholds provided by Gariano et al. (2015) have been included in the system. They were derived on an empirical basis starting from a catalogue of 265 shallow landslides in Sicily in the period 2002-2012. Finally, Delft-FEWS operational forecasting platform has been applied to link input data, SMA model and rainfall threshold models to produce warning on a daily basis for the entire region.

Global Environmental Alert Service

NASA Astrophysics Data System (ADS)

Grasso, V. F.; Cervone, G.; Singh, A.; Kafatos, M.

2006-12-01

Every year natural disasters such as earthquakes, floods, hurricanes, tsunamis, etc. occur around the world, causing hundreds of thousands of deaths and injuries, billions of dollars in economic losses, and destroying natural landmarks and adveresely affecting ecosystems. Due to increasing urbanization, and increasingly higher percentage of the world's population living in megacities, the existence of nuclear power plants and other facilities whose potential destruction poses unacceptable high risks, natural hazards represent an increasing threat for economic losses, as well as risk to people and property. Warning systems represent an innovative and effective approach to mitigate the risks associated with natural hazards. Several state-of-the-art analyses show that early warning technologies are now available for most natural hazards and systems are already in operation in some parts of the world. Nevertheless, recent disasters such as the 2004 Indian Ocean tsunami, the 2005 Kashmir earthquake and the 2005 Katrina hurricane, highlighted inadequacies in early warning system technologies. Furthermore, not all available technologies are deployed in every part of the world, due to the lack of awareness and resources in the poorer countries, leaving very large and densely populated areas at risk. Efforts towards the development of a global warning system are necessary for filling the gaps of existing technologies. A globally comprehensive early warning system based on existing technologies will be a means to consolidate scientific knowledge, package it in a form usable to international and national decision makers and actively disseminate this information to protect people and properties. There is not a single information broker who searches and packages the policy relevant material and delivers it in an understandable format to the public and decision makers. A critical review of existing systems reveals the need for the innovative service. We propose here a Global Environmental Alert Service (GEAS) that could provide information from monitoring, Earth observing and early warning systems to users in a near real time mode and bridge the gap between the scientific community and policy makers. Characteristics and operational aspects of GEAS are discussed.

An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

NASA Astrophysics Data System (ADS)

Zhang, Ru; Guo, Tao; Liu, Jianyi

2018-03-01

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

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

NASA Technical Reports Server (NTRS)

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

1980-01-01

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

76 FR 3064 - Travelers Information Stations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

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

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

PubMed

Wickens, Christopher; Colcombe, Angela

2007-10-01

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

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

PubMed

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

2017-09-01

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

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

PubMed Central

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

2011-01-01

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

Finite-Fault and Other New Capabilities of CISN ShakeAlert

NASA Astrophysics Data System (ADS)

Boese, M.; Felizardo, C.; Heaton, T. H.; Hudnut, K. W.; Hauksson, E.

2013-12-01

Over the past 6 years, scientists at Caltech, UC Berkeley, the Univ. of Southern California, the Univ. of Washington, the US Geological Survey, and ETH Zurich (Switzerland) have developed the 'ShakeAlert' earthquake early warning demonstration system for California and the Pacific Northwest. We have now started to transform this system into a stable end-to-end production system that will be integrated into the daily routine operations of the CISN and PNSN networks. To quickly determine the earthquake magnitude and location, ShakeAlert currently processes and interprets real-time data-streams from several hundred seismic stations within the California Integrated Seismic Network (CISN) and the Pacific Northwest Seismic Network (PNSN). Based on these parameters, the 'UserDisplay' software predicts and displays the arrival and intensity of shaking at a given user site. Real-time ShakeAlert feeds are currently being shared with around 160 individuals, companies, and emergency response organizations to gather feedback about the system performance, to educate potential users about EEW, and to identify needs and applications of EEW in a future operational warning system. To improve the performance during large earthquakes (M>6.5), we have started to develop, implement, and test a number of new algorithms for the ShakeAlert system: the 'FinDer' (Finite Fault Rupture Detector) algorithm provides real-time estimates of locations and extents of finite-fault ruptures from high-frequency seismic data. The 'GPSlip' algorithm estimates the fault slip along these ruptures using high-rate real-time GPS data. And, third, a new type of ground-motion prediction models derived from over 415,000 rupture simulations along active faults in southern California improves MMI intensity predictions for large earthquakes with consideration of finite-fault, rupture directivity, and basin response effects. FinDer and GPSlip are currently being real-time and offline tested in a separate internal ShakeAlert installation at Caltech. Real-time position and displacement time series from around 100 GPS sensors are obtained in JSON format from RTK/PPP(AR) solutions using the RTNet software at USGS Pasadena. However, we have also started to investigate the usage of onsite (in-receiver) processing using NetR9 with RTX and tracebuf2 output format. A number of changes to the ShakeAlert processing, xml message format, and the usage of this information in the UserDisplay software were necessary to handle the new finite-fault and slip information from the FinDer and GPSlip algorithms. In addition, we have developed a framework for end-to-end off-line testing with archived and simulated waveform data using the Earthworm tankplayer. Detailed background information about the algorithms, processing, and results from these test runs will be presented.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

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

Geoethical issues involved in Tsunami Warning System concepts and operations

NASA Astrophysics Data System (ADS)

Charalampakis, Marinos; Papadopoulos, Gerassimos A.; Tinti, Stefano

2016-04-01

The main goal of a Tsunami Warning System (TWS) is to mitigate the effect of an incoming tsunami by alerting coastal population early enough to allow people to evacuate safely from inundation zones. Though this representation might seem oversimplified, nonetheless, achieving successfully this goal requires a positive synergy of geoscience, communication, emergency management, technology, education, social sciences, politics. Geoethical issues arise always when there is an interaction between geoscience and society, and TWS is a paradigmatic case where interaction is very strong and is made critical because a) the formulation of the tsunami alert has to be made in a time as short as possible and therefore on uncertain data, and b) any evaluation error (underestimation or overestimation) can lead to serious (and sometimes catastrophic) consequences involving wide areas and a large amount of population. From the geoethical point of view three issues are critical: how to (i) combine forecasts and uncertainties reasonably and usefully, (ii) cope and possibly solve the dilemma whether it is better over-alerting or under-alerting population and (iii) deal with responsibility and liability of geoscientists, TWS operators, emergency operators and coastal population. The discussion will be based on the experience of the Hellenic National Tsunami Warning Center (HL-NTWC, Greece), which operates on 24/7 basis as a special unit of the Institute of Geodynamics, National Observatory of Athens, and acts also as Candidate Tsunami Service Provider (CTSP) in the framework of the North-Eastern Atlantic, the Mediterranean and connected seas Tsunami Warning System (NEAMTWS) of the IOC/UNESCO. Since August 2012, when HL-NTWC was officially declared as operational, 14 tsunami warning messages have been disseminated to a large number of subscribers after strong submarine earthquakes occurring in Greece and elsewhere in the eastern Mediterranean. It is recognized that the alerting process and procedure are quite complex and deserve an open and wide debate, that at the moment seems to be absent from media, scientific community and society, very likely until the next tsunami disaster.

Alert Triage v 0.1 beta

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

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

2016-01-06

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

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

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

PubMed

Faure, D; Payrastre, O; Auchet, P

2005-01-01

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

Flight crew interface aspects of forward-looking airborne windshear detection systems

NASA Technical Reports Server (NTRS)

Anderson, Charles D.; Carbaugh, David C.

1993-01-01

The goal of this research effort was to conduct analyses and research which could provide guidelines for design of the crew interface of an integrated windshear system. Addressed were HF issues, crew/system requirements, candidate display formats, alerting criteria, and crew procedures. A survey identified five flight management issues as top priority: missed alert acceptability; avoidance distance needed; false alert acceptability; nuisance rate acceptability; and crew procedures. Results of a simulation study indicated that the warning time for a look-ahead alert needs to be between 11 and 36 seconds (target of 23 seconds) before the reactive system triggers in order to be effective. Pilots considered the standard go-around maneuver most appropriate for look-ahead alerts, and the escape maneuvers used did not require lateral turns. Prototype display formats were reviewed or developed for alerting the crew; providing guidance to avoid or escape windshear; and status displays to provide windshear situational awareness. The three alerting levels now in use were considered appropriate, with a fourth (time-critical) level as a possible addition, although many reviewers felt only two levels of alerting were needed. Another survey gathered expert opinion on what crew procedures and alerting criteria should be used for look-ahead, or integrated, windshear systems, with a wide diversity of opinion in these areas.

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

PubMed Central

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

1997-01-01

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

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

DOT National Transportation Integrated Search

2014-02-01

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

Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

NASA Astrophysics Data System (ADS)

Gerber, M.

2011-12-01

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

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

NASA Astrophysics Data System (ADS)

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

2013-04-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

A system to improve medication safety in the setting of acute kidney injury: initial provider response.

PubMed

McCoy, Allison B; McCoy, Allison Beck; Peterson, Josh F; Gadd, Cynthia S; Gadd, Cindy; Danciu, Ioana; Waitman, Lemuel R

2008-11-06

Clinical decision support systems can decrease common errors related to inappropriate or excessive dosing for nephrotoxic or renally cleared drugs. We developed a comprehensive medication safety intervention with varying levels of workflow intrusiveness within computerized provider order entry to continuously monitor for and alert providers about early-onset acute kidney injury. Initial provider response to the interventions shows potential success in improving medication safety and suggests future enhancements to increase effectiveness.

The Explosive Universe with Gaia

NASA Astrophysics Data System (ADS)

Wyrzykowski, Łukasz; Hodgkin, Simon T.; Blagorodnova, Nadejda; Belokurov, Vasily

2014-01-01

The Gaia mission will observe the entire sky for 5 years providing ultra-precise astrometric, photometric and spectroscopic measurements for a billion stars in the Galaxy. Hence, naturally, Gaia becomes an all-sky multi-epoch photometric survey, which will monitor and detect variability with millimag precision as well as new transient sources such as supernovae, novae, microlensing events, tidal disruption events, asteroids, among others. Gaia data-flow allows for quick detections of anomalies within 24-48h after the observation. Such near-real-time survey will be able to detect about 6000 supernovae brighter than 19 mag up to redshifts of Z 0.15. The on-board low-resolution (R 100) spectrograph will allow for early and robust classification of transients and minimise the false-alert rate, even providing the estimates on redshift for supernovae. Gaia will also offer a unique possibility for detecting astrometric shifts in microlensing events, which, combined with Gaia's and ground-based photometry, will provide unique mass measurements of lenses, constrains on the dark matter content in the Milky Way and possible detections of free floating black holes. Alerts from Gaia will be publicly available soon after the detection is verified and tested. First alerts are expected early in 2014 and those will be used for ground-based verification. All facilities are invited to join the verification and the follow-up effort. Alerts will be published on a web page, via Skyalert.org and via emailing list. Each alert will contain coordinates, Gaia light curve and low-resolution spectra, classification and cross-matching results. More information on the Gaia Science Alerts can be found here: http://www.ast.cam.ac.uk/ioa/wikis/gsawgwiki/ The full version of the poster is available here: http://www.ast.cam.ac.uk/ioa/wikis/gsawgwiki/images/1/13/GaiaAlertsPosterIAUS298.pdf

CISN ShakeAlert: Faster Warning Information Through Multiple Threshold Event Detection in the Virtual Seismologist (VS) Early Warning Algorithm

NASA Astrophysics Data System (ADS)

Cua, G. B.; Fischer, M.; Caprio, M.; Heaton, T. H.; Cisn Earthquake Early Warning Project Team

2010-12-01

The Virtual Seismologist (VS) earthquake early warning (EEW) algorithm is one of 3 EEW approaches being incorporated into the California Integrated Seismic Network (CISN) ShakeAlert system, a prototype EEW system that could potentially be implemented in California. The VS algorithm, implemented by the Swiss Seismological Service at ETH Zurich, is a Bayesian approach to EEW, wherein the most probable source estimate at any given time is a combination of contributions from a likehihood function that evolves in response to incoming data from the on-going earthquake, and selected prior information, which can include factors such as network topology, the Gutenberg-Richter relationship or previously observed seismicity. The VS codes have been running in real-time at the Southern California Seismic Network since July 2008, and at the Northern California Seismic Network since February 2009. We discuss recent enhancements to the VS EEW algorithm that are being integrated into CISN ShakeAlert. We developed and continue to test a multiple-threshold event detection scheme, which uses different association / location approaches depending on the peak amplitudes associated with an incoming P pick. With this scheme, an event with sufficiently high initial amplitudes can be declared on the basis of a single station, maximizing warning times for damaging events for which EEW is most relevant. Smaller, non-damaging events, which will have lower initial amplitudes, will require more picks to initiate an event declaration, with the goal of reducing false alarms. This transforms the VS codes from a regional EEW approach reliant on traditional location estimation (and the requirement of at least 4 picks as implemented by the Binder Earthworm phase associator) into an on-site/regional approach capable of providing a continuously evolving stream of EEW information starting from the first P-detection. Real-time and offline analysis on Swiss and California waveform datasets indicate that the multiple-threshold approach is faster and more reliable for larger events than the earlier version of the VS codes. In addition, we provide evolutionary estimates of the probability of false alarms (PFA), which is an envisioned output stream of the CISN ShakeAlert system. The real-time decision-making approach envisioned for CISN ShakeAlert users, where users specify a threshhold PFA in addition to thresholds on peak ground motion estimates, has the potential to increase the available warning time for users with high tolerance to false alarms without compromising the needs of users with lower tolerances to false alarms.

Novel public health risk assessment process developed to support syndromic surveillance for the 2012 Olympic and Paralympic Games.

PubMed

Smith, Gillian E; Elliot, Alex J; Ibbotson, Sue; Morbey, Roger; Edeghere, Obaghe; Hawker, Jeremy; Catchpole, Mike; Endericks, Tina; Fisher, Paul; McCloskey, Brian

2017-09-01

Syndromic surveillance aims to provide early warning and real time estimates of the extent of incidents; and reassurance about lack of impact of mass gatherings. We describe a novel public health risk assessment process to ensure those leading the response to the 2012 Olympic Games were alerted to unusual activity that was of potential public health importance, and not inundated with multiple statistical 'alarms'. Statistical alarms were assessed to identify those which needed to result in 'alerts' as reliably as possible. There was no previously developed method for this. We identified factors that increased our concern about an alarm suggesting that an 'alert' should be made. Between 2 July and 12 September 2012, 350 674 signals were analysed resulting in 4118 statistical alarms. Using the risk assessment process, 122 'alerts' were communicated to Olympic incident directors. Use of a novel risk assessment process enabled the interpretation of large number of statistical alarms in a manageable way for the period of a sustained mass gathering. This risk assessment process guided the prioritization and could be readily adapted to other surveillance systems. The process, which is novel to our knowledge, continues as a legacy of the Games. © Crown copyright 2016.

What to Expect from the Virtual Seismologist: Delay Times and Uncertainties of Initial Earthquake Alerts in California

NASA Astrophysics Data System (ADS)

Behr, Y.; Cua, G. B.; Clinton, J. F.; Racine, R.; Meier, M.; Cauzzi, C.

2013-12-01

The Virtual Seismologist (VS) method is a Bayesian approach to regional network-based earthquake early warning (EEW) originally formulated by Cua and Heaton (2007). Implementation of VS into real-time EEW codes has been an on-going effort of the Swiss Seismological Service at ETH Zürich since 2006, with support from ETH Zürich, various European projects, and the United States Geological Survey (USGS). VS is one of three EEW algorithms that form the basis of the California Integrated Seismic Network (CISN) ShakeAlert system, a USGS-funded prototype end-to-end EEW system that could potentially be implemented in California. In Europe, VS is currently operating as a real-time test system in Switzerland, western Greece and Istanbul. As part of the on-going EU project REAKT (Strategies and Tools for Real-Time Earthquake Risk Reduction), VS installations in southern Italy, Romania, and Iceland are planned or underway. The possible use cases for an EEW system will be determined by the speed and reliability of earthquake source parameter estimates. A thorough understanding of both is therefore essential to evaluate the usefulness of VS. For California, we present state-wide theoretical alert times for hypothetical earthquakes by analyzing time delays introduced by the different components in the VS EEW system. Taking advantage of the fully probabilistic formulation of the VS algorithm we further present an improved way to describe the uncertainties of every magnitude estimate by evaluating the width and shape of the probability density function that describes the relationship between waveform envelope amplitudes and magnitude. We evaluate these new uncertainty values for past seismicity in California through off-line playbacks and compare them to the previously defined static definitions of uncertainty based on real-time detections. Our results indicate where VS alerts are most useful in California and also suggest where most effective improvements to the VS EEW system can be made.

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

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

DOT National Transportation Integrated Search

2010-08-01

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

Implementing a national early awareness and alert system for new and emerging health technologies in Italy: the COTE Project.

PubMed

Migliore, Antonio; Perrini, Maria Rosaria; Jefferson, Tom; Cerbo, Marina

2012-07-01

The aim of this study was to establish a national Early Awareness and Alert (EAA) system for the identification and assessment of new and emerging health technologies in Italy. In 2008, Agenas, a public body supporting Regions and the Ministry of Health (MoH) in health services research, started a project named COTE (Observatory of New and Emerging Health Technologies) with the ultimate aim of implementing a national EAA system. The COTE project involved all stakeholders (MoH, Regions, Industry, Universities, technical government bodies, and Scientific Societies), in defining the key characteristics and methods of the EAA system. Agreement with stakeholders was reached using three separate workshops. During the workshops, participants shared and agreed methods for identification of new and emerging health technologies, prioritization, and assessment. The structure of the Horizon Scanning (HS) reports was discussed and defined. The main channels for dissemination of outputs were identified as the EuroScan database, and the stakeholders' Web portals. During the final workshop, Agenas presented the first three HS reports produced at national level and proposed the establishment of a permanent national EAA system. The COTE Project created the basis for a permanent national EAA system in Italy. An infrastructure to enable the stakeholders network to grow was created, methods to submit new and emerging health technologies for possible evaluation were established, methods for assessment of the technologies selected were defined, and the stakeholders involvement was delineated (in the identification, assessment, and dissemination stages).

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

PubMed Central

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

2014-01-01

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

Wearable PPG sensor based alertness scoring system.

PubMed

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

2017-07-01

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

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

PubMed Central

Norris, Patrick R.; Dawant, Benoit M.

2002-01-01

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

Implementation of a Seismic Early Warning System in Portugal Mainland

NASA Astrophysics Data System (ADS)

Madureira, Guilherme; Carrilho, Fernando

2017-04-01

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

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

PubMed Central

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

2018-01-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

33 CFR 101.310 - Additional communication devices.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Design and internal validation of an obstetric early warning score: secondary analysis of the Intensive Care National Audit and Research Centre Case Mix Programme database.

PubMed

Carle, C; Alexander, P; Columb, M; Johal, J

2013-04-01

We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to discriminate survivors from non-survivors in this critical care data set. Further work is needed to validate our new clinical early warning score externally in the obstetric ward environment. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Event-based internet biosurveillance: relation to epidemiological observation

PubMed Central

2012-01-01

Background The World Health Organization (WHO) collects and publishes surveillance data and statistics for select diseases, but traditional methods of gathering such data are time and labor intensive. Event-based biosurveillance, which utilizes a variety of Internet sources, complements traditional surveillance. In this study we assess the reliability of Internet biosurveillance and evaluate disease-specific alert criteria against epidemiological data. Methods We reviewed and compared WHO epidemiological data and Argus biosurveillance system data for pandemic (H1N1) 2009 (April 2009 – January 2010) from 8 regions and 122 countries to: identify reliable alert criteria among 15 Argus-defined categories; determine the degree of data correlation for disease progression; and assess timeliness of Internet information. Results Argus generated a total of 1,580 unique alerts; 5 alert categories generated statistically significant (p < 0.05) correlations with WHO case count data; the sum of these 5 categories was highly correlated with WHO case data (r = 0.81, p < 0.0001), with expected differences observed among the 8 regions. Argus reported first confirmed cases on the same day as WHO for 21 of the first 64 countries reporting cases, and 1 to 16 days (average 1.5 days) ahead of WHO for 42 of those countries. Conclusion Confirmed pandemic (H1N1) 2009 cases collected by Argus and WHO methods returned consistent results and confirmed the reliability and timeliness of Internet information. Disease-specific alert criteria provide situational awareness and may serve as proxy indicators to event progression and escalation in lieu of traditional surveillance data; alerts may identify early-warning indicators to another pandemic, preparing the public health community for disease events. PMID:22709988

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

NASA Technical Reports Server (NTRS)

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

2016-01-01

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

A mobile care system with alert mechanism.

PubMed

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

2007-09-01

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

Early On-Orbit Operation of the Loop Heat Pipe System on the Swift BAT Instrument

NASA Technical Reports Server (NTRS)

Ottenstein, Laura; Ku, Jentung; Choi, Mike; Feenan, Dave

2005-01-01

The Burst Alert Telescope (BAT) is one of three instruments on the Swift satellite. Two Loop Heat Pipes (LHP's), one at either side of the BAT's Detector Array Plate (DAP), transfer heat to a common radiator for rejection to space. This viewgraph presentation provides information on LHP design for the BAT, and the performance of the LHPs in orbit.

The CRADLE vital signs alert: qualitative evaluation of a novel device designed for use in pregnancy by healthcare workers in low-resource settings.

PubMed

Nathan, Hannah L; Boene, Helena; Munguambe, Khatia; Sevene, Esperança; Akeju, David; Adetoro, Olalekan O; Charanthimath, Umesh; Bellad, Mrutyunjaya B; de Greeff, Annemarie; Anthony, John; Hall, David R; Steyn, Wilhelm; Vidler, Marianne; von Dadelszen, Peter; Chappell, Lucy C; Sandall, Jane; Shennan, Andrew H

2018-01-05

Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis. This study evaluated the usability and acceptability of the CRADLE VSA device. Evaluation was conducted in community and primary care settings in India, Mozambique and Nigeria and tertiary hospitals in South Africa. Purposeful sampling was used to convene 155 interviews and six focus groups with healthcare workers using the device (n = 205) and pregnant women and their family members (n = 41). Interviews and focus groups were conducted in the local language and audio-recorded, transcribed and translated into English for analysis. Thematic analysis was undertaken using an a priori thematic framework, as well as an inductive approach. Most healthcare workers perceived the CRADLE device to be easy to use and accurate. The traffic lights early warning system was unanimously reported positively, giving healthcare workers confidence with decision-making and a sense of professionalism. However, a minority in South Africa described manual inflation as tiring, particularly when measuring vital signs in obese and hypertensive women (n = 4) and a few South African healthcare workers distrusted the device's accuracy (n = 7). Unanimously, pregnant women liked the CRADLE device. The traffic light early warning system gave women and their families a better understanding of the importance of vital signs in pregnancy and during the postpartum period. The CRADLE device was well accepted by healthcare workers from a range of countries and levels of facility, including those with no previous vital signs measurement experience. The device motivated women to attend primary care and encouraged them to accept treatment and referral.

Electronic rumble strip

NASA Astrophysics Data System (ADS)

Stauffer, Donald R.; Lenz, James

1997-02-01

Single vehicle run-off-road accidents are responsible for significant numbers of injuries and fatalities, and significant property damage. This fact spurs interest in warning systems to alert drivers that vehicles are drifting towards the edge of the road, and that a run-off road accident is imminent. An early attempt at such a warning system is the use of machined grooves on the shoulder to create a rumble strip. Such a system only provides warning, however, as the vehicle actually leaves the traffic lane. More desirable is a system that warns in anticipation of such departure. Honeywell has under development a magnetic lateral guidance system that couples a sensitive magnetoresistive transducer with a magnetic traffic marking tape being developed by 3M. While this development was initially undertaken for use in automated highways, or for special tasks such as guiding snowplow owners, the system can provide an effective, all-weather warning system to provide alert of impending departure from the roadway. This electronic rumble strip is actually a simpler system than the baseline guidance system, and can monitor both distance from the traffic lane edge and the speed of approach to the edge with a low cost sensor.

Enhanced early warning system impact on nursing practice: A phenomenological study.

PubMed

Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

2018-05-01

To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

Real-time alerts and reminders using information systems.

PubMed

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

2011-09-01

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

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

PubMed

Källhammer, Jan-Erik; Smith, Kip

2012-08-01

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

Automated detection of physiologic deterioration in hospitalized patients.

PubMed

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

2015-03-01

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

Intense illumination in the morning hours improved mood and alertness but not mental performance.

PubMed

Leichtfried, Veronika; Mair-Raggautz, Maria; Schaeffer, Viktoria; Hammerer-Lercher, Angelika; Mair, Gerald; Bartenbach, Christian; Canazei, Markus; Schobersberger, Wolfgang

2015-01-01

Cognitive performance and alertness are two determinants for work efficiency, varying throughout the day and depending on bright light. We conducted a prospective crossover study evaluating the impacts of exposure to an intense, early morning illumination on sustained attention, alertness, mood, and serum melatonin levels in 33 healthy individuals. Compared with a dim illumination, the intense illumination negatively impacted performance requiring sustained attention; however, it positively impacted subjective alertness and mood and had no impact on serum melatonin levels. These results suggest that brief exposure to bright light in the morning hours can improve subjective measures of mood and alertness, but can also have detrimental effects on mental performance as a result of visual distraction. Therefore, it is important that adequate lighting should correspond to both non-visual and visual demands. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Human Factors Considerations for Safe Recovery from Faults In Flight Control Systems

NASA Technical Reports Server (NTRS)

Pritchett, Amy; Belcastro, C. M. (Technical Monitor)

2003-01-01

It is now possible - and important - to develop systems to help resolve Flight Control System (FCS) faults. From a human factors viewpoint, it is imperative that these systems take on roles, and provide functions, that are the most supportive to the pilot, given the stress, time pressure and workload they may experience following a FCS fault. FCS fault recovery systems may provide several different functions, including alerting, control assistance, and decision aiding. The biggest human factors questions are in the role suitable for the technology, and its specific functioning to achieve that role. Specifically, for these systems to be effective, they must meet the fundamental requirements that (1) they alert pilots to problems early enough that the pilot can reasonably resolve the fault and regain control of the aircraft and that (2) if the aircraft s handling qualities are severely degraded the HMS provide the appropriate stability augmentation to help the pilot stabilize and control the aircraft. This project undertook several research steps to develop such systems, focusing on the capabilities of pilots and on realistically attainable technologies. The ability to estimate which functions are the most valuable will help steer system development in the directions that can establish the highest safety levels.

Comparative analytics of infusion pump data across multiple hospital systems.

PubMed

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

2015-02-15

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

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

PubMed

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

1994-12-01

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

Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

PubMed

Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

2014-07-01

Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and useful ways. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

78 FR 16806 - The Commercial Mobile Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-19

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.300 - Alert aggregator. [Reserved

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

PubMed Central

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

2001-01-01

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

A proposed Primary Health Early Warning Score (PHEWS) with emphasis on early detection of sepsis in the elderly.

PubMed

Anderson, Ian

2016-03-01

There are several secondary care early warning scores which alert for severe illness including sepsis. None are specifically adjusted for primary care. A Primary Health Early Warning Score (PHEWS) is proposed which incorporates practical parameters from both secondary and primary care.

A two-stage clinical decision support system for early recognition and stratification of patients with sepsis: an observational cohort study.

PubMed

Amland, Robert C; Lyons, Jason J; Greene, Tracy L; Haley, James M

2015-10-01

To examine the diagnostic accuracy of a two-stage clinical decision support system for early recognition and stratification of patients with sepsis. Observational cohort study employing a two-stage sepsis clinical decision support to recognise and stratify patients with sepsis. The stage one component was comprised of a cloud-based clinical decision support with 24/7 surveillance to detect patients at risk of sepsis. The cloud-based clinical decision support delivered notifications to the patients' designated nurse, who then electronically contacted a provider. The second stage component comprised a sepsis screening and stratification form integrated into the patient electronic health record, essentially an evidence-based decision aid, used by providers to assess patients at bedside. Urban, 284 acute bed community hospital in the USA; 16,000 hospitalisations annually. Data on 2620 adult patients were collected retrospectively in 2014 after the clinical decision support was implemented. 'Suspected infection' was the established gold standard to assess clinical decision support clinimetric performance. A sepsis alert activated on 417 (16%) of 2620 adult patients hospitalised. Applying 'suspected infection' as standard, the patient population characteristics showed 72% sensitivity and 73% positive predictive value. A postalert screening conducted by providers at bedside of 417 patients achieved 81% sensitivity and 94% positive predictive value. Providers documented against 89% patients with an alert activated by clinical decision support and completed 75% of bedside screening and stratification of patients with sepsis within one hour from notification. A clinical decision support binary alarm system with cross-checking functionality improves early recognition and facilitates stratification of patients with sepsis.

Performance of Earthquake Early Warning Systems during the Major Events of the 2016-2017 Central Italy Seismic Sequence.

NASA Astrophysics Data System (ADS)

Festa, G.; Picozzi, M.; Alessandro, C.; Colombelli, S.; Cattaneo, M.; Chiaraluce, L.; Elia, L.; Martino, C.; Marzorati, S.; Supino, M.; Zollo, A.

2017-12-01

Earthquake early warning systems (EEWS) are systems nowadays contributing to the seismic risk mitigation actions, both in terms of losses and societal resilience, by issuing an alert promptly after the earthquake origin and before the ground shaking impacts the targets to be protected. EEWS systems can be grouped in two main classes: network based and stand-alone systems. Network based EEWS make use of dense seismic networks surrounding the fault (e.g. Near Fault Observatory; NFO) generating the event. The rapid processing of the P-wave early portion allows for the location and magnitude estimation of the event then used to predict the shaking through ground motion prediction equations. Stand-alone systems instead analyze the early P-wave signal to predict the ground shaking carried by the late S or surface waves, through empirically calibrated scaling relationships, at the recording site itself. We compared the network-based (PRESTo, PRobabilistic and Evolutionary early warning SysTem, www.prestoews.org, Satriano et al., 2011) and the stand-alone (SAVE, on-Site-Alert-leVEl, Caruso et al., 2017) systems, by analyzing their performance during the 2016-2017 Central Italy sequence. We analyzed 9 earthquakes having magnitude 5.0 < M < 6.5 at about 200 stations located within 200 km from the epicentral area, including stations of The Altotiberina NFO (TABOO). Performances are evaluated in terms of rate of success of ground shaking intensity prediction and available lead-time, i.e. the time available for security actions. PRESTo also evaluated the accuracy of location and magnitude. Both systems well predict the ground shaking nearby the event source, with a success rate around 90% within the potential damage zone. The lead-time is significantly larger for the network based system, increasing to more than 10s at 40 km from the event epicentre. The stand-alone system better performs in the near-source region showing a positive albeit small lead-time (<3s). Far away from the source, the performances slightly degrade, mostly owing to uncertain calibration of attenuation relationships. This study opens to the possibility of making EEWS operational in Italy, based on the available acceleration networks, by improving the capability of reducing the lead-time related to data telemetry.

Evaluation of Epidemic Intelligence Systems Integrated in the Early Alerting and Reporting Project for the Detection of A/H5N1 Influenza Events

PubMed Central

Barboza, Philippe; Vaillant, Laetitia; Mawudeku, Abla; Nelson, Noele P.; Hartley, David M.; Madoff, Lawrence C.; Linge, Jens P.; Collier, Nigel; Brownstein, John S.; Yangarber, Roman; Astagneau, Pascal; on behalf of the Early Alerting, Reporting Project of the Global Health Security Initiative

2013-01-01

The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI) Early Alerting and Reporting (EAR) project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7–13.8). This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users. PMID:23472077

Evaluation of epidemic intelligence systems integrated in the early alerting and reporting project for the detection of A/H5N1 influenza events.

PubMed

Barboza, Philippe; Vaillant, Laetitia; Mawudeku, Abla; Nelson, Noele P; Hartley, David M; Madoff, Lawrence C; Linge, Jens P; Collier, Nigel; Brownstein, John S; Yangarber, Roman; Astagneau, Pascal

2013-01-01

The objective of Web-based expert epidemic intelligence systems is to detect health threats. The Global Health Security Initiative (GHSI) Early Alerting and Reporting (EAR) project was launched to assess the feasibility and opportunity for pooling epidemic intelligence data from seven expert systems. EAR participants completed a qualitative survey to document epidemic intelligence strategies and to assess perceptions regarding the systems performance. Timeliness and sensitivity were rated highly illustrating the value of the systems for epidemic intelligence. Weaknesses identified included representativeness, completeness and flexibility. These findings were corroborated by the quantitative analysis performed on signals potentially related to influenza A/H5N1 events occurring in March 2010. For the six systems for which this information was available, the detection rate ranged from 31% to 38%, and increased to 72% when considering the virtual combined system. The effective positive predictive values ranged from 3% to 24% and F1-scores ranged from 6% to 27%. System sensitivity ranged from 38% to 72%. An average difference of 23% was observed between the sensitivities calculated for human cases and epizootics, underlining the difficulties in developing an efficient algorithm for a single pathology. However, the sensitivity increased to 93% when the virtual combined system was considered, clearly illustrating complementarities between individual systems. The average delay between the detection of A/H5N1 events by the systems and their official reporting by WHO or OIE was 10.2 days (95% CI: 6.7-13.8). This work illustrates the diversity in implemented epidemic intelligence activities, differences in system's designs, and the potential added values and opportunities for synergy between systems, between users and between systems and users.

Lessons from Hawaii: A Blessing in Disguise.

PubMed

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

2018-03-20

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

Alert generation and cockpit presentation for an integrated microburst alerting system

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-18

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

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

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

DTIC Science & Technology

1984-12-01

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

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

PubMed

Degnan, Dan; Merryfield, Dave; Hultgren, Steve

2004-01-01

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

Modeling, Analyzing, and Mitigating Dissonance Between Alerting Systems

NASA Technical Reports Server (NTRS)

Song, Lixia; Kuchar, James K.

2003-01-01

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

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

PubMed Central

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

2016-01-01

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

Probabilistic and Evolutionary Early Warning System: concepts, performances, and case-studies

NASA Astrophysics Data System (ADS)

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

2013-12-01

PRESTo (PRobabilistic and Evolutionary early warning SysTem) is a software platform for Earthquake Early Warning that integrates algorithms for real-time earthquake location, magnitude estimation and damage assessment into a highly configurable and easily portable package. In its regional configuration, the software processes, in real-time, the 3-component acceleration data streams coming from seismic stations, for P-waves arrival detection and, in the case a quite large event is occurring, can promptly performs event detection and location, magnitude estimation and peak ground-motion prediction at target sites. The regional approach has been integrated with a threshold-based early warning method that allows, in the very first seconds after a moderate-to-large earthquake, to identify the most Probable Damaged Zone starting from the real-time measurement at near-source stations located at increasing distances from the earthquake epicenter, of the peak displacement (Pd) and predominant period of P-waves (τc), over a few-second long window after the P-wave arrival. Thus, each recording site independently provides an evolutionary alert level, according to the Pd and τc it measured, through a decisional table. Since 2009, PRESTo has been under continuous real-time testing using data streaming from the Iripinia Seismic Network (Southern Italy) and has produced a bulletin of some hundreds low magnitude events, including all the M≥2.5 earthquakes occurred in that period in Irpinia. Recently, PRESTo has been also implemented at the accelerometric network and broad-band networks in South Korea and in Romania, and off-line tested in Iberian Peninsula, in Turkey, in Israel, and in Japan. The feasibility of an Early Warning System at national scale, is currently under testing by studying the performances of the PRESTo platform for the Italian Accelerometric Network. Moreover, PRESTo is under experimentation in order to provide alert in a high-school located in the neighborhood of Naples at about 100 km from the Irpinia region.

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

PubMed

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

2018-05-09

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

Earthquake Early Warning: New Strategies for Seismic Hardware

NASA Astrophysics Data System (ADS)

Allardice, S.; Hill, P.

2017-12-01

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

Auditory alert systems with enhanced detectability

NASA Technical Reports Server (NTRS)

Begault, Durand R. (Inventor)

2008-01-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.310 - Federal alert gateway. [Reserved

Code of Federal Regulations, 2014 CFR

2014-10-01

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

Alerts Visualization and Clustering in Network-based Intrusion Detection

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

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

2010-04-01

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

Design Science Methodology Applied to a Chemical Surveillance Tool

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

Huang, Zhuanyi; Han, Kyungsik; Charles-Smith, Lauren E.

Public health surveillance systems gain significant benefits from integrating existing early incident detection systems,supported by closed data sources, with open source data.However, identifying potential alerting incidents relies on finding accurate, reliable sources and presenting the high volume of data in a way that increases analysts work efficiency; a challenge for any system that leverages open source data. In this paper, we present the design concept and the applied design science research methodology of ChemVeillance, a chemical analyst surveillance system.Our work portrays a system design and approach that translates theoretical methodology into practice creating a powerful surveillance system built for specificmore » use cases.Researchers, designers, developers, and related professionals in the health surveillance community can build upon the principles and methodology described here to enhance and broaden current surveillance systems leading to improved situational awareness based on a robust integrated early warning system.« less

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

NASA Astrophysics Data System (ADS)

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

2014-11-01

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

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

PubMed

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

2002-10-01

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

Utility of de-escalatory confidence-building measures

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

Nation, J.

1989-06-01

This paper evaluates the utility of specific confidence-building de-escalatory measures and pays special attention to the evaluation of measures which place restrictions on or establish procedures for strategic forces. Some measures appear more promising than others. Potentially useful confidence-building measures largely satisfy defined criteria and include the phased return of strategic nuclear forces to peacetime bases and operations, the termination of interference with communications and NTMs (National Technical Means) and the termination of civil defense preparations. Less-promising CBMs include the standing down of supplemental early warning systems, the establishment of SSBN keep-out zones, and decreases in bomber alert rates. Establishmentmore » of SSBN keep-out zones and reduction in bomber rates are difficult to verify, while the standing-down of early warning systems provides little benefit at potentially large costs. Particular confidence-building measures (CBMs) may be most useful in building superpower confidence at specific points in the crisis termination phase. For example, a decrease in strategic bomber alert rates may provide some decrease in perception of the likelihood of war, but its potential costs, particularly in increasing bomber vulnerability, may limit its utility and implementation to the final crisis stages when the risks of re-escalation and surprise attack are lower.« less

NASA aviation safety reporting system

NASA Technical Reports Server (NTRS)

1978-01-01

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

Early Warning System of Flood Disaster Based on Ultrasonic Sensors and Wireless Technology

NASA Astrophysics Data System (ADS)

Indrasari, W.; Iswanto, B. H.; Andayani, M.

2018-04-01

A flood disaster provides considerable losses to the people who live around the river. To mitigate losses of material due to flood disaster required an early warning system of flood disaster. For that reason, it necessary to design a system that provide alert to the people prior the flood disaster. And this paper describes development of a device for early detection system of flood disasters. This device consists of two ultrasonic sensors as a water level detector, and a water flow sensor as a water flow velocity sensor. The wireless technology and GSM is used as an information medium. The system is designed based on water level conditions in the Katulampa Dam, Bogor. Characterization of water level detector showed that the device effectively works in a range of water level of 14-250 cm, with a maximum relative error of 4.3%. Meanwhile the wireless works properly as far as 75 m, and the SMS transmission time is 8.20 second.

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

PubMed

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

2017-09-01

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

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

Code of Federal Regulations, 2012 CFR

2012-10-01

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

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

Code of Federal Regulations, 2014 CFR

2014-10-01

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

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

PubMed

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

2012-08-27

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

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

PubMed Central

2012-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-02-01

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

Maximizing Trust in the Wireless Emergency Alerts (WEA) Service

DTIC Science & Technology

2014-02-01

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

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

PubMed

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

2017-11-01

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

What is the utility of using syndromic surveillance systems during large subnational infectious gastrointestinal disease outbreaks? An observational study using case studies from the past 5 years in England.

PubMed

Todkill, D; Elliot, A J; Morbey, R; Harris, J; Hawker, J; Edeghere, O; Smith, G E

2016-08-01

Syndromic surveillance systems in England have demonstrated utility in the early identification of seasonal gastrointestinal illness (GI) tracking its spatio-temporal distribution and enabling early public health action. There would be additional public health utility if syndromic surveillance systems could detect or track subnational infectious disease outbreaks. To investigate using syndromic surveillance for this purpose we retrospectively identified eight large GI outbreaks between 2009 and 2014 (four randomly and four purposively sampled). We then examined syndromic surveillance information prospectively collected by the Real-time Syndromic Surveillance team within Public Health England for evidence of possible outbreak-related changes. None of the outbreaks were identified contemporaneously and no alerts were made to relevant public health teams. Retrospectively, two of the outbreaks - which happened at similar times and in proximal geographical locations - demonstrated changes in the local trends of relevant syndromic indicators and exhibited a clustering of statistical alarms, but did not warrant alerting local health protection teams. Our suite of syndromic surveillance systems may be more suited to their original purposes than as means of detecting or monitoring localized, subnational GI outbreaks. This should, however, be considered in the context of this study's limitations; further prospective work is needed to fully explore the use of syndromic surveillance for this purpose. Provided geographical coverage is sufficient, syndromic surveillance systems could be able to provide reassurance of no or minor excess healthcare systems usage during localized GI incidents.

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

47 CFR 10.410 - Prioritization.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

Generalized Philosophy of Alerting with Applications for Parallel Approach Collision Prevention

NASA Technical Reports Server (NTRS)

Winder, Lee F.; Kuchar, James K.

2000-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

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

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

NASA Technical Reports Server (NTRS)

Davies, Jason T.; Wu, Minghong G.

2018-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

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

Feasibility study of earthquake early warning (EEW) in Hawaii

USGS Publications Warehouse

Thelen, Weston A.; Hotovec-Ellis, Alicia J.; Bodin, Paul

2016-09-30

The effects of earthquake shaking on the population and infrastructure across the State of Hawaii could be catastrophic, and the high seismic hazard in the region emphasizes the likelihood of such an event. Earthquake early warning (EEW) has the potential to give several seconds of warning before strong shaking starts, and thus reduce loss of life and damage to property. The two approaches to EEW are (1) a network approach (such as ShakeAlert or ElarmS) where the regional seismic network is used to detect the earthquake and distribute the alarm and (2) a local approach where a critical facility has a single seismometer (or small array) and a warning system on the premises.The network approach, also referred to here as ShakeAlert or ElarmS, uses the closest stations within a regional seismic network to detect and characterize an earthquake. Most parameters used for a network approach require observations on multiple stations (typically 3 or 4), which slows down the alarm time slightly, but the alarms are generally more reliable than with single-station EEW approaches. The network approach also benefits from having stations closer to the source of any potentially damaging earthquake, so that alarms can be sent ahead to anyone who subscribes to receive the notification. Thus, a fully implemented ShakeAlert system can provide seconds of warning for both critical facilities and general populations ahead of damaging earthquake shaking.The cost to implement and maintain a fully operational ShakeAlert system is high compared to a local approach or single-station solution, but the benefits of a ShakeAlert system would be felt statewide—the warning times for strong shaking are potentially longer for most sources at most locations.The local approach, referred to herein as “single station,” uses measurements from a single seismometer to assess whether strong earthquake shaking can be expected. Because of the reliance on a single station, false alarms are more common than when using a regional network of seismometers. Given the current network, a single-station approach provides more warning for damaging earthquakes that occur close to the station, but it would have limited benefit compared to a fully implemented ShakeAlert system. For Honolulu, for example, the single-station approach provides an advantage over ShakeAlert only for earthquakes that occur in a narrow zone extending northeast and southwest of O‘ahu. Instrumentation and alarms associated with the single-station approach are typically maintained and assessed within the target facility, and thus no outside connectivity is required. A single-station approach, then, is unlikely to help broader populations beyond the individuals at the target facility, but they have the benefit of being commercially available for relatively little cost. The USGS Hawaiian Volcano Observatory (HVO) is the Advanced National Seismic System (ANSS) regional seismic network responsible for locating and characterizing earthquakes across the State of Hawaii. During 2014 and 2015, HVO tested a network-based EEW algorithm within the current seismic network in order to assess the suitability for building a full EEW system. Using the current seismic instrumentation and processing setup at HVO, it is possible for a network approach to release an alarm a little more than 3 seconds after the earthquake is recorded on the fourth seismometer. Presently, earthquakes having M≥3 detected with the ElarmS algorithm have an average location error of approximately 4.5 km and an average magnitude error of -0.3 compared to the reviewed catalog locations from the HVO. Additional stations and upgrades to existing seismic stations would serve to improve solution precision and warning times and additional staffing would be required to provide support for a robust, network-based EEW system. For a critical facility on the Island of Hawaiʻi, such as the telescopes atop Mauna Kea, one phased approach to mitigate losses could be to immediately install a single station system to establish some level of warning. Subsequently, supporting the implementation of a full network-based EEW system on the Island of Hawaiʻi would provide additional benefit in the form of improved warning times once the system is fully installed and operational, which may take several years. Distributed populations across the Hawaiian Islands, including those outside the major cities and far from the likely earthquake source areas, would likely only benefit from a network approach such as ShakeAlert to provide warnings of strong shaking.

The COMESEP Alert System

NASA Astrophysics Data System (ADS)

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

2014-05-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

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

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

PubMed

Breighner, Crystal M; Kashani, Kianoush B

2017-09-01

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

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

PubMed

Wasser, Tobias D; Fox, Patrick K

2013-01-01

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

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

PubMed Central

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

2007-01-01

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

Fast Identification of Near-Trench Earthquakes Along the Mexican Subduction Zone Based on Characteristics of Ground Motion in Mexico City

NASA Astrophysics Data System (ADS)

Perez-Campos, X.; Singh, S. K.; Arroyo, D.; Rodríguez, Q.; Iglesias, A.

2015-12-01

The disastrous 1985 Michoacan earthquake gave rise to a seismic alert system for Mexico City which became operational in 1991. Initially limited to earthquakes along the Guerrero coast, the system now has a much wider coverage. Also, the 2004 Sumatra earthquake exposed the need for a tsunami early warning along the Mexican subduction zone. A fast identification of near-trench earthquakes along this zone may be useful in issuing a reliable early tsunami alert. The confusion caused by low PGA for the magnitude of an earthquake, leading to "missed" seismic alert, would be averted if its near-trench origin can be quickly established. It may also help reveal the spatial extent and degree of seismic coupling on the near-trench portion of the plate interface. This would lead to a better understanding of tsunami potential and seismic hazard along the Mexican subduction zone. We explore three methods for quick detection of near-trench earthquakes, testing them on recordings of 65 earthquakes at station CU in Mexico City (4.8 ≤Mw≤8.0; 270≤R≤615 km). The first method is based on the ratio of total to high-frequency energy, ER (Shapiro et al., 1998). The second method is based on parameter Sa*(6) which is the pseudo-acceleration response spectrum with 5% damping, Sa, at 6 s normalized by the PGA. The third parameter is the PGA residual, RESN, at CU, with respect to a newly-derived ground motion prediction equation at CU for coastal shallow-dipping thrust earthquakes following a bayesian approach. Since the near-trench earthquakes are relatively deficient in high-frequency radiation, we expect ER and Sa*(6) to be relatively large and RESN to be negative for such events. Tests on CU recordings show that if ER ≥ 100 and/or Sa*(6) ≥ 0.70, then the earthquake is near trench; for these events RESN ≤ 0. Such an event has greater tsunami potential. Few misidentifications and missed events are most probably a consequence of poor location, although unusual depth and source characteristics may also be responsible in some cases. We propose routine computation of these parameters (along with location and magnitude) by the National Seismological Service of Mexico and dissemination of the information to other interested agencies which are in charge of tsunami alert, seismic alert, and near real time ground motion intensity maps for Mexico City.

Behavioral and Brain Measures of Phasic Alerting Effects on Visual Attention.

PubMed

Wiegand, Iris; Petersen, Anders; Finke, Kathrin; Bundesen, Claus; Lansner, Jon; Habekost, Thomas

2017-01-01

In the present study, we investigated effects of phasic alerting on visual attention in a partial report task, in which half of the displays were preceded by an auditory warning cue. Based on the computational Theory of Visual Attention (TVA), we estimated parameters of spatial and non-spatial aspects of visual attention and measured event-related lateralizations (ERLs) over visual processing areas. We found that the TVA parameter sensory effectiveness a , which is thought to reflect visual processing capacity, significantly increased with phasic alerting. By contrast, the distribution of visual processing resources according to task relevance and spatial position, as quantified in parameters top-down control α and spatial bias w index , was not modulated by phasic alerting. On the electrophysiological level, the latencies of ERLs in response to the task displays were reduced following the warning cue. These results suggest that phasic alerting facilitates visual processing in a general, unselective manner and that this effect originates in early stages of visual information processing.

Safety at The William Quarrier Scottish Epilepsy Centre.

PubMed

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

2017-12-01

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

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

PubMed

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

2015-11-01

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

Performance Evaluation of Evasion Maneuvers for Parallel Approach Collision Avoidance

NASA Technical Reports Server (NTRS)

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

2000-01-01

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

Participatory design for drug-drug interaction alerts.

PubMed

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

2015-01-01

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

The Casualty Network System Capstone Project

DTIC Science & Technology

2012-12-01

capable of recording and transmitting a variety of vital signs such as: pulse rate, respiratory rate, SpO2 , and skin temperature. The IBD transmits...monitor biometric data of each individual on the team. When the MM is combined with CBRN sensor detection, the device will alert in the network to...obvious. By constantly monitoring vital signs of the team involved early clues of exposure (such as decreased SpO2 , increased respiratory rate and

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-06

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-31

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

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

Triggering Interventions for Influenza: The ALERT Algorithm

PubMed Central

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

2015-01-01

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

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care.

PubMed

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

2017-08-01

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

Modeling Pilot State in Next Generation Aircraft Alert Systems

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

Un-Alerted Smoke and Fire: Checklist Content and Intended Crew Response

NASA Technical Reports Server (NTRS)

Burian, Barbara K.

2015-01-01

An in-flight smoke or fire event is an emergency unlike almost any other. The early cues for un-alerted conditions, such as air conditioning smoke or fire, are often ambiguous and elusive. The checklists crews use for these conditions must help them respond quickly and effectively and must guide their decisions. Ten years ago an industry committee developed a template to guide the content of Part 121 checklists for un-alerted smoke and fire events. This template is based upon a new philosophy about how crews should use the checklists and respond to the events. To determine the degree to which current un-alerted checklists of in-flight smoke or fire comply or are consistent with the guidance outlined in the template, I collected and analysed checklists from North American air carriers.

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

PubMed

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

2016-04-01

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

Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.

PubMed

Stipulante, Samuel; Tubes, Rebecca; El Fassi, Mehdi; Donneau, Anne-Francoise; Van Troyen, Barbara; Hartstein, Gary; D'Orio, Vincent; Ghuysen, Alexandre

2014-02-01

Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area. We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation. At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42.3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253s in 2009 and 168s in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09). From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

PubMed

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

2016-01-01

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

Demonstration of the Cascadia G‐FAST geodetic earthquake early warning system for the Nisqually, Washington, earthquake

USGS Publications Warehouse

Crowell, Brendan; Schmidt, David; Bodin, Paul; Vidale, John; Gomberg, Joan S.; Hartog, Renate; Kress, Victor; Melbourne, Tim; Santillian, Marcelo; Minson, Sarah E.; Jamison, Dylan

2016-01-01

A prototype earthquake early warning (EEW) system is currently in development in the Pacific Northwest. We have taken a two‐stage approach to EEW: (1) detection and initial characterization using strong‐motion data with the Earthquake Alarm Systems (ElarmS) seismic early warning package and (2) the triggering of geodetic modeling modules using Global Navigation Satellite Systems data that help provide robust estimates of large‐magnitude earthquakes. In this article we demonstrate the performance of the latter, the Geodetic First Approximation of Size and Time (G‐FAST) geodetic early warning system, using simulated displacements for the 2001Mw 6.8 Nisqually earthquake. We test the timing and performance of the two G‐FAST source characterization modules, peak ground displacement scaling, and Centroid Moment Tensor‐driven finite‐fault‐slip modeling under ideal, latent, noisy, and incomplete data conditions. We show good agreement between source parameters computed by G‐FAST with previously published and postprocessed seismic and geodetic results for all test cases and modeling modules, and we discuss the challenges with integration into the U.S. Geological Survey’s ShakeAlert EEW system.

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

PubMed

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

2015-03-01

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

Monitoring cow activity and rumination time for an early detection of heat stress in dairy cow

NASA Astrophysics Data System (ADS)

Abeni, Fabio; Galli, Andrea

2017-03-01

The aim of this study was to explore the use of cow activity and rumination time by precision livestock farming tools as early alert for heat stress (HS) detection. A total of 58 Italian Friesian cows were involved in this study during summer 2015. Based on the temperature humidity index (THI), two different conditions were compared on 16 primiparous and 11 multiparous, to be representative of three lactation phases: early (15-84 DIM), around peak (85-154 DIM), and plateau (155-224 DIM). A separate dataset for the assessment of the variance partition included all the cows in the herd from June 7 to July 16. The rumination time (RT2h, min/2 h) and activity index (AI2h, bouts/2 h) were summarized every 2-h interval. The raw data were used to calculate the following variables: total daily RT (RTt), daytime RT (RTd), nighttime RT (RTn), total daily AI (AIt), daytime AI (AId), and nighttime AI (AIn). Either AIt and AId increased, whereas RTt, RTd, and RTn decreased with higher THI in all the three phases. The highest decrease was recorded for RTd and ranged from 49 % (early) to 45 % (plateau). The contribution of the cow within lactation phase was above 60 % of the total variance for AI traits and a share from 33.9 % (for RTt) to 54.8 % (RTn) for RT traits. These observations must be extended to different feeding managements and different animal genetics to assess if different thresholds could be identified to set an early alert system for the farmer.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

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

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

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

Managing the Alert Process at NewYork-Presbyterian Hospital

PubMed Central

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

2005-01-01

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

Towards cross-lingual alerting for bursty epidemic events.

PubMed

Collier, Nigel

2011-10-06

Online news reports are increasingly becoming a source for event-based early warning systems that detect natural disasters. Harnessing the massive volume of information available from multilingual newswire presents as many challanges as opportunities due to the patterns of reporting complex spatio-temporal events. In this article we study the problem of utilising correlated event reports across languages. We track the evolution of 16 disease outbreaks using 5 temporal aberration detection algorithms on text-mined events classified according to disease and outbreak country. Using ProMED reports as a silver standard, comparative analysis of news data for 13 languages over a 129 day trial period showed improved sensitivity, F1 and timeliness across most models using cross-lingual events. We report a detailed case study analysis for Cholera in Angola 2010 which highlights the challenges faced in correlating news events with the silver standard. The results show that automated health surveillance using multilingual text mining has the potential to turn low value news into high value alerts if informed choices are used to govern the selection of models and data sources. An implementation of the C2 alerting algorithm using multilingual news is available at the BioCaster portal http://born.nii.ac.jp/?page=globalroundup.

Alert Response to Motion Onset in the Retina

PubMed Central

Chen, Eric Y.; Marre, Olivier; Fisher, Clark; Schwartz, Greg; Levy, Joshua; da Silveira, Rava Azeredo

2013-01-01

Previous studies have shown that motion onset is very effective at capturing attention and is more salient than smooth motion. Here, we find that this salience ranking is present already in the firing rate of retinal ganglion cells. By stimulating the retina with a bar that appears, stays still, and then starts moving, we demonstrate that a subset of salamander retinal ganglion cells, fast OFF cells, responds significantly more strongly to motion onset than to smooth motion. We refer to this phenomenon as an alert response to motion onset. We develop a computational model that predicts the time-varying firing rate of ganglion cells responding to the appearance, onset, and smooth motion of a bar. This model, termed the adaptive cascade model, consists of a ganglion cell that receives input from a layer of bipolar cells, represented by individual rectified subunits. Additionally, both the bipolar and ganglion cells have separate contrast gain control mechanisms. This model captured the responses to our different motion stimuli over a wide range of contrasts, speeds, and locations. The alert response to motion onset, together with its computational model, introduces a new mechanism of sophisticated motion processing that occurs early in the visual system. PMID:23283327

Human-In-The-Loop Investigation of Interoperability Between Terminal Sequencing and Spacing, Automated Terminal Proximity Alert, and Wake-Separation Recategorization

NASA Technical Reports Server (NTRS)

Callantine, Todd J.; Bienert, Nancy; Borade, Abhay; Gabriel, Conrad; Gujral, Vimmy; Jobe, Kim; Martin, Lynne; Omar, Faisal; Prevot, Thomas; Mercer, Joey

2016-01-01

A human-in-the-loop simulation study addressed terminal-area controller-workstation interface variations for interoperability between three new capabilities being introduced by the FAA. The capabilities are Terminal Sequencing and Spacing (TSAS), Automated Terminal Proximity Alert (ATPA), and wake-separation recategorization, or 'RECAT.' TSAS provides controllers with Controller-Managed Spacing (CMS) tools, including slot markers, speed advisories, and early/late indications, together with runway assignments and sequence numbers. ATPA provides automatic monitor, warning, and alert cones to inform controllers about spacing between aircraft on approach. ATPA cones are sized according to RECAT, an improved method of specifying wake-separation standards. The objective of the study was to identify potential issues and provide recommendations for integrating TSAS with ATPA and RECAT. Participants controlled arrival traffic under seven different display configurations, then tested an 'exploratory' configuration developed with participant input. All the display conditions were workable and acceptable, but controllers strongly preferred having the CMS tools available on Feeder positions, and both CMS tools and ATPA available on Final positions. Controllers found the integrated systems favorable and liked being able to tailor configurations to individual preferences.

A New Paradigm of Technology-Enabled ‘Vital Signs’ for Early Detection of Health Change for Older Adults.

PubMed

Rantz, Marilyn J; Skubic, Marjorie; Popescu, Mihail; Galambos, Colleen; Koopman, Richelle J; Alexander, Gregory L; Phillips, Lorraine J; Musterman, Katy; Back, Jessica; Miller, Steven J

2015-01-01

Environmentally embedded (nonwearable) sensor technology is in continuous use in elder housing to monitor a new set of ‘vital signs' that continuously measure the functional status of older adults, detect potential changes in health or functional status, and alert healthcare providers for early recognition and treatment of those changes. Older adult participants' respiration, pulse, and restlessness are monitored as they sleep. Gait speed, stride length, and stride time are calculated daily, and automatically assess for increasing fall risk. Activity levels are summarized and graphically displayed for easy interpretation. Falls are detected when they occur and alerts are sent immediately to healthcare providers, so time to rescue may be reduced. Automated health alerts are sent to healthcare staff, based on continuously running algorithms applied to the sensor data, days and weeks before typical signs or symptoms are detected by the person, family members, or healthcare providers. Discovering these new functional status ‘vital signs', developing automated methods for interpreting them, and alerting others when changes occur have the potential to transform chronic illness management and facilitate aging in place through the end of life. Key findings of research in progress at the University of Missouri are discussed in this viewpoint article, as well as obstacles to widespread adoption.

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

PubMed

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

2014-01-01

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

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

PubMed Central

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

1999-01-01

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

Bioalerts: a python library for the derivation of structural alerts from bioactivity and toxicity data sets.

PubMed

Cortes-Ciriano, Isidro

2016-01-01

Assessing compound toxicity at early stages of the drug discovery process is a crucial task to dismiss drug candidates likely to fail in clinical trials. Screening drug candidates against structural alerts, i.e. chemical fragments associated to a toxicological response prior or after being metabolized (bioactivation), has proved a valuable approach for this task. During the last decades, diverse algorithms have been proposed for the automatic derivation of structural alerts from categorical toxicity data sets. Here, the python library bioalerts is presented, which comprises functionalities for the automatic derivation of structural alerts from categorical (dichotomous), e.g. toxic/non-toxic, and continuous bioactivity data sets, e.g. [Formula: see text] or [Formula: see text] values. The library bioalerts relies on the RDKit implementation of the circular Morgan fingerprint algorithm to compute chemical substructures, which are derived by considering radial atom neighbourhoods of increasing bond radius. In addition to the derivation of structural alerts, bioalerts provides functionalities for the calculation of unhashed (keyed) Morgan fingerprints, which can be used in predictive bioactivity modelling with the advantage of allowing for a chemically meaningful deconvolution of the chemical space. Finally, bioalerts provides functionalities for the easy visualization of the derived structural alerts.

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

PubMed

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

2018-03-01

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

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

PubMed

Spates, R P; Aller, K C

1994-09-01

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

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

ERIC Educational Resources Information Center

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

2008-01-01

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

Neutrino detection of transient sources with optical follow-up observations

NASA Astrophysics Data System (ADS)

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

2010-12-01

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

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

PubMed

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

2018-05-15

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

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

PubMed

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

2014-12-01

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

Warning Alert HITL Experiment Results

NASA Technical Reports Server (NTRS)

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

2018-01-01

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

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

PubMed

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

2016-07-01

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

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

PubMed

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

2012-01-01

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

ECDC Round Table Report and ProMed-mail most useful international information sources for the Netherlands Early Warning Committee.

PubMed

Bijkerk, Paul; Monnier, Annelie A; Fanoy, Ewout B; Kardamanidis, Katina; Friesema, Ingrid Hm; Knol, Mirjam J

2017-04-06

The Netherlands Early Warning Committee (NEWC) aims to identify infectious diseases causing a potential threat to Dutch public health. Threats are assessed and published as (information) alerts for public health experts. To identify threats from abroad, the NEWC screens 10 sources reporting disease outbreaks each week. To identify the sources essential for complete and timely reporting, we retrospectively analysed 178 international alerts published between 31 January 2013 and 30 January 2014. In addition, we asked the four NEWC coordinators about the required time to scan the information sources. We documented the date and source in which the signal was detected. The ECDC Round Table (RT) Report and ProMED-mail were the most complete and timely sources, reporting 140 of 178 (79%) and 121 of 178 (68%) threats respectively. The combination of both sources reported 169 (95%) of all threats in a timely manner. Adding any of the other sources resulted in minor increases in the total threats found, but considerable additional time investment per additional threat. Only three potential relevant threats (2%) would have been missed by only using the ECDC RT Report and ProMed-mail. We concluded that using only the ECDC RT Report and ProMed-mail to identify threats from abroad maintains a sensitive Early Warning System. This article is copyright of The Authors, 2017.

ECDC Round Table Report and ProMed-mail most useful international information sources for the Netherlands Early Warning Committee

PubMed Central

Monnier, Annelie A; Fanoy, Ewout B; Kardamanidis, Katina; Friesema, Ingrid HM; Knol, Mirjam J

2017-01-01

The Netherlands Early Warning Committee (NEWC) aims to identify infectious diseases causing a potential threat to Dutch public health. Threats are assessed and published as (information) alerts for public health experts. To identify threats from abroad, the NEWC screens 10 sources reporting disease outbreaks each week. To identify the sources essential for complete and timely reporting, we retrospectively analysed 178 international alerts published between 31 January 2013 and 30 January 2014. In addition, we asked the four NEWC coordinators about the required time to scan the information sources. We documented the date and source in which the signal was detected. The ECDC Round Table (RT) Report and ProMED-mail were the most complete and timely sources, reporting 140 of 178 (79%) and 121 of 178 (68%) threats respectively. The combination of both sources reported 169 (95%) of all threats in a timely manner. Adding any of the other sources resulted in minor increases in the total threats found, but considerable additional time investment per additional threat. Only three potential relevant threats (2%) would have been missed by only using the ECDC RT Report and ProMed-mail. We concluded that using only the ECDC RT Report and ProMed-mail to identify threats from abroad maintains a sensitive Early Warning System. PMID:28422006

Rapid MODIS-based detection of tree cover loss

NASA Astrophysics Data System (ADS)

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

2018-07-01

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

A Context-Aware EEG Headset System for Early Detection of Driver Drowsiness.

PubMed

Li, Gang; Chung, Wan-Young

2015-08-21

Driver drowsiness is a major cause of mortality in traffic accidents worldwide. Electroencephalographic (EEG) signal, which reflects the brain activities, is more directly related to drowsiness. Thus, many Brain-Machine-Interface (BMI) systems have been proposed to detect driver drowsiness. However, detecting driver drowsiness at its early stage poses a major practical hurdle when using existing BMI systems. This study proposes a context-aware BMI system aimed to detect driver drowsiness at its early stage by enriching the EEG data with the intensity of head-movements. The proposed system is carefully designed for low-power consumption with on-chip feature extraction and low energy Bluetooth connection. Also, the proposed system is implemented using JAVA programming language as a mobile application for on-line analysis. In total, 266 datasets obtained from six subjects who participated in a one-hour monotonous driving simulation experiment were used to evaluate this system. According to a video-based reference, the proposed system obtained an overall detection accuracy of 82.71% for classifying alert and slightly drowsy events by using EEG data alone and 96.24% by using the hybrid data of head-movement and EEG. These results indicate that the combination of EEG data and head-movement contextual information constitutes a robust solution for the early detection of driver drowsiness.

A Context-Aware EEG Headset System for Early Detection of Driver Drowsiness

PubMed Central

Li, Gang; Chung, Wan-Young

2015-01-01

Driver drowsiness is a major cause of mortality in traffic accidents worldwide. Electroencephalographic (EEG) signal, which reflects the brain activities, is more directly related to drowsiness. Thus, many Brain-Machine-Interface (BMI) systems have been proposed to detect driver drowsiness. However, detecting driver drowsiness at its early stage poses a major practical hurdle when using existing BMI systems. This study proposes a context-aware BMI system aimed to detect driver drowsiness at its early stage by enriching the EEG data with the intensity of head-movements. The proposed system is carefully designed for low-power consumption with on-chip feature extraction and low energy Bluetooth connection. Also, the proposed system is implemented using JAVA programming language as a mobile application for on-line analysis. In total, 266 datasets obtained from six subjects who participated in a one-hour monotonous driving simulation experiment were used to evaluate this system. According to a video-based reference, the proposed system obtained an overall detection accuracy of 82.71% for classifying alert and slightly drowsy events by using EEG data alone and 96.24% by using the hybrid data of head-movement and EEG. These results indicate that the combination of EEG data and head-movement contextual information constitutes a robust solution for the early detection of driver drowsiness. PMID:26308002

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

PubMed Central

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

2010-01-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

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

PubMed

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

2014-11-01

A number of European and international IT platforms are used to notify competent authorities of new potential chemical exposures. Recently the European Parliament and the Council of European Union adopted new legislation that aims to improve the co-ordinated response to cross border health threats (Decision 1082/2013/EU). The Decision, inter alia, sets provisions on notification, ad hoc monitoring and coordination of public health measures following serious cross border threats to health from biological, chemical and environmental events as well as events that have an unknown origin. The legal instrument applies to all European Union Member States and is comparable to the International Health Regulations in its content, requirements and adoption of a multiple hazards approach. An inter-sectoral and multidisciplinary response to events with potentially dangerous cross border exposure pathways is often required. For example, European Poisons Centres may be aware of cases of toxic exposure to a product and, in parallel, trading standards may be aware of the same product due to a breach of consumer product standards. Whilst both cases would have been recorded for separate purposes in different alerting systems, they relate to the same exposure pathway; therefore a process for linking these records would allow a more robust approach to risk assessment and risk mitigation. The Decision seeks to reconcile this issue for serious threats by linking relevant platforms into one overarching higher level risk management IT platform called the Early Warning Response System (EWRS). This system will serve to link other sectors within the European Commission (EC) to public health (e.g. medicines), as well as other EU agencies and international bodies via co-notification features. Other European alert systems will be linked to EWRS to facilitate information sharing at both the assessment and management levels. This paper provides a timely overview of the main systems run by the EC and other international organisations that provide alerts following chemical incidents that have, or may have, the potential to affect public health. The advantages and further considerations of linking these different systems and sectors are also highlighted. Recommendations are made with the purpose of ensuring that modifications to these systems made to satisfy with EU legislation enable a more timely coordinated response and greater awareness of events in Europe, thereby reducing the public health impact from chemical exposures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Tactical Conflict Detection in Terminal Airspace

NASA Technical Reports Server (NTRS)

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

2010-01-01

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

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

PubMed

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

2018-05-04

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

'Outbreak Gold Standard' selection to provide optimized threshold for infectious diseases early-alert based on China Infectious Disease Automated-alert and Response System.

PubMed

Wang, Rui-Ping; Jiang, Yong-Gen; Zhao, Gen-Ming; Guo, Xiao-Qin; Michael, Engelgau

2017-12-01

The China Infectious Disease Automated-alert and Response System (CIDARS) was successfully implemented and became operational nationwide in 2008. The CIDARS plays an important role in and has been integrated into the routine outbreak monitoring efforts of the Center for Disease Control (CDC) at all levels in China. In the CIDARS, thresholds are determined using the "Mean+2SD‟ in the early stage which have limitations. This study compared the performance of optimized thresholds defined using the "Mean +2SD‟ method to the performance of 5 novel algorithms to select optimal "Outbreak Gold Standard (OGS)‟ and corresponding thresholds for outbreak detection. Data for infectious disease were organized by calendar week and year. The "Mean+2SD‟, C1, C2, moving average (MA), seasonal model (SM), and cumulative sum (CUSUM) algorithms were applied. Outbreak signals for the predicted value (Px) were calculated using a percentile-based moving window. When the outbreak signals generated by an algorithm were in line with a Px generated outbreak signal for each week, this Px was then defined as the optimized threshold for that algorithm. In this study, six infectious diseases were selected and classified into TYPE A (chickenpox and mumps), TYPE B (influenza and rubella) and TYPE C [hand foot and mouth disease (HFMD) and scarlet fever]. Optimized thresholds for chickenpox (P 55 ), mumps (P 50 ), influenza (P 40 , P 55 , and P 75 ), rubella (P 45 and P 75 ), HFMD (P 65 and P 70 ), and scarlet fever (P 75 and P 80 ) were identified. The C1, C2, CUSUM, SM, and MA algorithms were appropriate for TYPE A. All 6 algorithms were appropriate for TYPE B. C1 and CUSUM algorithms were appropriate for TYPE C. It is critical to incorporate more flexible algorithms as OGS into the CIDRAS and to identify the proper OGS and corresponding recommended optimized threshold by different infectious disease types.

Two spatiotemporally distinct value systems shape reward-based learning in the human brain.

PubMed

Fouragnan, Elsa; Retzler, Chris; Mullinger, Karen; Philiastides, Marios G

2015-09-08

Avoiding repeated mistakes and learning to reinforce rewarding decisions is critical for human survival and adaptive actions. Yet, the neural underpinnings of the value systems that encode different decision-outcomes remain elusive. Here coupling single-trial electroencephalography with simultaneously acquired functional magnetic resonance imaging, we uncover the spatiotemporal dynamics of two separate but interacting value systems encoding decision-outcomes. Consistent with a role in regulating alertness and switching behaviours, an early system is activated only by negative outcomes and engages arousal-related and motor-preparatory brain structures. Consistent with a role in reward-based learning, a later system differentially suppresses or activates regions of the human reward network in response to negative and positive outcomes, respectively. Following negative outcomes, the early system interacts and downregulates the late system, through a thalamic interaction with the ventral striatum. Critically, the strength of this coupling predicts participants' switching behaviour and avoidance learning, directly implicating the thalamostriatal pathway in reward-based learning.

The effect of augmented real-time image guidance on task workload during endoscopic sinus surgery.

PubMed

Dixon, Benjamin J; Chan, Harley; Daly, Michael J; Vescan, Allan D; Witterick, Ian J; Irish, Jonathan C

2012-01-01

Due to proximity to critical structures, the need for spatial awareness during endoscopic sinus surgery (ESS) is essential. We have developed an augmented, real-time image-guided surgery (ART-IGS) system that provides live navigational data and proximity alerts to the operating surgeon during ablation. We wished to test the hypothesis that task workload would be reduced when using this technology. A trial involved 8 otolaryngology residents and fellows performing ESS on cadaveric specimens; 1 side in a conventional method (control) and 1 side with ART-IGS. After computed tomography scanning, anatomical contouring, and registration of the head, a three-dimensional (3D) virtual endoscopic view, ablative tool tracking, and proximity alerts were enabled. Each subject completed ESS tasks and rated their workload during and after the exercise using the National Aeronautics and Space Administration (NASA) Task Load Index (TLX). A questionnaire and open feedback interview were completed after the procedure. There was a significant reduction in mental demand, temporal demand, effort, and frustration when using the ART-IGS system in comparison to the control (p < 0.02). Perceived performance was increased (p = 0.02). Most subjects agreed that the system was sufficiently accurate, caused minimal interruption, and increased confidence. Optical tracking line-of-sight issues were frequently cited as the main limitation early in the study; however, this was largely resolved. ART-IGS reduces task workload for trainees performing ESS. Live navigation and alert zones may be a valuable intraoperative teaching aid. Copyright © 2012 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

Applied simulations and integrated modelling for the understanding of toxic and harmful algal blooms (ASIMUTH): Integrated HAB forecast systems for Europe's Atlantic Arc.

PubMed

Maguire, Julie; Cusack, Caroline; Ruiz-Villarreal, Manuel; Silke, Joe; McElligott, Deirdre; Davidson, Keith

2016-03-01

Reasons for the emergent interest in HABs are abundant, including concerns associated with human health, adverse effects on biological resources, economic losses attributed to recreation, tourism and seafood related industries, and the cost of maintaining public advisory services and monitoring programs for shellfish toxins and water quality. The impact of HABs can potentially be mitigated by early warning of their development. In this regard the project ASIMUTH (Applied Simulations and Integrated Modelling for the Understanding of Toxic and Harmful algal blooms) was borne in order to develop short term HAB alert systems for Atlantic Europe. This was achieved using information on the most current marine conditions (weather, water characteristics, toxicity, harmful algal presence etc.) combined with high resolution local numerical predictions. This integrated, multidisciplinary, trans-boundary approach to the study of HABs developed during ASIMUTH led to a better understanding of the physical, chemical and ecological factors controlling these blooms, as well as their impact on human activities. The outcome was an appropriate alert system for an effective management of areas that are usually associated with HAB events and where these episodes may have a more significant negative impact on human activities. Specifically for the aquaculture industry, the information provided enabled farmers to adapt their working practices in time to prevent mortalities in finfish farms and/or manage their shellfish harvest more effectively. This paper summarises the modelling and alert developments generated by the ASIMUTH project. Copyright © 2015 Elsevier B.V. All rights reserved.

An Obstacle Alerting System for Agricultural Application

NASA Technical Reports Server (NTRS)

DeMaio, Joe

2003-01-01

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

Alert Exchange Process Protocol

NASA Technical Reports Server (NTRS)

Groen, Frank

2015-01-01

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

Developing the Framework for an Early Warning System for Ebola based on Environmental Conditions

NASA Astrophysics Data System (ADS)

Dartevelle, Sebastien; Nguy-Robertson, Anthony; Bell, Jesse; Chretien, Jean-Paul

2017-04-01

The 2014-2016 Ebola outbreak in West Africa indicated that this lethal disease can become a National Security issue as it crossed boarders and taxed regional health care systems. Ebola symptoms are also similar to other endemic diseases. Thus, forewarning of its possible presence can alert local public health facilities and populations, and may thereby reduce response time. Early work by our group has identified local climate (e.g. temperature, precipitation) and vegetation health (e.g. remote sensing using normalized difference vegetation index, NDVI) variables as leading indicators to known historical Ebola outbreaks. The environmental stress placed on the system as it reaches a climatic tipping point provides optimal conditions for spillover of Ebola virus from the reservoir host (which is unknown but suspected to be bats) to humans. This work outlines a framework for an approach to provide early warning maps based on the present state of the environment. Time series data from Climate Forecast System ver. 2 and AVHRR and MODIS satellite sensors are the basis for the early warning models used. These maps can provide policy makers and local health care professionals timely information for disease surveillance and preparation for future Ebola outbreaks.

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

NASA Technical Reports Server (NTRS)

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

2015-01-01

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

47 CFR 10.410 - Prioritization.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-15

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

CISN ShakeAlert: Improving the Virtual Seismologist (VS) earthquake early warning framework to provide faster, more robust warning information

NASA Astrophysics Data System (ADS)

Meier, M.; Cua, G. B.; Wiemer, S.; Fischer, M.

2011-12-01

The Virtual Seismologist (VS) method is a Bayesian approach to regional network-based earthquake early warning (EEW) that uses observed phase arrivals, ground motion amplitudes and selected prior information to estimate earthquake magnitude, location and origin time, and predict the distribution of peak ground motion throughout a region using envelope attenuation relationships. Implementation of the VS algorithm in California is an on-going effort of the Swiss Seismological Service (SED) at ETH Zürich. VS is one of three EEW algorithms - the other two being ElarmS (Allen and Kanamori, 2003) and On-Site (Wu and Kanamori, 2005; Boese et al., 2008) - that form the basis of the California Integrated Seismic Network ShakeAlert system, a prototype end-to-end EEW system that could potentially be implemented in California. The current prototype version of VS in California requires picks at 4 stations to initiate an event declaration. On average, taking into account data latency, variable station distribution, and processing time, this initial estimate is available about 20 seconds after the earthquake origin time, corresponding to a blind zone of about 70 km around the epicenter which would receive no warning, but where it would be the most useful. To increase the available warning time, we want to produce EEW estimates faster (with less than 4 stations). However, working with less than 4 stations with our current approach would increase the number of false alerts, for which there is very little tolerance in a useful EEW system. We explore the use of back-azimuth estimations and the Voronoi-based concept of not-yet-arrived data for reducing false alerts of the earliest VS estimates. The concept of not-yet-arrived data was originally used to provide evolutionary location estimates in EEW (Horiuchi, 2005; Cua and Heaton, 2007; Satriano et al. 2008). However, it can also be applied in discriminating between earthquake and non-earthquake signals. For real earthquakes, the constraints on earthquake location from the not-yet-arrived data and the back-azimuth estimations are consistent with location constraints from the available picks. For non-earthquake signals, these different location constraints are in most cases inconsistent. We use archived event data from the Northern and Southern California Seismic Networks as well as archived continuous waveform data from where the current VS codes erroneously declared events to quantify how using a combination of pick-based and not-yet-arrived data constraints can reduce VS false alert rates while providing faster warning information. The consistency of the pick-based and not-yet-arrived data constraints are mapped into the VS likelihood parameter, which reflects the degree of believe that the signals come from a real earthquake. This approach contributes towards improving the robustness of the Virtual Seismologist Multiple Threshold Event Detection (VS-MTED), which allows for single-station event declarations, when signal amplitudes are large enough.

Nocturnal sleep and daytime alertness of aircrew after transmeridian flights

NASA Technical Reports Server (NTRS)

Nicholson, Anthony N.; Pascoe, Peta A.; Spencer, Michael B.; Stone, Barbara M.; Green, Roger L.

1986-01-01

The nocturnal sleep and daytime alertness of aircrew were studied by electroencephalography and the multiple sleep latency test. After a transmeridian flight from London To San Francisco, sleep onset was faster and, although there was increased wakefulness during the second half of the night, sleep duration and efficiency over the whole night were not changed. The progressive decrease in sleep latencies observed normally in the multiple sleep latency test during the morning continued throughout the day after arrival. Of the 13 subjects, 12 took a nap of around 1-h duration in the afternoon preceding the return flight. These naps would have been encouraged by the drowsiness at this time and facilitated by the departure of the aircraft being scheduled during the early evening. An early evening departure had the further advantage that the circadian increase in vigilance expected during the early part of the day would occur during the latter part of the return flight.

Assessment of the implementation of a national patient safety alert to reduce wrong site surgery.

PubMed

Rhodes, P; Giles, S J; Cook, G A; Grange, A; Hayton, R; Maxwell, M J; Sheldon, T A; Wright, J

2008-12-01

In 2005, guidance on how to prevent wrong site surgery in the form of a national safety alert was issued to all NHS hospital trusts in England and Wales by the National Patient Safety Agency. To investigate the response to the alert among clinicians in England and Wales 12-15 months after it had been issued. A before-after study, using telephone/face-to-face interviews with consultant surgeons and senior nurses in ophthalmology, orthopaedics and urology in 11 NHS hospitals in England & Wales in the year prior to the alert and 12-15 months after. The interviews were coded and analysed thematically. The study revealed marked heterogeneity in organisational processes in response to a national alert. There was a significant change in surgeons' self-reported practice, with only 48% of surgeons routinely marking patients prior to the alert and 85% after (p<0.001). However, inter-specialty differences remained and change in practice was not always matched by change in attitude. Compliance with the detailed recommendations about how marking should be carried out was inconsistent. There were unintended consequences in terms of greater bureaucracy and concerns about diffusion of responsibility and hastily performed marking to enable release of patients from wards. The alert was effective in promoting presurgical marking and encouraging awareness of safety issues in relation to correct site surgery. However, care should be taken to monitor unintended consequences and whether change is sustained. Greater flexibility for local adaptation coupled with better design and early testing of safety alerts prior to national dissemination may facilitate more sustainable changes in practice.

A CBO Study. The Army’s Future Combat Systems Program and Alternatives

DTIC Science & Technology

2006-08-01

In addition, a brigade of the 82nd Airborne Division is always on alert and ready to be airlifted to a crisis anywhere in the world.sea. Their...at www.inetres.com/gp/ military/cv/index.html; and Christopher Foss, ed., Jane’s Armour and Artillery, 1979-1980 (New York: Wyatt Publishing, 1979). a...operations (usually 24 hours a day) are gen- erally sustained for limited periods—typically, 45 days—during the early stages of a crisis . After that, the

Monitoring cow activity and rumination time for an early detection of heat stress in dairy cow.

PubMed

Abeni, Fabio; Galli, Andrea

2017-03-01

The aim of this study was to explore the use of cow activity and rumination time by precision livestock farming tools as early alert for heat stress (HS) detection. A total of 58 Italian Friesian cows were involved in this study during summer 2015. Based on the temperature humidity index (THI), two different conditions were compared on 16 primiparous and 11 multiparous, to be representative of three lactation phases: early (15-84 DIM), around peak (85-154 DIM), and plateau (155-224 DIM). A separate dataset for the assessment of the variance partition included all the cows in the herd from June 7 to July 16. The rumination time (RT2h, min/2 h) and activity index (AI2h, bouts/2 h) were summarized every 2-h interval. The raw data were used to calculate the following variables: total daily RT (RTt), daytime RT (RTd), nighttime RT (RTn), total daily AI (AIt), daytime AI (AId), and nighttime AI (AIn). Either AIt and AId increased, whereas RTt, RTd, and RTn decreased with higher THI in all the three phases. The highest decrease was recorded for RTd and ranged from 49 % (early) to 45 % (plateau). The contribution of the cow within lactation phase was above 60 % of the total variance for AI traits and a share from 33.9 % (for RTt) to 54.8 % (RTn) for RT traits. These observations must be extended to different feeding managements and different animal genetics to assess if different thresholds could be identified to set an early alert system for the farmer.

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

PubMed

Pfeiffer, Yvonne; Schwappach, David

2016-01-01

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

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

PubMed

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

2014-11-01

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

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

PubMed

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

2015-05-01

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

Cockpit display of hazardous weather information

NASA Technical Reports Server (NTRS)

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

1991-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2015-11-01

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

A new method for determining a sector alert

DOT National Transportation Integrated Search

2008-09-29

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

A new approach to monitoring and alerting congestion in airspace sectors

DOT National Transportation Integrated Search

2014-09-28

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

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

PubMed

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

2018-05-08

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

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

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

Human Factors Evaluation of Conflict Detection Tool for Terminal Area

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

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

PubMed

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

2018-05-01

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

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

PubMed

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

2018-06-01

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

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.320 - Provider alert gateway requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.420 - Message elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 10.10 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 10.440 - Embedded reference prohibition.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Alert 2002 Ground Truth Missions for Arctic Shoreline Delineation and Feature Extraction

DTIC Science & Technology

2002-12-01

consid6r6e. DRDC Ottawa TM 2002-147 This page intentionally left blank. DRDC Ottawa TM 2002-147 Executive summary _ The current world vector shoreline...northern permanently inhabited settlement in the world . Alert was first settled in early 1950s as a joint Canada/US weather station. The Canadian...military station was established in 1958. During the Cold War it was Canada’s most important intercept station for monitoring the Soviet Union. There are

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

USGS Publications Warehouse

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

2012-01-01

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

Coordinated Displays to Assist Cyber Defenders

DTIC Science & Technology

2016-09-23

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

The Zwicky Transient Facility Public Alert Stream

NASA Astrophysics Data System (ADS)

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

2018-06-01

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

47 CFR 10.430 - Character limit.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Alerts Analysis and Visualization in Network-based Intrusion Detection Systems

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

Yang, Dr. Li

2010-08-01

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

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

PubMed

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

2016-01-01

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

Personalized and automated remote monitoring of atrial fibrillation.

PubMed

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

2016-03-01

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

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

PubMed Central

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

2001-01-01

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

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

PubMed

Krall, M A; Sittig, D F

2001-01-01

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

Bio-ALIRT biosurveillance detection algorithm evaluation.

PubMed

Siegrist, David; Pavlin, J

2004-09-24

Early detection of disease outbreaks by a medical biosurveillance system relies on two major components: 1) the contribution of early and reliable data sources and 2) the sensitivity, specificity, and timeliness of biosurveillance detection algorithms. This paper describes an effort to assess leading detection algorithms by arranging a common challenge problem and providing a common data set. The objectives of this study were to determine whether automated detection algorithms can reliably and quickly identify the onset of natural disease outbreaks that are surrogates for possible terrorist pathogen releases, and do so at acceptable false-alert rates (e.g., once every 2-6 weeks). Historic de-identified data were obtained from five metropolitan areas over 23 months; these data included International Classification of Diseases, Ninth Revision (ICD-9) codes related to respiratory and gastrointestinal illness syndromes. An outbreak detection group identified and labeled two natural disease outbreaks in these data and provided them to analysts for training of detection algorithms. All outbreaks in the remaining test data were identified but not revealed to the detection groups until after their analyses. The algorithms established a probability of outbreak for each day's counts. The probability of outbreak was assessed as an "actual" alert for different false-alert rates. The best algorithms were able to detect all of the outbreaks at false-alert rates of one every 2-6 weeks. They were often able to detect for the same day human investigators had identified as the true start of the outbreak. Because minimal data exists for an actual biologic attack, determining how quickly an algorithm might detect such an attack is difficult. However, application of these algorithms in combination with other data-analysis methods to historic outbreak data indicates that biosurveillance techniques for analyzing syndrome counts can rapidly detect seasonal respiratory and gastrointestinal illness outbreaks. Further research is needed to assess the value of electronic data sources for predictive detection. In addition, simulations need to be developed and implemented to better characterize the size and type of biologic attack that can be detected by current methods by challenging them under different projected operational conditions.

Perceptual evaluation of visual alerts in surveillance videos

NASA Astrophysics Data System (ADS)

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

2015-03-01

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

Reviving a medical wearable computer for teaching purposes.

PubMed

Frenger, Paul

2014-01-01

In 1978 the author constructed a medical wearable computer using an early CMOS microprocessor and support chips. This device was targeted for use by health-conscious consumers and other early adopters. Its expandable functions included weight management, blood pressure control, diabetes care, medication reminders, smoking cessation, pediatric growth and development, simple medical database, digital communication with a doctor’s office and emergency alert system. Various physiological sensors could be plugged-into the calculator-sized chassis. The device was shown to investor groups but funding was not obtained; by 1992 the author ceased pursuing it. The Computing and Mathematics Chair at a local University, a NASA acquaintance, approached the author to mentor a CS capstone course for Summer 2012. With the author’s guidance, five students proceeded to convert this medical wearable computer design to an iPhone-based implementation using the Apple Xcode Developer Kit and other utilities. The final student device contained a body mass index (BMI) calculator, an emergency alert for 911 or other first responders, a medication reminder, a Doctor’s appointment feature, a medical database, medical Internet links, and a pediatric growth & development guide. The students’ final imple-mentation was successfully demonstrated on an actual iPhone 4 at the CS capstone meeting in mid-Summer.

An investigation of air transportation technology at the Massachusetts Institute of Technology, 1990-1991

NASA Technical Reports Server (NTRS)

Simpson, Robert W.

1991-01-01

Brief summaries are given of research activities at the Massachusetts Institute of Technology (MIT) under the sponsorship of the FAA/NASA Joint University Program. Topics covered include hazard assessment and cockpit presentation issues for microburst alerting systems; the situational awareness effect of automated air traffic control (ATC) datalink clearance amendments; a graphical simulation system for adaptive, automated approach spacing; an expert system for temporal planning with application to runway configuration management; deterministic multi-zone ice accretion modeling; alert generation and cockpit presentation for an integrated microburst alerting system; and passive infrared ice detection for helicopter applications.

Adapting the EDuMaP method to test the performance of the Norwegian early warning system for weather-induced landslides

NASA Astrophysics Data System (ADS)

Piciullo, Luca; Dahl, Mads-Peter; Devoli, Graziella; Colleuille, Hervé; Calvello, Michele

2017-06-01

The Norwegian national landslide early warning system (LEWS), operational since 2013, is managed by the Norwegian Water Resources and Energy Directorate and was designed for monitoring and forecasting the hydrometeorological conditions potentially triggering slope failures. Decision-making in the LEWS is based upon rainfall thresholds, hydrometeorological and real-time landslide observations as well as on landslide inventory and susceptibility maps. Daily alerts are issued throughout the country considering variable size warning zones. Warnings are issued once per day for the following 3 days and can be updated according to weather forecasts and information gathered by the monitoring network. The performance of the LEWS operational in Norway has been evaluated applying the EDuMaP method, which is based on the computation of a duration matrix relating number of landslides and warning levels issued in a warning zone. In the past, this method has been exclusively employed to analyse the performance of regional early warning models considering fixed warning zones. Herein, an original approach is proposed for the computation of the elements of the duration matrix in the case of early warning models issuing alerts on variable size areas. The approach has been used to evaluate the warnings issued in Western Norway, in the period 2013-2014, considering two datasets of landslides. The results indicate that the landslide datasets do not significantly influence the performance evaluation, although a slightly better performance is registered for the smallest dataset. Different performance results are observed as a function of the values adopted for one of the most important input parameters of EDuMaP, the landslide density criterion (i.e. setting the thresholds to differentiate among classes of landslide events). To investigate this issue, a parametric analysis has been conducted; the results of the analysis show significant differences among computed performances when absolute or relative landslide density criteria are considered.

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2013 CFR

2013-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2012 CFR

2012-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2010 CFR

2010-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

14 CFR 135.150 - Public address and crewmember interphone systems.

Code of Federal Regulations, 2011 CFR

2011-01-01

... to alert flight crewmembers; (iii) For the alerting system required by paragraph (b)(7)(ii) of this... systems. 135.150 Section 135.150 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... Aircraft and Equipment § 135.150 Public address and crewmember interphone systems. No person may operate an...

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

DOT National Transportation Integrated Search

2017-06-01

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

76 FR 11846 - Seventy-second Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

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

76 FR 58077 - Seventy-Third Meeting: RTCA Special Committee 147: Minimum Operational Performance Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

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

Delivering Alert Messages to Members of a Work Force

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

Solar radiation alert system : final report.

DOT National Transportation Integrated Search

2009-03-01

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

Speech Alarms Pilot Study

NASA Technical Reports Server (NTRS)

Sandor, A.; Moses, H. R.

2016-01-01

Currently on the International Space Station (ISS) and other space vehicles Caution & Warning (C&W) alerts are represented with various auditory tones that correspond to the type of event. This system relies on the crew's ability to remember what each tone represents in a high stress, high workload environment when responding to the alert. Furthermore, crew receive a year or more in advance of the mission that makes remembering the semantic meaning of the alerts more difficult. The current system works for missions conducted close to Earth where ground operators can assist as needed. On long duration missions, however, they will need to work off-nominal events autonomously. There is evidence that speech alarms may be easier and faster to recognize, especially during an off-nominal event. The Information Presentation Directed Research Project (FY07-FY09) funded by the Human Research Program included several studies investigating C&W alerts. The studies evaluated tone alerts currently in use with NASA flight deck displays along with candidate speech alerts. A follow-on study used four types of speech alerts to investigate how quickly various types of auditory alerts with and without a speech component - either at the beginning or at the end of the tone - can be identified. Even though crew were familiar with the tone alert from training or direct mission experience, alerts starting with a speech component were identified faster than alerts starting with a tone. The current study replicated the results from the previous study in a more rigorous experimental design to determine if the candidate speech alarms are ready for transition to operations or if more research is needed. Four types of alarms (caution, warning, fire, and depressurization) were presented to participants in both tone and speech formats in laboratory settings and later in the Human Exploration Research Analog (HERA). In the laboratory study, the alerts were presented by software and participants were asked to identify the alert as quickly and as accurately as possible. Reaction time and accuracy were measured. Participants identified speech alerts significantly faster than tone alerts. The HERA study investigated the performance of participants in a flight-like environment. Participants were instructed to complete items on a task list and respond to C&W alerts as they occurred. Reaction time and accuracy were measured to determine if the benefits of speech alarms are still present in an applied setting.

A Multidisciplinary Sepsis Program Enabled by a Two-Stage Clinical Decision Support System: Factors That Influence Patient Outcomes.

PubMed

Amland, Robert C; Haley, James M; Lyons, Jason J

2016-11-01

Sepsis is an inflammatory response triggered by infection, with risk of in-hospital mortality fueled by disease progression. Early recognition and intervention by multidisciplinary sepsis programs may reverse the inflammatory response among at-risk patient populations, potentially improving outcomes. This retrospective study of a sepsis program enabled by a 2-stage sepsis Clinical Decision Support (CDS) system sought to evaluate the program's impact, identify early indicators that may influence outcomes, and uncover opportunities for quality improvement. Data encompassed 16 527 adult hospitalizations from 2014 and 2015. Of 2108 non-intensive care unit patients screened-in by sepsis CDS, 97% patients were stratified by 177 providers. Risk of adverse outcome improved 30% from baseline to year end, with gains materializing and stabilizing at month 7 after sepsis program go-live. Early indicators likely to influence outcomes include patient age, recent hospitalization, electrolyte abnormalities, hypovolemic shock, hypoxemia, patient location when sepsis CDS activated, and specific alert patterns. © The Author(s) 2015.

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

PubMed

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

2016-03-11

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

Benefit Value to the Air Force of the GIDEP (Government Industry Data Exchange Program) Alert

DTIC Science & Technology

1984-06-15

cost avoidance within that organization is not the result of the ALERT system . 3-1 b) Designed Life - This is the expected life of the item as...Analytics1 Phase II efforts under contract F33615-S3- C-5098. The main findings of the report are: (1) The system set up to handle Government...slow to issue ALERTs. (4) There is no formally documented system for determining that the Air Force’s warranty rights are being enforced on items

An Automated Sample Preparation Instrument to Accelerate Positive Blood Cultures Microbial Identification by MALDI-TOF Mass Spectrometry (Vitek®MS).

PubMed

Broyer, Patrick; Perrot, Nadine; Rostaing, Hervé; Blaze, Jérome; Pinston, Frederic; Gervasi, Gaspard; Charles, Marie-Hélène; Dachaud, Fabien; Dachaud, Jacques; Moulin, Frederic; Cordier, Sylvain; Dauwalder, Olivier; Meugnier, Hélène; Vandenesch, Francois

2018-01-01

Sepsis is the leading cause of death among patients in intensive care units (ICUs) requiring an early diagnosis to introduce efficient therapeutic intervention. Rapid identification (ID) of a causative pathogen is key to guide directed antimicrobial selection and was recently shown to reduce hospitalization length in ICUs. Direct processing of positive blood cultures by MALDI-TOF MS technology is one of the several currently available tools used to generate rapid microbial ID. However, all recently published protocols are still manual and time consuming, requiring dedicated technician availability and specific strategies for batch processing. We present here a new prototype instrument for automated preparation of Vitek ® MS slides directly from positive blood culture broth based on an "all-in-one" extraction strip. This bench top instrument was evaluated on 111 and 22 organisms processed using artificially inoculated blood culture bottles in the BacT/ALERT ® 3D (SA/SN blood culture bottles) or the BacT/ALERT Virtuo TM system (FA/FN Plus bottles), respectively. Overall, this new preparation station provided reliable and accurate Vitek MS species-level identification of 87% (Gram-negative bacteria = 85%, Gram-positive bacteria = 88%, and yeast = 100%) when used with BacT/ALERT ® 3D and of 84% (Gram-negative bacteria = 86%, Gram-positive bacteria = 86%, and yeast = 75%) with Virtuo ® instruments, respectively. The prototype was then evaluated in a clinical microbiology laboratory on 102 clinical blood culture bottles and compared to routine laboratory ID procedures. Overall, the correlation of ID on monomicrobial bottles was 83% (Gram-negative bacteria = 89%, Gram-positive bacteria = 79%, and yeast = 78%), demonstrating roughly equivalent performance between manual and automatized extraction methods. This prototype instrument exhibited a high level of performance regardless of bottle type or BacT/ALERT system. Furthermore, blood culture workflow could potentially be improved by converting direct ID of positive blood cultures from a batch-based to real-time and "on-demand" process.

Safety Alerts: An Observational Study in Portugal.

PubMed

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

2015-09-01

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

Improving the Quality of Alerts and Predicting Intruder's Next Goal with Hidden Colored Petri-Net

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

Yu, Dong; Frincke, Deb A.

2006-06-22

Intrusion detection systems (IDS) often provide poor quality alerts, which are insufficient to support rapid identification of ongoing attacks or predict an intruder’s next likely goal. In this paper, we propose a novel approach to alert post-processing and correlation, the Hidden Colored Petri-Net (HCPN). Different from most other alert correlation methods, our approach treats the alert correlation problem as an inference problem rather than a filter problem. Our approach assumes that the intruder’s actions are unknown to the IDS and can be inferred only from the alerts generated by the IDS sensors. HCPN can describe the relationship between different stepsmore » carried out by intruders, model observations (alerts) and transitions (actions) separately, and associate each token element (system state) with a probability (or confidence). The model is an extension to Colored Petri-Net (CPN) .It is so called “hidden” because the transitions (actions) are not directly observable but can be inferred by looking through the observations (alerts). These features make HCPN especially suitable for discovering intruders’ actions from their partial observations (alerts,) and predicting intruders’ next goal. Our experiments on DARPA evaluation datasets and the attack scenarios from the Grand Challenge Problem (GCP) show that HCPN has promise as a way to reducing false positives and negatives, predicting intruder’s next possible action, uncovering intruders’ intrusion strategies after the attack scenario has happened, and providing confidence scores.« less

'Desa SIAGA', the 'Alert Village': the evolution of an iconic brand in Indonesian public health strategies.

PubMed

Hill, Peter S; Goeman, Lieve; Sofiarini, Rahmi; Djara, Maddi M

2014-07-01

In 1999, the Ministry of Women's Empowerment in Indonesia worked with advertisers in Jakarta and international technical advisors to develop the concept of 'Suami SIAGA', the 'Alert Husband', confronting Indonesian males with their responsibilities to be aware of their wives' needs and ensure early access if needed to trained obstetrics care. The model was rapidly expanded to apply to the 'Desa SIAGA', the 'Alert Village', with communities assuming the responsibility for awareness of the risks of pregnancy and childbirth, and supporting registered pregnant mothers with funding and transportation for emergency obstetric assistance, and identified blood donors. Based on the participant observation, interviews and documentary analysis, this article uses a systems perspective to trace the evolution of that iconic 'brand' as new national and international actors further developed the concept and its application in provincial and national programmes. In 2010, it underwent a further transformation to become 'Desa Siaga Aktif', a national programme with responsibilities expanded to include the provision of basic health services at village level, and the surveillance of communicable disease, monitoring of lifestyle activities and disaster preparedness, in addition to the management of obstetric emergencies. By tracking the use of this single 'brand', the study provides insights into the complex adaptive system of policy and programme development with its rich interactions between multiple international, national, provincial and sectoral stakeholders, the unpredictable responses to feedback from these actors and their activities and the resultant emergence of new policy elements, new programmes and new levels of operation within the system. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

The effect of phasic auditory alerting on visual perception.

PubMed

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

2017-08-01

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

Effects of historical and predictive information on ability of transport pilot to predict an alert

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1994-01-01

In the aviation community, the early detection of the development of a possible subsystem problem during a flight is potentially useful for increasing the safety of the flight. Commercial airlines are currently using twin-engine aircraft for extended transport operations over water, and the early detection of a possible problem might increase the flight crew's options for safely landing the aircraft. One method for decreasing the severity of a developing problem is to predict the behavior of the problem so that appropriate corrective actions can be taken. To investigate the pilots' ability to predict long-term events, a computer workstation experiment was conducted in which 18 airline pilots predicted the alert time (the time to an alert) using 3 different dial displays and 3 different parameter behavior complexity levels. The three dial displays were as follows: standard (resembling current aircraft round dial presentations); history (indicating the current value plus the value of the parameter 5 sec in the past); and predictive (indicating the current value plus the value of the parameter 5 sec into the future). The time profiles describing the behavior of the parameter consisted of constant rate-of-change profiles, decelerating profiles, and accelerating-then-decelerating profiles. Although the pilots indicated that they preferred the near term predictive dial, the objective data did not support its use. The objective data did show that the time profiles had the most significant effect on performance in estimating the time to an alert.

Prescription order risk factors for pediatric dosing alerts.

PubMed

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

2015-02-01

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

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

PubMed Central

Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

2012-01-01

Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID:23024254

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

PubMed Central

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

2015-01-01

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

Development of the Carers' Alert Thermometer (CAT) to identify family carers struggling with caring for someone dying at home: a mixed method consensus study.

PubMed

Knighting, Katherine; O'Brien, Mary R; Roe, Brenda; Gandy, Rob; Lloyd-Williams, Mari; Nolan, Mike; Jack, Barbara A

2015-05-03

There is an increasing international policy direction to promote home death for dying patients which will impact on the demands placed on family carers. The early identification of carer needs and appropriate intervention can help avoid crisis situations for the carer and avoidable hospital admissions which are reported to be a global concern. The aim of the study was to explore what professionals and carers of patients with cancer and advanced progressive illness, in their last year of life, find burdensome and to develop an alert system for use by non-specialist staff. A mixed-method, multi-phased, consensus study sequentially utilising qualitative and quantitative data to develop and pilot the Carers' Alert Thermometer (CAT). 245 people (117 carers and 128 professionals) participated in the study across a range of health and social care settings in the North West of England (2011-2014). A number of key domains were identified and prioritised by consensus for inclusion in the CAT. The 8 domains fit within two overarching themes of the reported carer experience; the support needed by the carer to provide care and the support needed for the carer's own health and well-being. The resultant CAT is an evidence-based alert thermometer consisting of 10 questions, guidance on the possible actions for each alert and space for an action plan to be jointly agreed by the assessor and carer. Preliminary piloting of the CAT has shown it to be valued, fit for purpose and it can be administered by a range of personnel. The CAT enables the identification of current and potential future needs so a proactive approach can be taken to supporting the carer as their role develops over time, with a view to enhancing their well-being and preventing avoidable hospital admissions; ultimately supporting patient choice to remain in their own home.

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

47 CFR 80.1113 - Transmission of a distress alert.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert

PubMed Central

Downing, N. Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

2016-01-01

Summary Bachground Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. Objective To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. Methods The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Results Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. Conclusion We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems. PMID:27437061

Validation of Test Performance and Clinical Time Zero for an Electronic Health Record Embedded Severe Sepsis Alert.

PubMed

Rolnick, Joshua; Downing, N Lance; Shepard, John; Chu, Weihan; Tam, Julia; Wessels, Alexander; Li, Ron; Dietrich, Brian; Rudy, Michael; Castaneda, Leon; Shieh, Lisa

2016-01-01

Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact sepsis management. To develop, evaluate, and validate an accurate and timely severe sepsis alert embedded in a commercial EHR. The sepsis alert was developed by identifying the most common severe sepsis criteria among a cohort of patients with ICD 9 codes indicating a diagnosis of sepsis. This alert requires criteria in three categories: indicators of a systemic inflammatory response, evidence of suspected infection from physician orders, and markers of organ dysfunction. Chart review was used to evaluate test performance and the ability to detect clinical time zero, the point in time when a patient develops severe sepsis. Two physicians reviewed 100 positive cases and 75 negative cases. Based on this review, sensitivity was 74.5%, specificity was 86.0%, the positive predictive value was 50.3%, and the negative predictive value was 94.7%. The most common source of end-organ dysfunction was MAP less than 70 mm/Hg (59%). The alert was triggered at clinical time zero in 41% of cases and within three hours in 53.6% of cases. 96% of alerts triggered before a manual nurse screen. We are the first to report the time between a sepsis alert and physician chart-review clinical time zero. Incorporating physician orders in the alert criteria improves specificity while maintaining sensitivity, which is important to reduce alert fatigue. By leveraging standard EHR functionality, this alert could be implemented by other healthcare systems.

DAIDALUS Observations From UAS Integration in the NAS Project Flight Test 4

NASA Technical Reports Server (NTRS)

Vincent, Michael J.; Tsakpinis, Dimitrios

2016-01-01

In order to validate the Unmanned Aerial System (UAS) Detect-and-Avoid (DAA) solution proposed by standards body RTCA Inc., the National Aeronautics and Space Administration (NASA) UAS Integration in the NAS project, alongside industry members General Atomics and Honeywell, conducted the fourth flight test in a series at Armstrong Flight Research Center in Edwards, California. Flight Test 4 (FT4) investigated problems of interoperability with the TCAS collision avoidance system with a DAA system as well as problems associated with sensor uncertainty. A series of scripted flight encounters between the NASA Ikhana UAS and various "intruder" aircraft were flown while alerting and guidance from the DAA algorithm were recorded to investigate the timeliness of the alerts and correctness of the guidance triggered by the DAA system. The results found that alerts were triggered in a timely manner in most instances. Cases where the alerting and guidance was incorrect were investigated further.

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

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

PubMed

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

2012-01-01

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

Carbamates and ICH M7 classification: Making use of expert knowledge.

PubMed

Hemingway, Rachel; Fowkes, Adrian; Williams, Richard V

2017-06-01

Carbamates are widely used in the chemical industry so understanding their toxicity is important to safety assessment. Carbamates have been associated with certain toxicities resulting in publication of structural alerts, including alerts for mutagenicity. Structural alerts for bacterial mutagenicity can be used in combination with statistical systems to enable ICH M7 classification, which allows assessment of the genotoxic risk posed by pharmaceutical impurities. This study tested a hypothetical bacterial mutagenicity alert for carbamates and examined the impact it would have on ICH M7 classifications using (Q)SAR predictions from the expert rule-based system Derek Nexus and the statistical-based system Sarah Nexus. Public datasets have a low prevalence of mutagenic carbamates, which highlighted that systems containing an alert for carbamates perform poorly for achieving correct ICH M7 classifications. Carbamates are commonly used as protecting groups and proprietary datasets containing such compounds were also found to have a low prevalence of mutagenic compounds. Expert review of the mutagenic compounds established that mutagenicity was often only observed under certain (non-standard) conditions and more generally that the Ames test may be a poor predictor for the risk of carcinogenicity posed by chemicals in this class. Overall a structural alert for the in vitro bacterial mutagenesis of carbamates does not benefit workflows for assigning ICH M7 classification to impurities. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Transient Alerts in LSST

NASA Astrophysics Data System (ADS)

Kantor, J.

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

The Diagnostic Utility of Bact/ALERT and Nested PCR in the Diagnosis of Tuberculous Meningitis.

PubMed

Sastry, Apurba Sankar; Bhat K, Sandhya; Kumudavathi

2013-01-01

The early laboratory diagnosis of Tuberculous Meningitis (TBM) is crucial, to start the antitubercular chemotherapy and to prevent its complications. However, the conventional methods are either less sensitive or time consuming. Hence, the diagnostic potentials of BacT/ALERT and Polymerase Chain Reaction (PCR) was evaluated in this study. The study group comprised of 62 cases and 33 controls. The cases were divided according to Ahuja's criteria into the confirmed (two cases), highly probable (19 cases), probable (26 cases) and the possible (15 cases) subgroups. Ziehl Neelsen's (ZN) and Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) medium culture, BacT/ALERT and nested Polymerase Chain Reaction (PCR) which targeted IS6110 were carried out on all the patients. The sensitivity of the LJ culture was 3.22%. BacT/ALERT showed a sensitivity and a specificity of 25.80% and 100% and those of nested PCR were found to be 40.32% and 96.97% respectively. The mean detection time of growth of the LJ culture was 31.28 days, whereas that of BacT/ALERT was 20.68 days. The contamination rate in the LJ culture and BacT/ALERT were 7.2% and 5.8% respectively. Nested PCR was found to be more sensitive, followed by BacT/ALERT as compared to the LJ culture and smear microscopy. As both false negative and false positive results have been reported for nested PCR, so it should not be used alone as a criterion for initiating or terminating the therapy, but it should be supported by clinical, radiological, cytological and other microbiological findings.

Predictive Information: Status or Alert Information?

NASA Technical Reports Server (NTRS)

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

2008-01-01

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

PubMedAlertMe - Standalone Windows-based PubMed SDI Software Application

PubMed Central

Ma’ayan, Avi

2008-01-01

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

Implementing a Commercial Rule Base as a Medication Order Safety Net

PubMed Central

Reichley, Richard M.; Seaton, Terry L.; Resetar, Ervina; Micek, Scott T.; Scott, Karen L.; Fraser, Victoria J.; Dunagan, W. Claiborne; Bailey, Thomas C.

2005-01-01

A commercial rule base (Cerner Multum) was used to identify medication orders exceeding recommended dosage limits at five hospitals within BJC HealthCare, an integrated health care system. During initial testing, clinical pharmacists determined that there was an excessive number of nuisance and clinically insignificant alerts, with an overall alert rate of 9.2%. A method for customizing the commercial rule base was implemented to increase rule specificity for problematic rules. The system was subsequently deployed at two facilities and achieved alert rates of less than 1%. Pharmacists screened these alerts and contacted ordering physicians in 21% of cases. Physicians made therapeutic changes in response to 38% of alerts presented to them. By applying simple techniques to customize rules, commercial rule bases can be used to rapidly deploy a safety net to screen drug orders for excessive dosages, while preserving the rule architecture for later implementations of more finely tuned clinical decision support. PMID:15802481

Behavioral Modification of Intraoperative Hyperglycemia Management with a Novel Real-time Audiovisual Monitor.

PubMed

Sathishkumar, Subramanian; Lai, Manda; Picton, Paul; Kheterpal, Sachin; Morris, Michelle; Shanks, Amy; Ramachandran, Satya Krishna

2015-07-01

Hyperglycemia, defined as blood glucose (BG) levels above 200 mg/dl (11.1 mM), is associated with increased postoperative morbidity. Yet, the treatment standard for intraoperative glycemic control is poorly defined for noncardiac surgery. Little is known of the interindividual treatment variability or methods to modify intraoperative glycemic management behaviors. AlertWatch (AlertWatch, USA) is a novel audiovisual alert system that serves as a secondary patient monitor for use in operating rooms. The authors evaluated the influence of use of AlertWatch on intraoperative glycemic management behavior. AlertWatch displays historical patient data (risk factors and laboratory results) from multiple networked information systems, combined with the patient's live physiologic data. The authors extracted intraoperative data for 19 months to evaluate the relationship between AlertWatch usage and initiation of insulin treatment for hyperglycemia. Outcome associations were adjusted for physical status, case duration, procedural complexity, emergent procedure, fasting BG value, home insulin therapy, patient age, and primary anesthetist. Overall, 2,341 patients had documented intraoperative hyperglycemia. Use of AlertWatch (791 of 2,341; 33.5%) was associated with 55% increase in insulin treatment (496 of 791 [62.7%] with and 817 of 1,550 [52.7%] without AlertWatch; adjusted odds ratio [95% CI], 1.55 [1.23 to 1.95]; P < 0.001) and 44% increase in BG recheck after insulin administration (407 of 791 [51.5%] with AlertWatch and 655 of 1,550 [42.3%] in controls; adjusted odds ratio [95% CI], 1.44 [1.14 to 1.81]; P = 0.002). AlertWatch is associated with a significant increase in desirable intraoperative glycemic management behavior and may help achieve tighter intraoperative glycemic control.

Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.

PubMed

Hoste, Eric A J; Kashani, Kianoush; Gibney, Noel; Wilson, F Perry; Ronco, Claudio; Goldstein, Stuart L; Kellum, John A; Bagshaw, Sean M

2016-01-01

Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert. Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts. Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation. This paper reflects the findings of a non-systematic review and expert opinion. We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

Alerts in mobile healthcare applications: requirements and pilot study.

PubMed

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

2004-06-01

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

Evaluation of Helmet Mounted Display Alerting Symbology

NASA Technical Reports Server (NTRS)

DeMaio, Joe; Rutkowski, Michael (Technical Monitor)

2000-01-01

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

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

PubMed

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

2014-01-01

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

Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

NASA Astrophysics Data System (ADS)

Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

AGARD Flight Test Techniques Series. Volume 16. Introduction to Airborne Early Warning Radar Flight Test. (Introduction aux essais en vol des Radars Aeroportes d’Alerte Lointaine)

DTIC Science & Technology

1999-11-01

Acknowledgements The authors would like to acknowledge several people who contributed directly or indirectly to this book. First, to Bruce Hislop and Larry...McGraw Hill Publishing Company, 1980 . 27. Smith, L. J., and Matthews, N. 0., Aircraft Flight Test Data Processing-A Review of the State of the Art...AGARDograph 160, Volume 12, 1980 . 28. Smith, Sidney L. and Mosier, Jane N., Guidelines for Designing User Interfaces to Computer Based Systems, MITRE

75 FR 4760 - Review of the Emergency Alert System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

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

An approach for representing sensor data to validate alerts in Ambient Assisted Living.

PubMed

Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A

2012-01-01

The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations--obtained through an argumentation process--of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert.

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

PubMed

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

2013-12-01

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

Automated critical test result notification system: architecture, design, and assessment of provider satisfaction.

PubMed

Lacson, Ronilda; O'Connor, Stacy D; Andriole, Katherine P; Prevedello, Luciano M; Khorasani, Ramin

2014-11-01

Communicating critical results of diagnostic imaging procedures is a national patient safety goal. The purposes of this study were to describe the system architecture and design of Alert Notification of Critical Results (ANCR), an automated system designed to facilitate communication of critical imaging results between care providers; to report providers' satisfaction with ANCR; and to compare radiologists' and ordering providers' attitudes toward ANCR. The design decisions made for each step in the alert communication process, which includes user authentication, alert creation, alert communication, alert acknowledgment and management, alert reminder and escalation, and alert documentation, are described. To assess attitudes toward ANCR, internally developed and validated surveys were administered to all radiologists (n = 320) and ordering providers (n = 4323) who sent or received alerts 3 years after ANCR implementation. The survey response rates were 50.4% for radiologists and 36.1% for ordering providers. Ordering providers were generally dissatisfied with the training received for use of ANCR and with access to technical support. Radiologists were more satisfied with documenting critical result communication (61.1% vs 43.2%; p = 0.0001) and tracking critical results (51.6% vs 35.1%; p = 0.0003) than were ordering providers. Both groups agreed use of ANCR reduces medical errors and improves the quality of patient care. Use of ANCR enables automated communication of critical test results. The survey results confirm overall provider satisfaction with ANCR but highlight the need for improved training strategies for large numbers of geographically dispersed ordering providers. Future enhancements beyond acknowledging receipt of critical results are needed to help ensure timely and appropriate follow-up of critical results to improve quality and patient safety.

Automated Critical Test Result Notification System: Architecture, Design, and Assessment of Provider Satisfaction

PubMed Central

Lacson, Ronilda; O'Connor, Stacy D.; Andriole, Katherine P.; Prevedello, Luciano M.; Khorasani, Ramin

2015-01-01

OBJECTIVE Communicating critical results of diagnostic imaging procedures is a national patient safety goal. The purposes of this study were to describe the system architecture and design of Alert Notification of Critical Results (ANCR), an automated system designed to facilitate communication of critical imaging results between care providers; to report providers’ satisfaction with ANCR; and to compare radiologists’ and ordering providers’ attitudes toward ANCR. MATERIALS AND METHODS The design decisions made for each step in the alert communication process, which includes user authentication, alert creation, alert communication, alert acknowledgment and management, alert reminder and escalation, and alert documentation, are described. To assess attitudes toward ANCR, internally developed and validated surveys were administered to all radiologists (n = 320) and ordering providers (n = 4323) who sent or received alerts 3 years after ANCR implementation. RESULTS The survey response rates were 50.4% for radiologists and 36.1% for ordering providers. Ordering providers were generally dissatisfied with the training received for use of ANCR and with access to technical support. Radiologists were more satisfied with documenting critical result communication (61.1% vs 43.2%; p = 0.0001) and tracking critical results (51.6% vs 35.1%; p = 0.0003) than were ordering providers. Both groups agreed use of ANCR reduces medical errors and improves the quality of patient care. CONCLUSION Use of ANCR enables automated communication of critical test results. The survey results confirm overall provider satisfaction with ANCR but highlight the need for improved training strategies for large numbers of geographically dispersed ordering providers. Future enhancements beyond acknowledging receipt of critical results are needed to help ensure timely and appropriate follow-up of critical results to improve quality and patient safety. PMID:25341163

Combining Surveillance Systems: Effective Merging of U.S. Veteran and Military Health Data

DTIC Science & Technology

2016-08-04

respectively, and better in VA data for 34% and 15%. The VA system tended to alert earlier with a typical H3N2 seasonal influenza affecting older...manageable effect on customary alert rates. Citation: Pavlin JA, Burkom HS, Elbert Y, Lucero-Obusan C, Winston CA, et al. (2013) Combining...facilities within the CBSA. We applied ESSENCE alerting algorithms [11] to weekly CBSA-level outpatient data and analyzed the two data streams (DoD and VA

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

NASA Astrophysics Data System (ADS)

Tinti, Stefano; Armigliato, Alberto

2016-04-01

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

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2016-12-01

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

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

PubMed

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

2010-01-01

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

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

PubMed Central

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

2010-01-01

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

Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

PubMed Central

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

2008-01-01

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

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

DOT National Transportation Integrated Search

2001-04-01

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

Engine monitoring display study

NASA Technical Reports Server (NTRS)

Hornsby, Mary E.

1992-01-01

The current study is part of a larger NASA effort to develop displays for an engine-monitoring system to enable the crew to monitor engine parameter trends more effectively. The objective was to evaluate the operational utility of adding three types of information to the basic Boeing Engine Indicating and Crew Alerting System (EICAS) display formats: alphanumeric alerting messages for engine parameters whose values exceed caution or warning limits; alphanumeric messages to monitor engine parameters that deviate from expected values; and a graphic depiction of the range of expected values for current conditions. Ten training and line pilots each flew 15 simulated flight scenarios with five variants of the basic EICAS format; these variants included different combinations of the added information. The pilots detected engine problems more quickly when engine alerting messages were included in the display; adding a graphic depiction of the range of expected values did not affect detection speed. The pilots rated both types of alphanumeric messages (alert and monitor parameter) as more useful and easier to interpret than the graphic depiction. Integrating engine parameter messages into the EICAS alerting system appears to be both useful and preferred.

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

NASA Astrophysics Data System (ADS)

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

2004-09-01

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

[Health alert management and emerging risk].

PubMed

Pillonel, J

2010-12-01

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

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

DTIC Science & Technology

2017-09-01

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

Incidence of potential drug interactions in a transplant centre setting and relevance of electronic alerts for clinical practice support.

PubMed

Polidori, Piera; Di Giorgio, Concetta; Provenzani, Alessio

2012-01-01

Adverse drug events may occur as a result of drug-drug interactions (DDIs). Information technology (IT) systems can be an important decision-making tool for healthcare workers to identify DDIs. The aim of the study is to analyse drug prescriptions in our main hospital units, in order to measure the incidence and severity of potential DDIs. The utility of clinical decision-support systems (CDSSs) and computerised physician order entry (CPOE) in term of alerts adherence was also assessed. DDIs were assessed using a Micromedex® healthcare series database. The system, adopted by the hospital, generates alerts for prescriptions with negative interactions and thanks to an 'acknowledgement function' it is possible to verify physician adherence to alerts. This function, although used previously, became mandatory from September 2010. Physician adherence to alerts and mean monthly incidence of potential DDIs in analysed units, before and after the mandatory 'acknowledgement function', were calculated. The intensive care unit (ICU) registered the greatest incidence of potential DDIs (49.0%), followed by the abdominal surgery unit and dialysis (43.4 and 42.0%, respectively). The cardiothoracic surgery unit (41.6%), step-down unit (38.3%) and post-anaesthesia care unit (30.0%) were comparable. The operating theatre and endoscopy registered the fewest potential DDIs (28.2 and 22.7%, respectively). Adherence to alerts after the 'acknowledgement function' increased by 25.0% in the ICU, 54.0% in the cardiothoracic surgery unit, 52.5% in the abdominal surgery unit, 58.0% in the stepdown unit, 67.0% in dialysis, 51.0% in endoscopy and 48.0% in the post-anaesthesia care unit. In the operating theatre, adherence to alerts decreased from 34.0 to 30.0%. The incidence of potential DDIs after mandatory use of the 'acknowledgement function' decreased slightly in endoscopy (-2.9%), the abdominal surgery unit (-2.7%), dialysis (-1.9%) and the step-down unit (-1.4%). Improving DDI alerts will improved patient safety by more appropriately alerting clinicians.

Wearable Smart System for Visually Impaired People

PubMed Central

2018-01-01

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs. PMID:29533970

Wearable Smart System for Visually Impaired People.

PubMed

Ramadhan, Ali Jasim

2018-03-13

In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs.

Experimental Study of Collision Detection Schema Used by Pilots During Closely Spaced Parallel Approaches

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Hansman, R. John

1996-01-01

An experimental flight simulator study was conducted to examine the mental alerting logic and thresholds used by subjects to issue an alert and execute an avoidance maneuver. Subjects flew a series of autopilot landing approaches with traffic on a closely-spaced parallel approach; during some runs, the traffic would deviate towards the subject and the subject was to indicate the point when they recognized the potential traffic conflict, and then indicate a direction of flight for an avoidance maneuver. A variety of subjects, including graduate students, general aviation pilots and airline pilots, were tested. Five traffic displays were evaluated, with a moving map TCAS-type traffic display as a baseline. A side-task created both high and low workload situations. Subjects appeared to use the lateral deviation of the intruder aircraft from its approach path as the criteria for an alert regardless of the display available. However, with displays showing heading and/or trend information, their alerting thresholds were significantly lowered. This type of range-only schema still resulted in many near misses, as a high convergence rate was often established by the time of the subject's alert. Therefore, the properties of the intruder's trajectory had the greatest effect on the resultant near miss rate; no display system reliably caused alerts timely enough for certain collision avoidance. Subjects' performance dropped significantly on a side-task while they analyzed the need for an alert, showing alert generation can be a high workload situation at critical times. No variation was found between subjects with and with out piloting experience. These results suggest the design of automatic alerting systems should take into account the range-type alerting schema used by the human, such that the rationale for the automatic alert should be obvious to, and trusted by, the operator. Although careful display design may help generate pilot/automation trust, issues such as user non-conformance to automatically generated commands can remain a possibility.

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

NASA Astrophysics Data System (ADS)

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

2002-05-01

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

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

NASA Astrophysics Data System (ADS)

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

2011-12-01

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

The Early Development Index and Children from Culturally and Linguistically Diverse Backgrounds

ERIC Educational Resources Information Center

Li, Jianghong; D'Angiulli, Amedeo; Kendall, Garth E.

2007-01-01

The Early Development Index (EDI) is a teacher-completed checklist, intended to be a population-level tool to measure children's readiness for school and to alert communities to potential developmental problems in children. In response to the increasing popularity of the EDI, this paper provides a critical and timely evaluation and identifies the…

In-season monitoring of hip and groin strength, health and function in elite youth soccer: Implementing an early detection and management strategy over two consecutive seasons.

PubMed

Wollin, Martin; Thorborg, Kristian; Welvaert, Marijke; Pizzari, Tania

2018-03-14

The primary purpose of this study was to describe an early detection and management strategy when monitoring in-season hip and groin strength, health and function in soccer. Secondly to compare pre-season to in-season test results. Longitudinal cohort study. Twenty-seven elite male youth soccer players (age: 15.07±0.73years) volunteered to participate in the study. Monitoring tests included: adductor strength, adductor/abductor strength ratio and hip and groin outcome scores (HAGOS). Data were recorded at pre-season and at 22 monthly intervals in-season. Thresholds for alerts to initiate further investigations were defined as any of the following: adductor strength reductions >15%, adductor/abductor strength ratio <0.90, and HAGOS subscale scores <75 out of 100 in any of the six subscales. Overall, 105 alerts were detected involving 70% of players. Strength related alerts comprised 40% and remaining 60% of alerts were related to HAGOS. Hip adductor strength and adductor/abductor strength ratio were lowest at pre-season testing and had increased significantly by month two (p<0.01, mean difference 0.26, CI95%: 0.12, 0.41N/kg and p<0.01, mean difference 0.09, CI95%: 0.04, 0.13 respectively). HAGOS subscale scores were lowest at baseline with all, except Physical Activity, showing significant improvements at time-point one (p<0.01). Most (87%) time-loss were classified minimal or mild. In-season monitoring aimed at early detection and management of hip and groin strength, health and function appears promising. Hip and groin strength, health and function improved quickly from pre-season to in-season in a high-risk population for ongoing hip and groin problems. Copyright © 2018 Sports Medicine Australia. All rights reserved.

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

PubMed Central

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

2012-01-01

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

47 CFR 10.210 - CMAS participation election procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false CMAS participation election procedures. 10.210 Section 10.210 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.210 CMAS participation election procedures...

Intrusion Detection System Visualization of Network Alerts

DTIC Science & Technology

2010-07-01

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

How to select a proper early warning threshold to detect infectious disease outbreaks based on the China infectious disease automated alert and response system (CIDARS).

PubMed

Wang, Ruiping; Jiang, Yonggen; Michael, Engelgau; Zhao, Genming

2017-06-12

China Centre for Diseases Control and Prevention (CDC) developed the China Infectious Disease Automated Alert and Response System (CIDARS) in 2005. The CIDARS was used to strengthen infectious disease surveillance and aid in the early warning of outbreak. The CIDARS has been integrated into the routine outbreak monitoring efforts of the CDC at all levels in China. Early warning threshold is crucial for outbreak detection in the CIDARS, but CDCs at all level are currently using thresholds recommended by the China CDC, and these recommended thresholds have recognized limitations. Our study therefore seeks to explore an operational method to select the proper early warning threshold according to the epidemic features of local infectious diseases. The data used in this study were extracted from the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), and data for infectious disease cases were organized by calendar week (1-52) and year (2009-2015) in Excel format; Px was calculated using a percentile-based moving window (moving window [5 week*5 year], x), where x represents one of 12 centiles (0.40, 0.45, 0.50….0.95). Outbreak signals for the 12 Px were calculated using the moving percentile method (MPM) based on data from the CIDARS. When the outbreak signals generated by the 'mean + 2SD' gold standard were in line with a Px generated outbreak signal for each week during the year of 2014, this Px was then defined as the proper threshold for the infectious disease. Finally, the performance of new selected thresholds for each infectious disease was evaluated by simulated outbreak signals based on 2015 data. Six infectious diseases were selected in this study (chickenpox, mumps, hand foot and mouth diseases (HFMD), scarlet fever, influenza and rubella). Proper thresholds for chickenpox (P75), mumps (P80), influenza (P75), rubella (P45), HFMD (P75), and scarlet fever (P80) were identified. The selected proper thresholds for these 6 infectious diseases could detect almost all simulated outbreaks within a shorter time period compared to thresholds recommended by the China CDC. It is beneficial to select the proper early warning threshold to detect infectious disease aberrations based on characteristics and epidemic features of local diseases in the CIDARS.

Implementation of a computer-assisted monitoring system for the detection of adverse drug reactions in gastroenterology.

PubMed

Dormann, H; Criegee-Rieck, M; Neubert, A; Egger, T; Levy, M; Hahn, E G; Brune, K

2004-02-01

To investigate the effectiveness of a computer monitoring system that detects adverse drug reactions (ADRs) by laboratory signals in gastroenterology. A prospective, 6-month, pharmaco-epidemiological survey was carried out on a gastroenterological ward at the University Hospital Erlangen-Nuremberg. Two methods were used to identify ADRs. (i) All charts were reviewed daily by physicians and clinical pharmacists. (ii) A computer monitoring system generated a daily list of automatic laboratory signals and alerts of ADRs, including patient data and dates of events. One hundred and nine ADRs were detected in 474 admissions (377 patients). The computer monitoring system generated 4454 automatic laboratory signals from 39 819 laboratory parameters tested, and issued 2328 alerts, 914 (39%) of which were associated with ADRs; 574 (25%) were associated with ADR-positive admissions. Of all the alerts generated, signals of hepatotoxicity (1255), followed by coagulation disorders (407) and haematological toxicity (207), were prevalent. Correspondingly, the prevailing ADRs were concerned with the metabolic and hepato-gastrointestinal system (61). The sensitivity was 91%: 69 of 76 ADR-positive patients were indicated by an alert. The specificity of alerts was increased from 23% to 76% after implementation of an automatic laboratory signal trend monitoring algorithm. This study shows that a computer monitoring system is a useful tool for the systematic and automated detection of ADRs in gastroenterological patients.

Communication and Alert Maintenance Program for Early Response Act

THOMAS, 112th Congress

Rep. Richardson, Laura [D-CA-37

2011-09-07

House - 09/27/2011 Referred to the Subcommittee on Emergency Preparedness, Response and Communications. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

MiBAlert-a new information tool to fight multidrug-resistant bacteria in the hospital setting.

PubMed

Olesen, Bente; Anhøj, Jacob; Rasmussen, Kenneth Palle; Mølbak, Kåre; Voldstedlund, Marianne

2016-11-01

Although the timely isolation of patients is an essential intervention to limit spread of drug-resistant bacteria, information about the colonization status is often unavailable or lost when patients are readmitted or transferred between hospitals. Therefore, carriers of drug resistant bacteria are not recognized sufficiently early, and proper and timely isolation precautions are not taken. Consequently, resistant bacteria of public health concerns including vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) can spread epidemically. To ensure timely identification and proper isolation of such patients we developed an automatic real-time alert of carriers of drug resistant bacteria. The aim of this paper is to describe the system, called MiBAlert, and share the initial experiences in connection with an outbreak of VRE in the greater Copenhagen area (the Capital region), Denmark. We obtained data on cases of VRE from hospitals in Copenhagen during the period when the first version of MiBAlert was implemented and log-data on the use of MiBAlert. Furthermore, a survey was conducted among 88 staff members to investigate their experiences of MiBAlert. The alert is a tool directed toward healthcare personnel accessing the electronic health record (EHR) and those further involved in the care and treatment of the patient. It is based on a web service using data from the national microbiological database, MiBa. MiBAlert is a real-time electronic non-intrusive alert generated automatically in the header of the EHR each time record is accessed. On February 15, 2015 a pilot version of MiBAlert was launched. All positive tests for VRE throughout 1year were shown with alert status by MiBAlert visible to all medical staff with access to EHR. The alert system was automatically updated directly in the EHR across the five hospitals in the Capital region. We found that the system performed satisfactorily, being operational 24/7 all 135 trial days, apart from 72min, for all the hospitals. Of the staff who responded to the survey, 82% considered that MiBAlert overall improved compliance with isolation precautions regarding VRE-positive patients. We found a marked decline of new patients infected or colonized with VRE concomitant with the implementation of MiBAlert and the survey results. We found that MiBAlert was a valuable tool in a bundle approach to counter a multiple hospital outbreak of VRE, and that it has a great potential to improve the control of other drug-resistant bacteria. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Disease management: atrial fibrillation and home monitoring.

PubMed

Ricci, Renato Pietro

2013-06-01

Device-detected atrial fibrillation (AF) episodes predict poor clinical outcome regardless of symptoms. Potential benefits of remote monitoring are early arrhythmia detection and patient continuous monitoring. Several studies of device remote monitoring consistently demonstrated that AF represents the most common clinical alert and that detailed information on arrhythmia onset, duration, and burden as well as on the ventricular rate may be early available for clinical evaluation. Reaction time to AF alerts was very short in all series involving either pacemakers or defibrillators and action ability of AF alerts was very high. In the Home Guide Registry, in which 1650 patients were enrolled, AF was detected in 16.3% of patients and represented 36% of all cardiovascular events during the follow-up. Timely anticoagulation introduction in asymptomatic patients may impact on the stroke rate. According to the results of repeated Monte Carlo simulations based on a real population of 166 patients, daily monitoring may reduce the 2-year stroke risk by 9-18% with an absolute reduction of 0.2-0.6%, compared with conventional inter-visit intervals of 6-12 months. In the COMPAS trial, the incidence of hospitalizations for atrial arrhythmias and related stroke was significantly higher in the control group than in the remote monitoring group. Major questions will be addressed by the ongoing IMPACT trial in which a remote monitoring guided anticoagulation strategy based on AF detection will be compared with a physician-directed standard strategy. In patients with heart failure, AF early detection combined with other indexes may help prevent hospitalizations.

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

DTIC Science & Technology

1982-06-01

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

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

47 CFR 80.1115 - Transmission of a distress alert by a station not itself in distress.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Safety System (GMDSS) Operating Procedures for Distress and Safety Communications § 80.1115 Transmission of a distress alert by a station not itself in distress. (a) A station in the mobile or mobile-satellite service which learns that a mobile unit is in distress must initiate and transmit a distress alert...

FT4 Data Analysis Summary (SSI-ARC)

NASA Technical Reports Server (NTRS)

Isaacson, Douglas R.; Gong, Chester; Reardon, Scott Edward; Santiago, Confesor

2016-01-01

Standards for Unmanned Aircraft System (UAS) Detect-and-Avoid (DAA) systems are currently being developed under the auspices of the RTCA Special Committee 228 (SC-228). To support the development of these standards, a series of flight tests has been conducted at NASAs Armstrong Flight Research Center (NASA-AFRC). The fourth in this series of flight test activities (Flight Test 4, or simply FT4) was conducted during the Spring and Summer of 2016. FT4 supported the objectives of numerous organizations working toward UAS DAA Minimum Operational Performance Standards (MOPS) and UAS DAA Radar MOPS. The summary provided herein is limited to the objectives, analysis and conclusions of the NASA Ames Research Center (NASA-ARC) SSI team toward the refinement of UAS DAA MOPS. This document provides a high-level overview of FT4 and the SSI-ARC objectives, a summary of the data analysis methodology and recommendations for UAS DAA MOPS refinements based on the data analysis results. A total of 72 encounters were flown to support SSI-ARC objectives. Test results were generally consistent with acceptable UAS DAA system performance and will be considered in broader SC-228 requirements validation efforts. Observed alert lead times indicated acceptable UAS DAA alerting performance. Effective interoperability between the UAS DAA system and the Traffic Alert and Collision Avoidance System (TCAS) was observed with one notable exception: TCAS Resolutions Advisories (RA) were observed in the absence of any DAA alert on two occasions, indicating the need for alert parameter refinement. Findings further indicated the need for continued work in the areas of DAA Well Clear Recovery logic and alert stability for Mode-C-only intruders. Finally, results demonstrated a high level of compliance with a set of evaluation criteria designed to provide anecdotal evidence of acceptable UAS DAA system performance.

An Approach for Representing Sensor Data to Validate Alerts in Ambient Assisted Living

PubMed Central

Muñoz, Andrés; Serrano, Emilio; Villa, Ana; Valdés, Mercedes; Botía, Juan A.

2012-01-01

The mainstream of research in Ambient Assisted Living (AAL) is devoted to developing intelligent systems for processing the data collected through artificial sensing. Besides, there are other elements that must be considered to foster the adoption of AAL solutions in real environments. In this paper we focus on the problem of designing interfaces among caregivers and AAL systems. We present an alert management tool that supports carers in their task of validating alarms raised by the system. It generates text-based explanations—obtained through an argumentation process—of the causes leading to alarm activation along with graphical sensor information and 3D models, thus offering complementary types of information. Moreover, a guideline to use the tool when validating alerts is also provided. Finally, the functionality of the proposed tool is demonstrated through two real cases of alert. PMID:22778642

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

PubMed

Epstein, Richard H; Dexter, Franklin

2012-10-01

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

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

PubMed

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

2015-06-01

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

47 CFR 10.270 - Subscribers' right to terminate subscription.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Subscribers' right to terminate subscription. 10.270 Section 10.270 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.270 Subscribers' right to...

47 CFR 10.260 - Timing of subscriber notification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Timing of subscriber notification. 10.260 Section 10.260 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL MOBILE ALERT SYSTEM Election to Participate in Commercial Mobile Alert System § 10.260 Timing of subscriber notification. A CMS...

Flood Monitoring and Early Warning System Using Ultrasonic Sensor

NASA Astrophysics Data System (ADS)

Natividad, J. G.; Mendez, J. M.

2018-03-01

The purpose of this study is to develop a real-time flood monitoring and early warning system in the northern portion of the province of Isabela, particularly the municipalities near Cagayan River. Ultrasonic sensing techniques have become mature and are widely used in the various fields of engineering and basic science. One of advantage of ultrasonic sensing is its outstanding capability to probe inside objective non-destructively because ultrasound can propagate through any kinds of media including solids, liquids and gases. This study focuses only on the water level detection and early warning system (via website and/or SMS) that alerts concern agencies and individuals for a potential flood event. Furthermore, inquiry system is also included in this study to become more interactive wherein individuals in the community could inquire the actual water level and status of the desired area or location affected by flood thru SMS keyword. The study aims in helping citizens to be prepared and knowledgeable whenever there is a flood. The novelty of this work falls under the utilization of the Arduino, ultrasonic sensors, GSM module, web-monitoring and SMS early warning system in helping stakeholders to mitigate casualties related to flood. The paper envisions helping flood-prone areas which are common in the Philippines particularly to the local communities in the province. Indeed, it is relevant and important as per needs for safety and welfare of the community.

Evaluation of BacT/Alert 3D Liquid Culture System for Recovery of Mycobacteria from Clinical Specimens Using Sodium Dodecyl (Lauryl) Sulfate-NaOH Decontamination

PubMed Central

Carricajo, A.; Fonsale, N.; Vautrin, A. C.; Aubert, G.

2001-01-01

A total of 52 mycobacterial isolates were recovered from 1,197 clinical specimens decontaminated by a sodium dodecyl (lauryl) sulfate (SDS)-NaOH protocol. Of these, 94% were recovered with the BacT/Alert 3D system (Organon Teknika, Durham, N.C.) and 79% were recovered on Löwenstein-Jensen (LJ) medium. Mean times to detection of organisms of the Mycobacterium tuberculosis complex (n = 47) were 22.8 days with LJ medium and 16.2 days with the system. The BacT/Alert 3D system is a rapid and efficient detection system which can be used with an SDS-NaOH decontamination procedure. PMID:11574623

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

PubMed

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

2015-08-01

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

An Approach to Quantify Workload in a System of Agents

NASA Technical Reports Server (NTRS)

Stocker, Richard; Rungta, Neha; Mercer, Eric; Raimondi, Franco; Holbrook, Jon; Cardoza, Colleen; Goodrich, Michael

2015-01-01

The role of humans in aviation and other domains continues to shift from manual control to automation monitoring. Studies have found that humans are often poorly suited for monitoring roles, and workload can easily spike in off-nominal situations. Current workload measurement tools, like NASA TLX, use human operators to assess their own workload after using a prototype system. Such measures are used late in the design process and can result in ex- pensive alterations when problems are discovered. Our goal in this work is to provide a quantitative workload measure for use early in the design process. We leverage research in human cognition to de ne metrics that can measure workload on belief-desire-intentions based multi-agent systems. These measures can alert designers to potential workload issues early in design. We demonstrate the utility of our approach by characterizing quantitative differences in the workload for a single pilot operations model compared to a traditional two pilot model.

Most Common Foodborne Pathogens and Mycotoxins on Fresh Produce: A Review of Recent Outbreaks.

PubMed

Yeni, F; Yavaş, S; Alpas, H; Soyer, Y

2016-07-03

Every year millions of people are affected and thousands of them die due to infections and intoxication as a result of foodborne outbreaks, which also cause billions of dollars' worth of damage, public health problems, and agricultural product loss. A considerable portion of these outbreaks is related to fresh produce and caused by foodborne pathogens on fresh produce and mycotoxins. Escherichia coli O104:H4 outbreak, occurred in Germany in 2011, has attracted a great attention on foodborne outbreaks caused by contaminated fresh produce, and especially the vulnerability and gaps in the early warning and notification networks in the surveillance systems in all around the world. In the frame of this paper, we reviewed the most common foodborne pathogens on fresh produce, traceback investigations of the outbreaks caused by these pathogens, and lastly international early warning and notification systems, including PulseNet International and Rapid Alert System for Food and Feed, aiming to detect foodborne outbreaks.

Quality-improvement analytics for intravenous infusion pumps.

PubMed

Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

2013-04-15

The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

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

NASA Astrophysics Data System (ADS)

Kumar, Munesh; Siddique, Shoaib; Noor, Humera

2009-04-01

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

On pleasure and thrill: the interplay between arousal and valence during visual word recognition.

PubMed

Recio, Guillermo; Conrad, Markus; Hansen, Laura B; Jacobs, Arthur M

2014-07-01

We investigated the interplay between arousal and valence in the early processing of affective words. Event-related potentials (ERPs) were recorded while participants read words organized in an orthogonal design with the factors valence (positive, negative, neutral) and arousal (low, medium, high) in a lexical decision task. We observed faster reaction times for words of positive valence and for those of high arousal. Data from ERPs showed increased early posterior negativity (EPN) suggesting improved visual processing of these conditions. Valence effects appeared for medium and low arousal and were absent for high arousal. Arousal effects were obtained for neutral and negative words but were absent for positive words. These results suggest independent contributions of arousal and valence at early attentional stages of processing. Arousal effects preceded valence effects in the ERP data suggesting that arousal serves as an early alert system preparing a subsequent evaluation in terms of valence. Copyright © 2014 Elsevier Inc. All rights reserved.

Conditional Outlier Detection for Clinical Alerting

PubMed Central

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

2010-01-01

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

Conditional outlier detection for clinical alerting.

PubMed

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

2010-11-13

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

The Impact of Alerting Designs on Air Traffic Controller's Eye Movement Patterns and Situation Awareness.

PubMed

Kearney, Peter; Li, Wen-Chin; Yu, Chung-San; Braithwaite, Graham

2018-06-26

This research investigated controller' situation awareness by comparing COOPANS's acoustic alerts with newly designed semantic alerts. The results demonstrate that ATCOs' visual scan patterns had significant differences between acoustic and semantic designs. ATCOs established different eye movement patterns on fixations number, fixation duration and saccade velocity. Effective decision support systems require human-centred design with effective stimuli to direct ATCO's attention to critical events. It is necessary to provide ATCOs with specific alerting information to reflect the nature of of the critical situation in order to minimize the side-effects of startle and inattentional deafness. Consequently, the design of a semantic alert can significantly reduce ATCOs' response time, therefore providing valuable extra time in a time-limited situation to formulate and execute resolution strategies in critical air safety events. The findings of this research indicate that the context-specified design of semantic alerts could improve ATCO's situational awareness and significantly reduce response time in the event of Short Term Conflict Alert activation which alerts to two aircraft having less than the required lateral or vertical separation.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: Advanced Collision Avoidance System for UAS (ACAS Xu) Interoperability White Paper Presentation

NASA Technical Reports Server (NTRS)

Fern, Lisa

2017-01-01

The Phase 1 DAA Minimum Operational Performance Standards (MOPS) provided requirements for two classes of DAA equipment: equipment Class 1 contains the basic DAA equipment required to assist a pilot in remaining well clear, while equipment Class 2 integrates the Traffic Alert and Collision Avoidance (TCAS) II system. Thus, the Class 1 system provides RWC functionality only, while the Class 2 system is intended to provide both RWC and Collision Avoidance (CA) functionality, in compliance with the Minimum Aviation System Performance (MASPS) for the Interoperability of Airborne Collision Avoidance Systems. The FAAs TCAS Program Office is currently developing Airborne Collision Avoidance System X (ACAS X) to support the objectives of the Federal Aviation Administrations (FAA) Next Generation Air Transportation System Program (NextGen). ACAS X has a suite of variants with a common underlying design that are intended to be optimized for their intended airframes and operations. ACAS Xu being is designed for UAS and allows for new surveillance technologies and tailored logic for platforms with different performance characteristics. In addition to Collision Avoidance (CA) alerting and guidance, ACAS Xu is being tuned to provide RWC alerting and guidance in compliance with the SC 228 DAA MOPS. With a single logic performing both RWC and CA functions, ACAS Xu will provide industry with an integrated DAA solution that addresses many of the interoperability shortcomings of Phase I systems. While the MOPS for ACAS Xu will specify an integrated DAA system, it will need to show compliance with the RWC alerting thresholds and alerting requirements defined in the DAA Phase 2 MOPS. Further, some functional components of the ACAS Xu system such as the remote pilots displayed guidance might be mostly references to the corresponding requirements in the DAA MOPS. To provide a seamless, integrated, RWC-CA system to assist the pilot in remaining well clear and avoiding collisions, several issues need to be addressed within the Phase 2 SC-228 DAA efforts. Interoperability of the RWC and CA alerting and guidance, and ensuring pilot comprehension, compliance and performance, will be a primary research area.

78 FR 44931 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... disseminate emergency alerts and notification information to DLA installation personnel. DATES: This proposed... effectively disseminate emergency alerts and notification information to DLA installation personnel. Routine...

Communication and Alert Maintenance Program for Early Response Act of 2010

THOMAS, 111th Congress

Rep. Richardson, Laura [D-CA-37

2010-09-29

House - 11/01/2010 Referred to the Subcommittee on Emergency Communications, Preparedness, and Response. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

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

NASA Technical Reports Server (NTRS)

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

2013-01-01

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