Providing Feasible Implementation Support: Direct Training and Implementation Planning in Consultation

ERIC Educational Resources Information Center

Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Boyle, Ashley M.

2016-01-01

To deliver interventions completely and consistently (i.e., with adequate treatment integrity) and, thus, have a positive impact on student outcomes, implementers, such as teachers and paraprofessionals, often require support. To efficiently deliver implementation support, school psychologists could embed research-based strategies into their…

Prevention

MedlinePlus

... Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Gail’s Story YouTube embed video: YouTube embed video: https://www.youtube-nocookie.com/embed/ZOoRLFdOdac Video: Aaron’s Story YouTube embed video: YouTube embed video: ...

A Business Overview & Summary of the SM-27S/T MACHETE RDT&E Program as Undertaken by the Military Aerospace/Tactical Air Warfare Systems Division of STAVATTI

DTIC Science & Technology

2005-06-27

www.embraer.com The EMB-314 Super Tucano is produced by Empresa Brasil De Aeronautica (EMBRAER). An advanced derivative of the EMB-312 which entered...Bronco. Built by Rockwell International, the Bronco was des igned spec i f ica l ly to f igh t l im i ted ‘brushfire’ wars and entered the LARA com...packaging, handling, storage and transportation ; computer resources; maintenance planning; support equipment; manpower & personnel; facilities; training

Distributing Leadership for Sustainable Peer Feedback on Tertiary Teaching

ERIC Educational Resources Information Center

Wingrove, Dallas; Clarke, Angela; Chester, Andrea

2015-01-01

A growing evidence-based literature supports the value of peer feedback as a positive professional learning activity that enhances confidence, builds collegial relationships and supports reflective practice. Less clear is how best to embed such programs in university practices. This paper describes a leadership approach developed to support the…

Palliative Care: Video Tells a Mother's Story of Caring Support

MedlinePlus

... page please turn JavaScript on. Feature: Palliative Care Video Tells a Mother's Story of Caring Support Past Issues / Spring 2014 Table of Contents YouTube embedded video: http://www.youtube-nocookie.com/embed/-hOBYFS_Z68 ...

Diagnostic approach of myocarditis: strike the golden mean.

PubMed

Hazebroek, M R; Everaerts, K; Heymans, S

2014-02-01

Myocarditis is a challenging diagnosis due to the extreme diversity of clinical manifestations. The actual incidence of myocarditis is also difficult to determine as endomyocardial biopsy (EMB), the diagnostic gold standard, is used infrequently. Nevertheless, in up to 30 % of patients with biopsy-proven myocarditis, progression to dilated cardiomyopathy (DCM) can occur and is associated with a poor prognosis. Recent position statements of the European Society of Cardiology (ESC) and the American Heart Association vary widely with regard to indications for performing an EMB in these patients. This makes decision-making, in particular for general practitioners (GPs) and regional hospitals, difficult and unclear. Therefore, we will present a short summary of the ESC Working Group on Myocardial and Pericardial Diseases statement and our suggestions for GPs and regional hospitals for the diagnostic approach in patients with suspected myocarditis.

Sport Education and Social Goals in Physical Education: Relationships with Enjoyment, Relatedness, and Leisure-Time Physical Activity

ERIC Educational Resources Information Center

Wallhead, Tristan L.; Garn, Alex C.; Vidoni, Carla

2013-01-01

Background: Adolescents' decisions to engage in physical activities are influenced by the social aspects of the activity, including opportunity for affiliation, being part of a team, and the social status it offers. A curriculum and instructional model that has been shown to embed the student social system within a positive program of action is…

A Study of Driver's Route Choice Behavior Based on Evolutionary Game Theory

PubMed Central

Jiang, Xiaowei; Ji, Yanjie; Deng, Wei

2014-01-01

This paper proposes a route choice analytic method that embeds cumulative prospect theory in evolutionary game theory to analyze how the drivers adjust their route choice behaviors under the influence of the traffic information. A simulated network with two alternative routes and one variable message sign is built to illustrate the analytic method. We assume that the drivers in the transportation system are bounded rational, and the traffic information they receive is incomplete. An evolutionary game model is constructed to describe the evolutionary process of the drivers' route choice decision-making behaviors. Here we conclude that the traffic information plays an important role in the route choice behavior. The driver's route decision-making process develops towards different evolutionary stable states in accordance with different transportation situations. The analysis results also demonstrate that employing cumulative prospect theory and evolutionary game theory to study the driver's route choice behavior is effective. This analytic method provides an academic support and suggestion for the traffic guidance system, and may optimize the travel efficiency to a certain extent. PMID:25610455

A study of driver's route choice behavior based on evolutionary game theory.

PubMed

Jiang, Xiaowei; Ji, Yanjie; Du, Muqing; Deng, Wei

2014-01-01

This paper proposes a route choice analytic method that embeds cumulative prospect theory in evolutionary game theory to analyze how the drivers adjust their route choice behaviors under the influence of the traffic information. A simulated network with two alternative routes and one variable message sign is built to illustrate the analytic method. We assume that the drivers in the transportation system are bounded rational, and the traffic information they receive is incomplete. An evolutionary game model is constructed to describe the evolutionary process of the drivers' route choice decision-making behaviors. Here we conclude that the traffic information plays an important role in the route choice behavior. The driver's route decision-making process develops towards different evolutionary stable states in accordance with different transportation situations. The analysis results also demonstrate that employing cumulative prospect theory and evolutionary game theory to study the driver's route choice behavior is effective. This analytic method provides an academic support and suggestion for the traffic guidance system, and may optimize the travel efficiency to a certain extent.

Sea lice population and sex differences in P-glycoprotein expression and emamectin benzoate resistance on salmon farms in the Bay of Fundy, New Brunswick, Canada.

PubMed

Igboeli, Okechukwu O; Burka, John F; Fast, Mark D

2014-06-01

Parasitic sea lice are a major challenge for salmon aquaculture. This is especially due to the recent development of resistance to emamectin benzoate (EMB) in the parasite. We investigated: (1) whether EMB treatment success in Grand Manan, Bay of Fundy, NB, Canada can be explained through EMB bioassay and P-glycoprotein (P-gp) mRNA expression studies; (2) if other populations of sea lice not under EMB selective pressure possess similar EMB sensitivity as Grand Manan sea lice populations; and (3) the heritability of EMB resistance in Lepeophtheirus salmonis. EMB bioassay results indicated population, species, sex and temporal differences in EMB EC50 values. RT-qPCR analyses revealed population and sex differences in P-gp mRNA levels, correlating with the bioassay results. Laboratory-reared sea lice maintained their EMB sensitivity status up to the F3 generation. Caligus elongatus, collected from Grand Manan showed more than twofold lower EMB EC50 values compared with L. salmonis collected from the same site. Concurrent exposure to EMB and verapamil yielded no increase in C. elongatus sensitivity to the parasiticide. Sea lice bioassay and P-gp mRNA studies can be used to track EMB resistance and sex differences in EMB sensitivity and P-gp mRNA levels exist in the parasite. © 2013 Society of Chemical Industry.

Using Quality Enhancement Processes to Achieve Sustainable Development and Support for Sessional Staff

ERIC Educational Resources Information Center

Lekkas, D.; Winning, T. A.

2017-01-01

Consistent with quality enhancement, we report on how we used a continuous improvement cycle to formalise and embed an academic development and support programme for our School's sessional staff. Key factors in establishing and maintaining the programme included: local change agents supported initially by institutional project funding; School…

Progress on mechanism of ethambutol resistance in Mycobacterium Tuberculosis.

PubMed

Wang, Ting; Jiao, Wei-wei; Shen, A-dong

2016-10-20

The occurance and prevalence of multidrug-resistant tuberculosis poses a serious threat to the global tuberculosis control. Ethambutol (EMB) is one of the first-line anti-tuberculosis drugs, which is usually used in combination with isoniazid and rifampicin for treating pan-sensitive tuberculosis, and it can also be used in drug-resistant tuberculosis. However, the situation of EMB resistance is alarmingly high, especially in multi-drug resistant tuberculosis. In China, EMB resistance rate in the previously treated cases was up to 17.2% and showed an increased tendency. What was worse, 51.3%-66.7% of multidrug-resistant tuberculosis cases were resistant to EMB. Thus, it is important to understand the drug resistance mechanism of EMB, which will help to slow down the drug resistance rate of EMB. In this review, we focus on the current status of EMB resistance, the effects of EMB and the mechanisms of EMB resistance in Mycobacterium tuberculosis.

Evaluation of Decision Rules in a Tiered Assessment of Inhalation Exposure to Nanomaterials.

PubMed

Brouwer, Derk; Boessen, Ruud; van Duuren-Stuurman, Birgit; Bard, Delphine; Moehlmann, Carsten; Bekker, Cindy; Fransman, Wouter; Klein Entink, Rinke

2016-10-01

Tiered or stepwise approaches to assess occupational exposure to nano-objects, and their agglomerates and aggregates have been proposed, which require decision rules (DRs) to move to a next tier, or terminate the assessment. In a desk study the performance of a number of DRs based on the evaluation of results from direct reading instruments was investigated by both statistical simulations and the application of the DRs to real workplace data sets. A statistical model that accounts for autocorrelation patterns in time-series, i.e. autoregressive integrated moving average (ARIMA), was used as 'gold' standard. The simulations showed that none of the proposed DRs covered the entire range of simulated scenarios with respect to the ARIMA model parameters, however, a combined DR showed a slightly better agreement. Application of the DRs to real workplace datasets (n = 117) revealed sensitivity up to 0.72, whereas the lowest observed specificity was 0.95. The selection of the most appropriate DR is very much dependent on the consequences of the decision, i.e. ruling in or ruling out of scenarios for further evaluation. Since a basic assessment may also comprise of other type of measurements and information, an evaluation logic was proposed which embeds the DRs, but furthermore supports decision making in view of a tiered-approach exposure assessment. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Roles of conserved proline and glycosyltransferase motifs of EmbC in biosynthesis of lipoarabinomannan.

PubMed

Berg, Stefan; Starbuck, James; Torrelles, Jordi B; Vissa, Varalakshmi D; Crick, Dean C; Chatterjee, Delphi; Brennan, Patrick J

2005-02-18

D-Arabinans, composed of D-arabinofuranose (D-Araf), dominate the structure of mycobacterial cell walls in two settings, as part of lipoarabinomannan (LAM) and arabinogalactan, each with markedly different structures and functions. Little is known of the complexity of their biosynthesis. beta-D-Arabinofuranosyl-1-monophosphoryldecaprenol is the only known sugar donor. EmbA, EmbB, and EmbC, products of the paralogous genes embA, embB, and embC, the sites of resistance to the anti-tuberculosis drug ethambutol (EMB), are the only known implicated enzymes. EmbA and -B apparently contribute to the synthesis of arabinogalactan, whereas EmbC is reserved for the synthesis of LAM. The Emb proteins show no overall similarity to any known proteins beyond Mycobacterium and related genera. However, functional motifs, equivalent to a proline-rich motif of several bacterial polysaccharide co-polymerases and a superfamily of glycosyltransferases, were found. Site-directed mutagenesis in glycosyltransferase superfamily C resulted in complete ablation of LAM synthesis. Point mutations in three amino acids of the proline motif of EmbC resulted in marked reduction of LAM-arabinan synthesis and accumulation of an unknown intermediate and of the known precursor lipomannan. Yet the pattern of the differently linked d-Araf units observed in wild type LAM-arabinan was largely retained in the proline motif mutants. The results allow for the presentation of a unique model of arabinan synthesis.

Aligning Career with Faith: Reflective Practice for Christian Nurse Educators.

PubMed

McKnight, Heather

Christian nurses are challenged by the process of incorporating faith and Christianity into their career. Nurse educators are particularly challenged to embed Christian principles into the tenure and promotion journey. Developing a God-inspired plan takes time and patience. Prayer, reflective practice, evaluation, decisions, and follow-through are areas that can be incorporated to infuse faith throughout the tenure and promotion process.

A 200K SNP chip reveals a novel Pacific salmon louse genotype linked to differential efficacy of emamectin benzoate.

PubMed

Messmer, Amber M; Leong, Jong S; Rondeau, Eric B; Mueller, Anita; Despins, Cody A; Minkley, David R; Kent, Matthew P; Lien, Sigbjørn; Boyce, Brad; Morrison, Diane; Fast, Mark D; Norman, Joseph D; Danzmann, Roy G; Koop, Ben F

2018-04-16

Antiparasitic drugs such as emamectin benzoate (EMB) are relied upon to reduce the parasite load, particularly of the sea louse Lepeophtheirus salmonis, on farmed salmon. The decline in EMB treatment efficacy for this purpose is an important issue for salmon producers around the world, and particularly for those in the Atlantic Ocean where widespread EMB tolerance in sea lice is recognized as a significant problem. Salmon farms in the Northeast Pacific Ocean have not historically experienced the same issues with treatment efficacy, possibly due to the relatively large population of endemic salmonid hosts that serve to both redistribute surviving lice and dilute populations potentially under selection by introducing naïve lice to farms. Frequent migration of lice among farmed and wild hosts should limit the effect of farm-specific selection pressures on changes to the overall allele frequencies of sea lice in the Pacific Ocean. A previous study using microsatellites examined L. salmonis oncorhynchi from 10 Pacific locations from wild and farmed hosts and found no population structure. Recently however, a farm population of sea lice was detected where EMB bioassay exposure tolerance was abnormally elevated. In response, we have developed a Pacific louse draft genome that complements the previously-released Atlantic louse sequence. These genomes were combined with whole-genome re-sequencing data to design a highly sensitive 201,279 marker SNP array applicable for both subspecies (90,827 validated Pacific loci; 153,569 validated Atlantic loci). Notably, kmer spectrum analysis of the re-sequenced samples indicated that Pacific lice exhibit a large within-individual heterozygosity rate (average of 1 in every 72 bases) that is markedly higher than that of Atlantic individuals (1 in every 173 bases). The SNP chip was used to produce a high-density map for Atlantic sea louse linkage group 5 that was previously shown to be associated with EMB tolerance in Atlantic lice. Additionally, 478 Pacific louse samples from farmed and wild hosts obtained between 2005 and 2014 were also genotyped on the array. Clustering analysis allowed us to detect the apparent emergence of an otherwise rare genotype at a high frequency among the lice collected from two farms in 2013 that had reported elevated EMB tolerance. This genotype was not observed in louse samples collected from the same farm in 2010, nor in any lice sampled from other locations prior to 2013. However, this genotype was detected at low frequencies in louse samples from farms in two locations reporting elevated EMB tolerance in 2014. These results suggest that a rare genotype present in Pacific lice may be locally expanded in farms after EMB treatment. Supporting this hypothesis, 437 SNPs associated with this genotype were found to be in a region of linkage group 5 that overlaps the region associated with EMB resistance in Atlantic lice. Finally, five of the top diagnostic SNPs within this region were used to screen lice that had been subjected to an EMB survival assay, revealing a significant association between these SNPs and EMB treatment outcome. To our knowledge this work is the first report to identify a genetic link to altered EMB efficacy in L. salmonis in the Pacific Ocean. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

A Bayesian Attractor Model for Perceptual Decision Making

PubMed Central

Bitzer, Sebastian; Bruineberg, Jelle; Kiebel, Stefan J.

2015-01-01

Even for simple perceptual decisions, the mechanisms that the brain employs are still under debate. Although current consensus states that the brain accumulates evidence extracted from noisy sensory information, open questions remain about how this simple model relates to other perceptual phenomena such as flexibility in decisions, decision-dependent modulation of sensory gain, or confidence about a decision. We propose a novel approach of how perceptual decisions are made by combining two influential formalisms into a new model. Specifically, we embed an attractor model of decision making into a probabilistic framework that models decision making as Bayesian inference. We show that the new model can explain decision making behaviour by fitting it to experimental data. In addition, the new model combines for the first time three important features: First, the model can update decisions in response to switches in the underlying stimulus. Second, the probabilistic formulation accounts for top-down effects that may explain recent experimental findings of decision-related gain modulation of sensory neurons. Finally, the model computes an explicit measure of confidence which we relate to recent experimental evidence for confidence computations in perceptual decision tasks. PMID:26267143

Value-based resource management: a model for best value nursing care.

PubMed

Caspers, Barbara A; Pickard, Beth

2013-01-01

With the health care environment shifting to a value-based payment system, Catholic Health Initiatives nursing leadership spearheaded an initiative with 14 hospitals to establish best nursing care at a lower cost. The implementation of technology-enabled business processes at point of care led to a new model for best value nursing care: Value-Based Resource Management. The new model integrates clinical patient data from the electronic medical record and embeds the new information in care team workflows for actionable real-time decision support and predictive forecasting. The participating hospitals reported increased patient satisfaction and cost savings in the reduction of overtime and improvement in length of stay management. New data generated by the initiative on nursing hours and cost by patient and by population (Medicare severity diagnosis-related groups), and patient health status outcomes across the acute care continuum expanded business intelligence for a value-based population health system.

Ameliorative effect of vitamin C against hepatotoxicity induced by emamectin benzoate in rats.

PubMed

Khaldoun Oularbi, H; Richeval, C; Lebaili, N; Zerrouki-Daoudi, N; Baha, M; Djennas, N; Allorge, D

2017-07-01

In the present study, we aimed to assess the potential protective effect of ascorbic acid (AA) against emamectin benzoate (EMB)-induced hepatotoxicity. For this purpose, biochemical, histopathological and analytical investigations were performed. Male Wistar rats were distributed into three groups, that is, a control group, an EMB group given 10 mg EMB/kg body weight (BW) by gavage and an EMB + AA group given 10 mg EMB/kg BW and vitamin C intraperitoneally (200 mg/kg). The duration of the treatment was 28 days and the duration of the study was 42 days. There was a statistically significant increase of all hepatic biomarkers, that is, aspartate aminotransferase, alanine aminotransferase and gamma-glutamyltransferase activities, and glycemia, in EMB-treated group when compared with the control group. Light microscopic observations revealed variable signs of hepatotoxicity in the EMB group, which were represented by alteration of normal hepatic architecture, inflammatory cell infiltration, hepatocellular steatosis and foci of necrosis at 28 and 42 days post-treatment. However, co-treatment with vitamin C reduced EMB-related liver toxicity and diminished the abnormal biochemical and architectural damage. Emamectin B1a and B1b residues were detectable in all plasma samples of treated rats at 14, 21 and 28 days of treatment. The drug liver tissue concentration was significantly lower in EMB + AA group compared with EMB group at 28 and 42 days. In conclusion, the findings of the present study clearly indicate a significant protective action of vitamin C against EMB hepatotoxicity.

Risks for Heart Disease & Stroke

MedlinePlus

... Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Know Your Risk Factors YouTube embed video: YouTube ... https://www.youtube-nocookie.com/embed/GQ0f7-ksmGI Video: José’s Story YouTube embed video: YouTube embed video: ...

Potential genotoxic and cytotoxicity of emamectin benzoate in human normal liver cells

PubMed Central

Zhang, Zhijie; Zhao, Xinyu; Qin, Xiaosong

2017-01-01

Pesticide residue inducing cancer-related health problems draw people more attention recently. Emamectin benzoate (EMB) has been widely used in agriculture around the world based on its specificity targets. Although potential risk and the molecular mechanism of EMB toxicity to human liver has not been well-characterized. Unlike well-reported toxicity upon central nervous system, potential genotoxic and cytotoxicity of EMB in human liver cell was ignored and very limited. In this study, we identify genotoxicity and cytotoxicity of EMB to human normal liver cells (QSG7701 cell line) in vitro. We demonstrate that EMB inhibited the viability of QSG7701 cells and induced the DNA damage. Established assays of cytotoxicity were performed to characterize the mechanism of EMB toxicity on QSG7701 cells. Typical chromatin condensation and DNA fragmentation indicated the apoptosis of QSG7701 cells induced by EMB. And the intracellular biochemical results demonstrated that EMB-enhanced apoptosis of QSG7701 cells concurrent with generated ROS, a loss of mitochondrial membrane potential, the cytochrome-c release, up regulate the Bax/Bcl-2 and the activation of caspase-9/-3. Our results of EMB induces the death of QSG7701 cells maybe via mitochondrial-mediated intrinsic apoptotic pathways would contribute to promote the awareness of EMB as an extensive used pesticide to human being effects and reveal the underlying mechanisms of potential genotoxic. PMID:29137255

Potential genotoxic and cytotoxicity of emamectin benzoate in human normal liver cells.

PubMed

Zhang, Zhijie; Zhao, Xinyu; Qin, Xiaosong

2017-10-10

Pesticide residue inducing cancer-related health problems draw people more attention recently. Emamectin benzoate (EMB) has been widely used in agriculture around the world based on its specificity targets. Although potential risk and the molecular mechanism of EMB toxicity to human liver has not been well-characterized. Unlike well-reported toxicity upon central nervous system, potential genotoxic and cytotoxicity of EMB in human liver cell was ignored and very limited. In this study, we identify genotoxicity and cytotoxicity of EMB to human normal liver cells (QSG7701 cell line) in vitro . We demonstrate that EMB inhibited the viability of QSG7701 cells and induced the DNA damage. Established assays of cytotoxicity were performed to characterize the mechanism of EMB toxicity on QSG7701 cells. Typical chromatin condensation and DNA fragmentation indicated the apoptosis of QSG7701 cells induced by EMB. And the intracellular biochemical results demonstrated that EMB-enhanced apoptosis of QSG7701 cells concurrent with generated ROS, a loss of mitochondrial membrane potential, the cytochrome-c release, up regulate the Bax/Bcl-2 and the activation of caspase-9/-3. Our results of EMB induces the death of QSG7701 cells maybe via mitochondrial-mediated intrinsic apoptotic pathways would contribute to promote the awareness of EMB as an extensive used pesticide to human being effects and reveal the underlying mechanisms of potential genotoxic.

Effects of the antituberculous drug ethambutol on zinc balance, distribution, and turnover: short-term studies modeling chronic toxicity

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

King, A.B.

1987-01-01

Alterations in Zn metabolism have been reported in both tuberculous patients and experimental animals receiving ethambutol (d-2-2'-ethylenediimino-di-1-butanol dihydrochloride) (EMB), and these changes have been associated with ocular side effects of EMB. EMB has chelating properties but is not likely to chelate Zn at physiologic pH. However, its acid metabolite is a stronger chelator. This research addressed whether EMB affects the absorption and disposition of dietary Zn, and whether effects of EMB on Zn are modified by (a) marginal Zn intake of (b) drugs that may induce metabolism of EMB. Weanling male Sprague-Dawley rats fed an AIN-76A diet received daily bymore » gavage either deionized water or EMB doses of 400-1600 mg/kg bw. in a preliminary, 15-day dose-response study and 400-600 mg/kg in three subsequent 15- to 30-day studies. Apparent absorption and biological turnover of Zn were measured by /sup 65/Zn balance and retention in rats fed adequate (49 ppm) or marginal (11 ppm) Zn. Effects of EMB were similar in both dietary groups. EMB treatment produced alopecia and reduced feed intake, feed efficiency, weight gain, and serum Zn, but showed no effect on hepatic, renal, or femoral Zn concentrations. Absorption, turnover, and urinary excretion of Zn were increased in rats fed EMB.« less

The Model of Children's Active Travel (M-CAT): a conceptual framework for examining factors influencing children's active travel.

PubMed

Pont, Karina; Ziviani, Jenny; Wadley, David; Abbott, Rebecca

2011-06-01

The current decline in children's participation in physical activity has attracted the attention of those concerned with children's health and wellbeing. A sustainable approach to ensuring children engage in adequate amounts of physical activity is to support their involvement in incidental activity such as active travel (AT), which includes walking or riding a bicycle to or from local destinations, such as school or a park. Understanding how we can embed physical activity into children's everyday occupational roles is a way in which occupational therapists can contribute to this important health promotion agenda. To present a simple, coherent and comprehensive framework as a means of examining factors influencing children's AT. Based on current literature, this conceptual framework incorporates the observable environment, parents' perceptions and decisions regarding their children's AT, as well as children's own perceptions and decisions regarding AT within their family contexts across time. The Model of Children's Active Travel (M-CAT) highlights the complex and dynamic nature of factors impacting the decision-making process of parents and children in relation to children's AT. The M-CAT offers a way forward for researchers to examine variables influencing active travel in a systematic manner. Future testing of the M-CAT will consolidate understanding of the factors underlying the decision-making process which occurs within families in the context of their communities. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

77 FR 70941 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Interaction of Systems and Structures

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

... primary structure is metal with composite empennage and control surfaces. The Model EMB-550 airplane is...., Model EMB-550 Airplane; Interaction of Systems and Structures AGENCY: Federal Aviation Administration... conditions for the Embraer S.A. Model EMB-550 airplane. This airplane will have a novel or unusual design...

78 FR 11556 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Interaction of Systems and Structures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

.... The primary structure is metal with composite empennage and control surfaces. The Model EMB-550...-1246; Special Conditions No. 25-481-SC] Special Conditions: Embraer S.A., Model EMB-550 Airplane... special conditions. SUMMARY: These special conditions are issued for the Embraer S.A. Model EMB-550...

Repeated administration of ethambutol in therapeutic dose causes testes alteration and spermatogenesis disruption in Wistar rats.

PubMed

Shayakhmetova, G M; Bondarenko, L B; Voronina, A K; Matvienko, A V; Kitam, V; Kovalenko, V M

2017-05-01

Ethambutol (EMB) is conventionally used to treat tuberculosis and atypical Mycobacterium infections in combination with other antimycobacterial drugs. Eventually, EMB testicular toxicity has not been explored extensively yet. The aim of the study is to evaluate testicular toxicity of EMB. We explored the impact of EMB on male rats' fertility, testosterone level and germ cells state, testicular pro- and anti-oxidant status and DNA damage, as well as identified EMB effects on cytochrome P-450 2E1 (CYP2E1) both with computer simulation and in vivo. We demonstrated that EMB administration to male rats decreased in epididymal sperm count (19%) and fertility index (53%). These events were accompanied by reduction in serum testosterone content (1.6 times) and appearance of spermatogenic epithelium damages. It was also found in testes the intensification of lipid peroxidation, decrease in reduced glutathione content and changes in DNA fragmentation. Additionally, computer simulation showed direct interaction of EMB with CYP2E1 active site and heme. On the top of this, we demonstrated that level of testicular CYP2E1 messenger RNA in EMB-treated rats was increased 8.7 folds and p-nitrophenol hydroxylase activity in testes rose three folds. As this shows, EMB-caused CYP2E1 induction, oxidative stress, and apoptosis in the testes contribute to inhibition of steroidogenesis enzymes and spermatogenesis disruption.

78 FR 14005 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Flight Envelope Protection: Pitch and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

...-1211; Special Conditions No. 25-486-SC] Special Conditions: Embraer S.A., Model EMB-550 Airplanes... Embraer S.A. Model EMB-550 airplane. This airplane will have a novel or unusual design feature associated...: Background On May 14, 2009, Embraer S.A. applied for a type certificate for their new Model EMB-550 airplane...

78 FR 11562 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Flight Envelope Protection: High Speed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... control surfaces. The Model EMB-550 airplane is designed for 8 passengers, with a maximum of 12 passengers... the pilot or copilot sidestick. The longitudinal control law design of the Embraer S.A. Model EMB- 550... EMB-550 airplane. This airplane will have a novel or unusual design feature, specifically an...

Rotorcraft Diagnostics

NASA Technical Reports Server (NTRS)

Haste, Deepak; Azam, Mohammad; Ghoshal, Sudipto; Monte, James

2012-01-01

Health management (HM) in any engineering systems requires adequate understanding about the system s functioning; a sufficient amount of monitored data; the capability to extract, analyze, and collate information; and the capability to combine understanding and information for HM-related estimation and decision-making. Rotorcraft systems are, in general, highly complex. Obtaining adequate understanding about functioning of such systems is quite difficult, because of the proprietary (restricted access) nature of their designs and dynamic models. Development of an EIM (exact inverse map) solution for rotorcraft requires a process that can overcome the abovementioned difficulties and maximally utilize monitored information for HM facilitation via employing advanced analytic techniques. The goal was to develop a versatile HM solution for rotorcraft for facilitation of the Condition Based Maintenance Plus (CBM+) capabilities. The effort was geared towards developing analytic and reasoning techniques, and proving the ability to embed the required capabilities on a rotorcraft platform, paving the way for implementing the solution on an aircraft-level system for consolidation and reporting. The solution for rotorcraft can he used offboard or embedded directly onto a rotorcraft system. The envisioned solution utilizes available monitored and archived data for real-time fault detection and identification, failure precursor identification, and offline fault detection and diagnostics, health condition forecasting, optimal guided troubleshooting, and maintenance decision support. A variant of the onboard version is a self-contained hardware and software (HW+SW) package that can be embedded on rotorcraft systems. The HM solution comprises components that gather/ingest data and information, perform information/feature extraction, analyze information in conjunction with the dependency/diagnostic model of the target system, facilitate optimal guided troubleshooting, and offer decision support for optimal maintenance.

Emamectin benzoate induces ROS-mediated DNA damage and apoptosis in Trichoplusia Tn5B1-4 cells.

PubMed

Luan, Shaorong; Yun, Xinming; Rao, Wenbing; Xiao, Ciying; Xu, Zhikang; Lang, Jialin; Huang, Qingchun

2017-08-01

Emamectin benzoate (EMB), a novel macrocyclic lactone insecticide, possesses high efficacy and beneficial selective toxicity in agriculture, but so far the EMB-induced cytotoxic action in arthropod insect remains unclear. The present studies were carried out to characterize the property of EMB on the induction of reactive oxygen species (ROS)-mediated DNA damage and apoptosis in Trichoplusia Tn5B1-4 cell model. Following the exposure to EMB at 2.5, 5, 10 or 15 μM, the cells changed to be round, suspended and aggregated, and the decline of cell proliferating ability and cell viability was positively related with the exposure time. Median inhibitory concentration (IC 50 ) of EMB on cell viability was 3.72 μM during 72 h exposure. Apoptosis was induced in 29.8% (24 h) and 39.5% (48 h) of the cells by EMB at 15 μM, showing chromatin condensation in nuclei. The content of ROS in the cells increased rapidly as the concentration of EMB increased, and the pre-incubation of the cells with vitamin E significantly reduced the ROS accumulation. In the treatment of 15 μM EMB, the migrated cell nucleus with DNA strand breaks appeared a teardrop, pear-shaped, or large fan-like tail, and 63.1% of γH2AX-positive cells contained more than four foci, accompanying with high expression level of caspase-3 in time-dependent manner, which consequently led to cell apoptotic death. These evidences in ROS-mediated DNA damage and cell apoptosis induced by EMB may be helpful for deep understanding the cytotoxic action of EMB based on cell model. Copyright © 2017 Elsevier B.V. All rights reserved.

Mutation at embB Codon 306, a Potential Marker for the Identification of Multidrug Resistance Associated with Ethambutol in Mycobacterium tuberculosis

PubMed Central

Cuevas-Córdoba, Betzaida; Juárez-Eusebio, Dulce María; Almaraz-Velasco, Raquel; Muñiz-Salazar, Raquel; Laniado-Laborin, Rafael

2015-01-01

Ethambutol inhibits arabinogalactan and lipoarabinomannan biosynthesis in mycobacteria. The occurrence of mutations in embB codon 306 in ethambutol-susceptible isolates and their absence in resistant isolates has raised questions regarding the utility of this codon as a potential marker for resistance against ethambutol. The characterization of mutations on embB 306 will contribute to a better understanding of the mechanisms of resistance to this drug; therefore, the purpose of this study was to investigate the association between embB 306 mutations and first-line drug resistance profiles in tuberculosis isolates. We sequenced the region surrounding the embB 306 codon in 175 tuberculosis clinical isolates, divided according to drug sensitivity, in three groups: 110 were resistant to at least one first-line drug, of which 61 were resistant to ethambutol (EMBr), 49 were sensitive to ethambutol (EMBs) but were resistant to another drug, and 65 were pansensitive isolates (Ps). The associations between embB 306 mutations and phenotypic resistance to all first-line drugs were determined, and their validity and safety as a diagnostic marker were assessed. One of the Ps isolates (1/65), one of the EMBs isolates (1/49), and 20 of the EMBr isolates (20/61) presented with an embB 306 mutation. Four different single-nucleotide polymorphisms (SNPs) at embB 306 were associated with simultaneous resistance to ethambutol, isoniazid, and rifampin (odds ratio [OR], 17.7; confidence interval [CI], 5.6 to 56.1) and showed a positive predictive value of 82%, with a specificity of 97% for diagnosing multidrug resistance associated with ethambutol, indicating its potential as a molecular marker for several drugs. PMID:26124153

Beyond allostatic load: rethinking the role of stress in regulating human development.

PubMed

Ellis, Bruce J; Del Giudice, Marco

2014-02-01

How do exposures to stress affect biobehavioral development and, through it, psychiatric and biomedical disorder? In the health sciences, the allostatic load model provides a widely accepted answer to this question: stress responses, while essential for survival, have negative long-term effects that promote illness. Thus, the benefits of mounting repeated biological responses to threat are traded off against costs to mental and physical health. The adaptive calibration model, an evolutionary-developmental theory of stress-health relations, extends this logic by conceptualizing these trade-offs as decision nodes in allocation of resources. Each decision node influences the next in a chain of resource allocations that become instantiated in the regulatory parameters of stress response systems. Over development, these parameters filter and embed information about key dimensions of environmental stress and support, mediating the organism's openness to environmental inputs, and function to regulate life history strategies to match those dimensions. Drawing on the adaptive calibration model, we propose that consideration of biological fitness trade-offs, as delineated by life history theory, is needed to more fully explain the complex relations between developmental exposures to stress, stress responsivity, behavioral strategies, and health. We conclude that the adaptive calibration model and allostatic load model are only partially complementary and, in some cases, support different approaches to intervention. In the long run, the field may be better served by a model informed by life history theory that addresses the adaptive role of stress response systems in regulating alternative developmental pathways.

76 FR 52220 - Airworthiness Directives; Embraer-Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

... Support, Av. Brig. Farina Lima, 2170, Sao Jose dos Campos--SP, CEP: 12227-901--PO Box: 36/2, BRASIL..., BRASIL; telephone: ++55 12 3927-5383; fax: ++55 12 3927-2619; e-mail: embraer.com .br">phenom.reliability...

Detection on emamectin benzoate-induced apoptosis and DNA damage in Spodoptera frugiperda Sf-9 cell line.

PubMed

Wu, Xiwei; Zhang, Lei; Yang, Chao; Zong, Mimi; Huang, Qingchun; Tao, Liming

2016-01-01

Emamectin benzoate (EMB), an important macrocyclic lactone insecticide that belongs to the avermectin family and possesses excellent potency in controlling pests, is non-carcinogenic and non-mutagenic conducted in rats and mice, but EMB-induced cytotoxicity and genotoxicity in arthropod insect have been seldom reported yet. In the present paper, we quantified the cytotoxicity of EMB through the detections on cell viability, DNA damage, and cell apoptosis in Spodoptera frugiperda Sf-9 cells in vitro. The results showed that EMB caused a concentration- and time-dependent reduction on the viability of Sf-9 cells, and the median inhibitory concentrations (IC50) were 3.34μM at 72h of exposure. The dual acridine orange/ethidium bromide staining showed that exposure to EMB induced a significant time- and concentration-dependent increase on cell apoptosis. The alkaline comet assay revealed that EMB induced significant increases on single-strand DNA breaks, and the percentage of γH2AX-positive cells represented a time- and concentration-dependent formation of DNA double-strand breaks in Sf-9 cells. Interestingly, the similar cytotoxic actions of EMB also went for the human cancerous HeLa cells as a control cell group. Data demonstrated the potential cytotoxic effect of EMB on Sf-9 cells that was significantly greater than the effect of hydrogen peroxide at the same concentrations. Copyright © 2015 Elsevier Inc. All rights reserved.

Immunostimulation of Salmo salar L., and its effect on Lepeophtheirus salmonis (Krøyer) P-glycoprotein mRNA expression following subsequent emamectin benzoate exposure.

PubMed

Igboeli, O O; Purcell, S L; Wotton, H; Poley, J; Burka, J F; Fast, M D

2013-03-01

Control of sea lice, Lepeophtheirus salmonis, on farmed Atlantic salmon, Salmo salar, relies heavily on chemotherapeutants. However, reduced efficacy of many treatments and need for integrated sea lice management plans require innovative strategies. Resistance to emamectin benzoate (EMB), a major sea lice parasiticide, has been linked with P-glycoprotein (P-gp) expression. We hypothesized that host immunostimulation would complement EMB treatment outcome. Lepeophtheirus salmonis-infected Atlantic salmon were fed immunostimulatory or control feeds. Sea lice were collected for 24-h EMB bioassays 1 and 2 weeks prior to commencement of EMB treatment of the fish. Two weeks after cessation of immunostimulant-treated feed, EMB was administered at 150 μg kg(-1) fish biomass for 7 days. The bioassay revealed stage, gender and immunostimulant-related differences in EMB EC(50) . Sea lice attached to salmon with a history of immunostimulation exhibited significantly greater survival than those on control feeds, despite similar levels of EMB in host tissues. Lepeophtheirus salmonis from salmon with a history of immunostimulation also exhibited higher P-gp mRNA expression as well as greater survivability compared to controls. Administration of immunostimulants prior to EMB treatment caused increased expression of P-gp mRNA which could have consequently caused decreased efficacy of the parasiticide. © 2013 Blackwell Publishing Ltd.

L-form transformation phenomenon in Mycobacterium tuberculosis associated with drug tolerance to ethambutol.

PubMed

Slavchev, Georgi; Michailova, Lilia; Markova, Nadya

2016-12-01

Cell wall-deficient bacterial forms (L-forms) may occur along with resistance to factors that trigger their appearance. It is of interest to study the relationship between the L-form transformation of Mycobacterium tuberculosis and the exhibition of drug tolerance to ethambutol (EMB), an inhibitor of cell wall synthesis. L-form variant was produced from a sensitive EMB strain of M. tuberculosis through a cryogenic stress treatment protocol and was subsequently cultivated in Middlebrook 7H9 semisolid medium, containing EMB in a minimal inhibitory concentration of 2mg/L. Susceptibility to EMB of the parental strain and its L-form variant was evaluated phenotypically and using polymerase chain reaction-restriction fragment length polymorphism assay targeting a mutation in the embB306 gene fragment. In contrast to the sensitivity to EMB of the parental strain, its L-form variant showed phenotypic resistance to high concentrations of EMB (16mg/L), but the mutation in embB306 was not found. Electron microscopy observation of the L-form variant showed a heterogenic population of bacteria, with different degrees of cell wall deficiency, as well as cells of protoplastic type without cell walls. Of special interest were the observed capsule-like structures around the L-form cells and the biofilm-like matrix produced by the L-form population. We suggest that the expression of phenotypic resistance to EMB in M. tuberculosis can be associated with alterations or loss of cell walls in L-form bacteria, respectively, which results in a lack of a specific target for EMB action. In addition, production of capsule-like structures and biofilm matrix by L-forms could contribute to their resistance and survival in the presence of antibacterial agents. Copyright © 2016 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Rapid molecular screening for multidrug-resistant tuberculosis in a resource-limited region of China.

PubMed

Zhang, Dan; Liu, Beizhong; Wang, Yufeng; Pang, Yu

2014-10-01

To investigate the molecular characteristics of MDR and XDR strains circulating in Chongqing, China. The drug target genes conferring for rifampicin (RIF), isoniazid (INH), ethambutol (EMB), ofloxacin (OFLX) and kanamycin (KAN) resistance were screened by DNA sequencing to determine the mutation frequencies in this area. Drug susceptibility of 208 MDR isolates revealed that 132 (63.46%) were resistant to streptomycin (SM), 96 (46.15%) to ethambutol (EMB), 51 (24.52%) to ofloxacin (OFLX), and 26 (12.50%) to kanamycin (KAN); six (2.88%) isolates had XDR profiles. In comparison with the drug susceptibility phenotype, the sensitivity of drug resistance by DNA sequencing was 91.83% for RIF, 87.50% for INH, 66.67% for EMB, 74.51% for OFLX and 53.85% for KAN resistance. 12.50% of EMB- and 1.27% of OFLX-susceptible isolates were harboured genetic mutations in embB and gyrA, respectively. Our findings demonstrate that the hot-spot regions localised in rpoB, katG and inhA genes serve as excellent markers for the corresponding drug resistance, while EMB, OFLX or KAN drug-resistant TB cases may not be identifiable by scanning embB, gyrA, rrs and eis promoter in Chongqing, indicating that further studies on the drug resistance mechanisms of EMB, OFLX and KAN are urgently needed to elucidate the low sensitivity between genomic substitutions and drug-resistant phenotype. © 2014 John Wiley & Sons Ltd.

Large-Scale Aerosol Modeling and Analysis

DTIC Science & Technology

2009-09-30

Modeling of Burning Emissions ( FLAMBE ) project, and other related parameters. Our plans to embed NAAPS inside NOGAPS may need to be put on hold...AOD, FLAMBE and FAROP at FNMOC are supported by 6.4 funding from PMW-120 for “Large-scale Atmospheric Models”, “Small-scale Atmospheric Models

Designing Dreams or Constructing Contradictions? European Union Multifunctional Policies and the Polish Organic Farm Sector

ERIC Educational Resources Information Center

De Master, Kathryn

2012-01-01

Analysts have heralded the principle of "multifunctionality" undergirding the European Union's Common Agricultural Policy "Second Pillar" support mechanisms as a "new...and strong paradigm" for agriculture (van der Ploeg and Roep 2003), with the potential to re-embed social, environmental, and ethical concerns into…

Auditing and Mapping Key Skills within University Curricula

ERIC Educational Resources Information Center

Tariq, Vicki N.; Scott, Eileen M.; Cochrane, A. Clive; Lee, Maria; Ryles, Linda

2004-01-01

Universities are encouraged to embed key skills in their undergraduate curricula, yet there is often little support on how to identify skills development and progression. This paper describes a tool that facilitates colleagues in auditing key skills and career/employability skills within individual modules and mapping these skills across degree…

Networked Environments that Create Hybrid Spaces for Learning Science

ERIC Educational Resources Information Center

Otrel-Cass, Kathrin; Khoo, Elaine; Cowie, Bronwen

2014-01-01

Networked learning environments that embed the essence of the Community of Inquiry (CoI) framework utilise pedagogies that encourage dialogic practices. This can be of significance for classroom teaching across all curriculum areas. In science education, networked environments are thought to support student investigations of scientific problems,…

On Promoting Understanding and Equity through Compassionate Educational Practice: Toward a New Inclusion

ERIC Educational Resources Information Center

Bilias-Lolis, Evelyn; Gelber, Nicholas W.; Rispoli, Kristin M.; Bray, Melissa A.; Maykel, Cheryl

2017-01-01

This work offers a conceptual synthesis of several contemporary educational service delivery models that implicitly embed compassionate educational practices into supporting the learning and growth of diverse student populations. This manuscript discusses how such paradigms, such as culturally responsive positive behavior intervention and supports…

Supervisors Need Support, Too

ERIC Educational Resources Information Center

Martin, James G.

2017-01-01

In recent years, there has been an increasing focus on professional learning structures for teaching and finding ways to embed this learning into the daily work of teachers. This is premised on the understanding that one-shot professional development yields little transfer or change of practice to ultimately impact student learning. But how has…

75 FR 68684 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-09

..., Sao Jose dos Campos--SP, CEP: 12227-901--P.O. Box: 38/2, BRASIL, telephone: ++55 12 3927-5383; fax... Support, Av. Brig. Farina Lima, 2170, Sao Jose dos Campos--SP, CEP: 12227-901--P.O. Box: 38/2, BRASIL...

The South Eastern Europe Brigade: An Option for NATO-Led Peace Support Operations?

DTIC Science & Technology

2011-06-10

Exercise CSSB Combat Service Support Battalion DOS Day of Supply DRO Disaster Relief Operations EOD Explosive Ordnance Disposal ETF Engineer Task...the adoption of the second Additional Protocol, the SEEBRIG member nations established an Engineer Task Force ( ETF ). The concept embeds purpose...capabilities, like the ETF structure, could be used as niche military capabilities by outside organizations that may need them. SEEBRIG engineer capabilities

Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma.

PubMed

Wernick, B; Cipriano, A; Odom, S R; MacBean, U; Mubang, R N; Wojda, T R; Liu, S; Serres, S; Evans, D C; Thomas, P G; Cook, C H; Stawicki, S P

2017-06-01

The spleen is one of the most commonly injured abdominal solid organs during blunt trauma. Modern management of splenic trauma has evolved to include non-operative therapies, including observation and angioembolization to preclude splenectomy in most cases of blunt splenic injury. Despite the shift in management strategies, relatively little is known about the hematologic changes associated with these various modalities. The aim of this study was to determine if there are significant differences in hematologic characteristics over time based on the treatment modality employed following splenic trauma. We hypothesized that alterations seen in hematologic parameters would vary between observation (OBS), embolization (EMB), and splenectomy (SPL) in the setting of splenic injury. An institutional review board-approved, retrospective study of routine hematologic indices examined data between March 2000 and December 2014 at three academic trauma centers. A convenience sample of patients with splenic trauma and admission lengths of stay >96 h was selected for inclusion, resulting in a representative sample of each sub-group (OBS, EMB, and SPL). Basic demographics and injury severity data (ISS) were abstracted. Platelet count, red blood cell (RBC) count and RBC indices, and white blood cell (WBC) count with differential were analyzed between the time of admission and a maximum of 1080 h (45 days) post-injury. Comparisons between OBS, EMB, and SPL groups were then performed using non-parametric statistical testing, with statistical significance set at p < 0.05. Data from 130 patients (40 SPL, 40 EMB, and 50 OBS) were analyzed. The median age was 40 years, with 67 % males. Median ISS was 21.5 (21 for SPL, 19 for EMB, and 22 for OBS, p = n/s) and median Glasgow Coma Scale (GCS) was 15. Median splenic injury grade varied by interventional modality (grade 4 for SPL, 3 for EMB, and 2 for OBS, p < 0.05). Inter-group comparisons demonstrated no significant differences in RBC counts. However, mean corpuscular volume (MCV) and RBC distribution width (RDW) were elevated in the SPL and EMB groups (p < 0.01). Similarly, EMB and SPL groups had higher platelet counts than the OBS group (p < 0.01). In aggregate, WBC counts were highest following SPL, followed by EMB and OBS (p < 0.01). Similar trends were noted in neutrophil and monocyte counts (p < 0.01), but not in lymphocyte counts (p = n/s). This study describes important trends and patterns among fundamental hematologic parameters following traumatic splenic injuries managed with SPL, EMB, or OBS. As expected, observed WBC counts were highest following SPL, then EMB, and finally OBS. No differences were noted in RBC count between the three groups, but RDW was significantly greater following SPL compared to EMB and OBS. We also found that MCV was highest following OBS, when compared to EMB or SPL. Finally, our data indicate that platelet counts are similarly elevated for both SPL and EMB, when compared to the OBS group. These results provide an important foundation for further research in this still relatively unexplored area.

76 FR 64785 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-19

...--Internal, of Chapter 5, Time Limits Maintenance Checks, of EMBRAER EMB145 Aircraft Maintenance Manual, Part...--Tail Cone Fairing--Internal, of Chapter 5, Time Limits Maintenance Checks, of EMBRAER EMB145 Aircraft... Maintenance Checks, of EMBRAER EMB145 Aircraft Maintenance Manual, Part II, AMM-145/1124, Revision 54, dated...

78 FR 11553 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Electronic Flight Control System...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... metal with composite empennage and control surfaces. The Model EMB-550 airplane is designed for 8...; Electronic Flight Control System: Control Surface Awareness and Mode Annunciation AGENCY: Federal Aviation... Embraer S.A. Model EMB-550 airplane. This airplane will have a novel or unusual design feature(s...

Myocardial Parvovirus B19 Persistence: Lack of Association with Clinicopathologic Phenotype in Adults with Heart Failure

PubMed Central

Stewart, Garrick C.; Lopez-Molina, Javier; Gottumukkala, Raju V.; Rosner, Gregg F.; Anello, Mary S.; Hecht, Jonathan L.; Winters, Gayle L.; Padera, Robert F.; Baughman, Kenneth L.; Lipes, Myra A.

2011-01-01

Background Multiple viruses have been isolated from the heart, but their significance remains controversial. We sought to determine the prevalence of cardiotropic viruses in endomyocardial biopsy (EMB) samples from adult heart failure (HF) patients and to define the clinicopathologic profile of patients exhibiting viral positivity. Methods and Results EMB from 100 patients (median EF 30%, IQR 20–45%) presenting for cardiomyopathy evaluation (median symptom duration 5 months, IQR 1–13 months) were analyzed by polymerase chain reaction for adenovirus, cytomegalovirus, enteroviruses, Epstein-Barr virus, and parvovirus B19. Each isolate was sequenced and viral load was determined. Parvovirus B19 was the only virus detected in EMB samples (12% of subjects). No subject had anti-parvovirus IgM antibodies, but all had IgG antibodies, suggesting viral persistence. The clinical presentation of parvovirus-positive patients was markedly heterogeneous, with both acute and chronic HF, variable ventricular function, and ischemic cardiomyopathy. No subject met Dallas histopathological criteria for active or borderline myocarditis. Two patients with a positive cardiac MRI and presumed “parvomyocarditis” had similar viral loads as autopsy controls without heart disease. The oldest parvovirus-positive subjects were positive for genotype 2, suggesting lifelong persistence in heart tissue. Conclusions Parvovirus B19 was the only virus isolated from EMB samples in this series of adult HF patients from the United States. Positivity was associated with a wide array of clinical presentations and heart failure phenotypes. Our studies do not support a causative role for parvovirus B19 persistence in HF and therefore advocate against the use of antiviral therapy for these patients. PMID:21097605

Improving Metacomprehension and Calibration Accuracy through Embedded Cognitive and Metacognitive Strategy Prompts

ERIC Educational Resources Information Center

Reid, Alan J.

2013-01-01

A societal shift from print-based to digital texts has afforded the ability to embed reader support within an instructional text. Numerous factors make eBooks an attractive option for colleges and universities, though undergraduates consistently reaffirm a preference for print-based materials. Given that many undergraduates arrive to college with…

Digital Media Production to Support Literacy for Secondary Students with Diverse Learning Abilities

ERIC Educational Resources Information Center

Leach, April Marie

2017-01-01

Producing digital media is a hands-on, inquiry-based mindful process that naturally embeds Universal Design for Learning (UDL) principles into literacy instruction, providing options for learning and assessment for a wide array of students with diverse learning abilities. Video production learning experiences acknowledge the cognitive talents of…

Social Benefits of a Tangible User Interface for Children with Autistic Spectrum Conditions

ERIC Educational Resources Information Center

Farr, William; Yuill, Nicola; Raffle, Hayes

2010-01-01

Tangible user interfaces (TUIs) embed computer technology in graspable objects. This study assessed the potential of Topobo, a construction toy with programmable movement, to support social interaction in children with Autistic Spectrum Conditions (ASC). Groups of either typically developing (TD) children or those with ASC had group play sessions…

Mobile Learning with a Mobile Game: Design and Motivational Effects

ERIC Educational Resources Information Center

Schwabe, Gerhard; Goth, Christoph

2005-01-01

Mobile technologies offer the opportunity to embed learning in a natural environment. This paper describes the design of the MobileGame prototype, exploring the opportunities to support learning through an orientation game in a university setting. The paper first introduces the scenario and then describes the general architecture of the prototype.…

Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

ERIC Educational Resources Information Center

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2007-01-01

In this paper we describe our research using a multi-user virtual environment, "Quest Atlantis," to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment…

The Role of Executive Functions for Dyadic Literacy Learning in Kindergarten

ERIC Educational Resources Information Center

van de Sande, Eva; Segers, Eliane; Verhoeven, Ludo

2018-01-01

The current study used a dyadic and coconstructive approach to examine how to embed exercises that support executive functioning into early literacy instruction to empower its effects. Using a randomized controlled trial design with 100 children, we examined the effects of dyadic activities in which children scaffolded each other's learning and…

Outside the Green Box: Embedding Education for Sustainable Development through Cooperative Inquiry

ERIC Educational Resources Information Center

Summers, Denise; Turner, Rebecca

2011-01-01

By 2010 all educators in the English lifelong learning sector were expected to embed "education for sustainable development" to support their learners in becoming sustainable citizens. The teacher training team at a college in southwest England used a "cooperative inquiry" approach to develop themselves and their curriculum, to…

Effects of Goal-Setting Instruction on Academic Engagement for Students at Risk

ERIC Educational Resources Information Center

Rowe, Dawn A.; Mazzotti, Valerie L.; Ingram, Angela; Lee, Seunghee

2017-01-01

Research indicates teachers feel teaching goal-setting is an effective way to enhance academic engagement. However, teachers ultimately feel unprepared to embed goal-setting instruction into academic content to support active student engagement. Given the importance teachers place on goal-setting skills, there is a need to identify strategies to…

A Strategic Quality Assurance Framework in an African Higher Education Context

ERIC Educational Resources Information Center

Ansah, Francis

2015-01-01

This study is based on a pragmatist analysis of selected international accounts on quality assurance in higher education. A pragmatist perspective was used to conceptualise a logical internal quality assurance model to embed and support the alignment of graduate competencies in curriculum and assessment of Ghanaian polytechnics. Through focus…

Agent Models for Self-Motivated Home-Assistant Bots

NASA Astrophysics Data System (ADS)

Merrick, Kathryn; Shafi, Kamran

2010-01-01

Modern society increasingly relies on technology to support everyday activities. In the past, this technology has focused on automation, using computer technology embedded in physical objects. More recently, there is an expectation that this technology will not just embed reactive automation, but also embed intelligent, proactive automation in the environment. That is, there is an emerging desire for novel technologies that can monitor, assist, inform or entertain when required, and not just when requested. This paper presents three self-motivated, home-assistant bot applications using different self-motivated agent models. Self-motivated agents use a computational model of motivation to generate goals proactively. Technologies based on self-motivated agents can thus respond autonomously and proactively to stimuli from their environment. Three prototypes of different self-motivated agent models, using different computational models of motivation, are described to demonstrate these concepts.

Perceived Gender Ratings for High and Low Scorers on the Autism-Spectrum Quotient Consistent with the Extreme Male Brain Account of Autism

PubMed Central

Simons, Jessica M.; Maybery, Murray T.; Leung, Doris; Ng, Honey L. H.; Whitehouse, Andrew J. O.

2015-01-01

The Extreme Male Brain (EMB) theory posits that autistic traits are linked to excessive exposure to testosterone in utero. While findings from a number of studies are consistent with this theory, other studies have produced contradictory results. For example, some findings suggest that rather than being linked to hypermasculinization for males, or defeminization for females, elevated levels of autistic traits are instead linked to more androgynous physical features. The current study provided further evidence relevant to the EMB and androgony positions by comparing groups of males selected for high or low scores on the Autism-spectrum Quotient (AQ) as to the rated masculinity of their faces and voices, and comparable groups of females as to the rated femininity of their faces and voices. The voices of High-AQ males were rated as more masculine than those of Low-AQ males, while the faces of High-AQ females were rated as less feminine than those of Low-AQ females. There was no effect of AQ group on femininity ratings for female voices or on masculinity ratings for male faces. The results thus provide partial support for a link between high levels of autistic-like traits and hypermasculinization for males and defeminization for females, consistent with the EMB theory. PMID:26186689

76 FR 37244 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-120, -120ER...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... To Refer to Latest Revision of the Aircraft Maintenance Manual (AMM) Great Lakes stated that the...--Description and Operation, of Chapter 28, Fuel, the EMBRAER EMB120 Brasilia Aircraft Maintenance Manual, MM... Operation, of Chapter 28, Fuel, of the EMBRAER EMB120 Brasilia Aircraft Maintenance Manual, Revision 24...

78 FR 11560 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Electronic Flight Control System...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... or unusual design feature(s) associated with an electronic flight control system with respect to... control surfaces. The Model EMB-550 airplane is designed for 8 passengers, with a maximum of 12 passengers... the pilot or copilot sidestick. The Embraer S.A. Model EMB-550 airplane has a flight control design...

78 FR 31835 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Landing Pitchover Condition

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... Model EMB-550 airplane. The Model EMB-550 airplane is the first of a new family of jet airplanes... the fuel vent and exhaust emission requirements of 14 CFR part 34 and the noise certification... condition from which ultimate loads must also be determined. Loads must be determined for critical fuel and...

Adverse Childhood Experiences, Resilience and Mindfulness-Based Approaches: Common Denominator Issues for Children with Emotional, Mental, or Behavioral Problems

PubMed Central

Bethell, Christina; Gombojav, Narangerel; Solloway, Michele; Wissow, Lawrence

2016-01-01

Synopsis US children with emotional, mental, or behavioral conditions (EMB) have disproportionate exposure to potentially traumatizing adverse childhood experiences (ACEs) (70.7% EMB vs. 46.9% non-EMB). Neuroscience, epigenetic, developmental, social, epidemiologic, and other sciences provide theoretical and empirical explanations for observed early and lifelong physical, mental, emotional, educational, and social impacts of the trauma and chronic stress that can result from ACEs. Together, these sciences point to possibilities to strengthen families and promote child resilience and school and life success using mindfulness-based, mind-body approaches (MBMB) that neuroscience and other studies show promote healthy regulation of stress, resilience, and healing from emotional trauma. This paper examines US population-based associations between prevalence of EMB, ACEs, and risk regulating protective factors that are potentially malleable using MBMB, such as child resilience, parental coping and stress, and parent-child engagement. US rates of MBMB use among children with EMB are estimated. Findings encourage family-centered and mindfulness-based approaches to address social and emotional trauma and potentially interrupt intergenerational cycles of ACEs and prevalence of EMB among children and youth. PMID:26980120

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

Shi Haibin, E-mail: shihb@vip.sina.com; Yang Zhengqiang; Liu Sheng

To evaluate the efficacy and safety of cyanoacrylate glue embolization in the treatment of severe arterioportal shunt (APS) presenting with hepatofugal portal venous flow in hepatocellular carcinoma (HCC) patients. Between July 2000 and January 2010, 27 HCC patients with severe APS presenting with hepatofugal portal venous flow underwent transarterial angiography and treatment. Among them, four patients were excluded from the study. Twelve patients underwent transarterial chemoperfusion and embolization of APS with cyanoacrylate glue between January 2006 and January 2010 (Emb group), and the other 11 patients undergoing only transarterial chemoperfusion without embolization of APS between July 2000 and December 2005more » served as a control group (non-Emb group). The change of APS, survival rates, and procedure related complications were analyzed. In the Emb group, APS was improved in all of the 12 patients after initial glue embolization; long-term APS improvement with hepatopetal portal flow was achieved in 80 % (8 of 10) patients who underwent follow-up angiography. Survival rates in the Emb group were 67 % at 6 months, 33 % at 1 year, and 8 % at 2 years, whereas those in the non-Emb group were 0 % at 6 months (P < 0.05). Median survival time in the Emb group was 275 days, which was longer than that of 107 days in the non-Emb group (P = 0.001). There were no major complications in both groups. The preliminary experience suggests that glue embolization may be an effective and safe therapy in the management of severe APS accompanied by HCC and also improve patient survival.« less

Supporting Authors in the Development of Task-Based Learning in Serious Virtual Worlds

ERIC Educational Resources Information Center

Bellotti, Francesco; Berta, Riccardo; De Gloria, Alessandro; Primavera, Ludovica

2010-01-01

Serious virtual worlds (SVWs) represent a great opportunity for learning and should embed a lot of high-quality contextualised information so that the player can take the most from his or her exploration of the environment. This requires defining new methodologies and tools for effective production. We have investigated this issue in implementing…

Logging On: Using Online Learning to Support the Academic Nomad

ERIC Educational Resources Information Center

Gargano, Terra; Throop, Julia

2017-01-01

The Internet is cited for bringing about the most rapid and significant social change within societies worldwide. Higher education does not lie at the fringe of this discussion, but is rather at the center of it. Online learning is no longer considered a mere supplement to education but digital tools now routinely embed themselves in higher…

Building a University-Wide Agenda for Intercultural Competence and Understanding: Lessons Learned at the University of Minnesota

ERIC Educational Resources Information Center

Furco, Andrew; Lockhart, Kristin Nering

2018-01-01

Furthering intercultural competence in higher education requires colleges and universities to establish an intentional, mission driven strategic plan that embeds intercultural understanding and practice across the institution's work. To secure broad-based buy-in and support, this plan needs to consider the various ways that different units within…

Supporting Teachers to Embed Numeracy across the Curriculum: A Sociocultural Approach

ERIC Educational Resources Information Center

Bennison, Anne

2015-01-01

Numeracy is an integral part of subjects across the curriculum. If all teachers are able to identify and exploit the numeracy learning opportunities that exist in the subjects they teach, then students' numeracy capabilities along with learning in each subject is likely to be enhanced. This article builds on previous research where it was…

Immobilization of halophilic Bacillus sp. EMB9 protease on functionalized silica nanoparticles and application in whey protein hydrolysis.

PubMed

Sinha, Rajeshwari; Khare, S K

2015-04-01

The present work targets the fabrication of an active, stable, reusable enzyme preparation using functionalized silica nanoparticles as an effective enzyme support for crude halophilic Bacillus sp. EMB9 protease. The immobilization efficiency under optimized conditions was 60%. Characterization of the immobilized preparation revealed marked increase in pH and thermal stability. It retained 80% of its original activity at 70 °C while t 1/2 at 50 °C showed a five-fold enhancement over that for the free protease. Kinetic constants K m and V max were indicative of a higher reaction velocity along with decreased affinity for substrate. The preparation could be efficiently reused up to 6 times and successfully hydrolysed whey proteins with high degree of hydrolysis. Immobilization of a crude halophilic protease on a nanobased scaffold makes the process cost effective and simple.

Relationship between dose of emamectin benzoate and molting response of ovigerous American lobsters (Homarus americanus).

PubMed

Waddy, S L; Merritt, V A; Hamilton-Gibson, M N; Aiken, D E; Burridge, L E

2007-05-01

A widely-prescribed treatment to control sea lice on cultured salmon is the administration of feed medicated with SLICE (active ingredient emamectin benzoate (EMB)). High doses of EMB can disrupt the molt cycle of ovigerous American lobsters, causing them to enter proecdysis prematurely and lose their attached eggs when the shell is cast. To determine the dose response to EMB, lobsters were forced to ingest doses that ranged from 0.05 to 0.39 microg g(-1). A significant proportion of lobsters given doses of 0.39 and 0.22 microg g(-1) (37% and 23%, respectively) molted prematurely, almost a year earlier than the control group. All the lobsters in the 0.05 and 0.12 microg g(-1) groups molted at the normal time and the mean time of molt was similar to that of the control group. Thus, the no-observed-effect level (NOEL) and lowest-observed-effect level (LOEL) of EMB on the molt cycle were 0.12 and 0.22 microg EMB g(-1) lobster, respectively. To acquire the LOEL, a 500-g lobster would have to consume 22 g of salmon feed medicated with SLICE at a level of 5 microg EMB g(-1) feed.

Biochemical basis of mercury remediation and bioaccumulation by Enterobacter sp. EMB21.

PubMed

Sinha, Arvind; Kumar, Sumit; Khare, Sunil Kumar

2013-01-01

The aims of this study were to isolate metal bioaccumulating bacterial strains and to study their applications in removal of environmental problematic heavy metals like mercury. Five bacterial strains belonging to genera Enterobacter, Bacillus, and Pseudomonas were isolated from oil-spilled soil. Among these, one of the strains Enterobacter sp. EMB21 showed mercury bioaccumulation inside the cells simultaneous to its bioremediation. The bioaccumulation of remediated mercury was confirmed by transmission electron microscopy and energy dispersive X-ray. The mercury-resistant loci in the Enterobacter sp. EMB21 cells were plasmid-mediated as confirmed by transformation of mercury-sensitive Escherichia coli DH5α by Enterobacter sp. EMB21 plasmid. Effect of different culture parameters viz-a-viz inoculum size, pH, carbon, and nitrogen source revealed that alkaline pH and presence of dextrose and yeast extract favored better remediation. The results indicated the usefulness of Enterobacter sp. EMB21 for the effective remediation of mercury in bioaccumulated form. The Enterobacter sp. EMB21 seems promising for heavy metal remediation wherein the remediated metal can be trapped inside the cells. The process can further be developed for the synthesis of valuable high-end functional alloy, nanoparticles, or metal conjugates from the metal being remediated.

Reaping benefits from intellectual capital.

PubMed

Weston, Marla J; Estrada, Nicolette A; Carrington, Jane

2007-01-01

The wealth and value of organizations are increasingly based on intellectual capital. Although acquiring talented individuals and investing in employee learning adds value to the organization, reaping the benefits of intellectual capital involves translating the wisdom of employees into reusable and sustained actions. This requires a culture that creates employee commitment, encourages learning, fosters sharing, and involves employees in decision making. An infrastructure to recognize and embed promising and best practices through social networks, evidence-based practice, customization of innovations, and use of information technology results in increased productivity, stronger financial performance, better patient outcomes, and greater employee and customer satisfaction.

Optimization and field use of a bioassay to monitor sea lice Lepeophtheirus salmonis sensitivity to emamectin benzoate.

PubMed

Westcott, Jillian D; Stryhn, Henrik; Burka, John F; Hammell, K Larry

2008-04-01

A bioassay for sea lice Lepeophtheirus salmonis sensitivity towards emamectin benzoate (EMB) was validated for field use. A probit regression model with natural responsiveness was used for the number of affected (moribund or dead) sea lice in bioassays involving different concentrations of EMB. Bioassay optimization included an evaluation of the inter-rater reliability of sea lice responsiveness to EMB and an evaluation of gender-related differences in susceptibility. Adoption of a set of bioassay response criteria improved the concordance (evaluated using the concordance correlation coefficient) between raters' assessments and the model estimation of EC50 values (the 'effective concentration' leading to a response of 50% of the lice not prone to natural response). An evaluation of gender-related differences in EMB susceptibility indicated that preadult stage female sea lice exhibited a significantly larger sensitivity towards EMB in 12 of 19 bioassays compared to preadult males. In order to evaluate sea lice sensitivity to EMB in eastern Canada, the intensive salmon farming area in the Bay of Fundy in southwestern New Brunswick was divided into 4 distinct regions based on industry health management practices and hydrographics. A total of 38 bioassays were completed from 2002 to 2005 using populations of preadult stage sea lice collected from Atlantic salmon Salmo salar farms within the 4 described regions. There was no significant overall effect of region or year on EC50 values; however, analysis of variance indicated a significant effect of time of year on EC50 values in 2002 and a potential effect in 2004 to 2005. Although the range of EC50 values obtained in this 3 yr study did not appear sufficient to affect current clinical success in the control of sea lice, the results suggest a seasonal- or temperature-associated variation in sensitivity to EMB. This will need to be considered if changes in EMB efficacy occur in the future.

SU-E-I-23: Design and Clinical Application of External Marking Body in Multi- Mode Medical Images Registration and Fusion

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

Chen, Z; Gong, G

2014-06-01

Purpose: To design an external marking body (EMB) that could be visible on computed tomography (CT), magnetic resonance (MR), positron emission tomography (PET) and single-photon emission computed tomography (SPECT) images and to investigate the use of the EMB for multiple medical images registration and fusion in the clinic. Methods: We generated a solution containing paramagnetic metal ions and iodide ions (CT'MR dual-visible solution) that could be viewed on CT and MR images and multi-mode image visible solution (MIVS) that could be obtained by mixing radioactive nuclear material. A globular plastic theca (diameter: 3–6 mm) that mothball the MIVS and themore » EMB was brought by filling MIVS. The EMBs were fixed on the patient surface and CT, MR, PET and SPECT scans were obtained. The feasibility of clinical application and the display and registration error of EMB among different image modalities were investigated. Results: The dual-visible solution was highly dense on CT images (HU>700). A high signal was also found in all MR scanning (T1, T2, STIR and FLAIR) images, and the signal was higher than subcutaneous fat. EMB with radioactive nuclear material caused a radionuclide concentration area on PET and SPECT images, and the signal of EMB was similar to or higher than tumor signals. The theca with MIVS was clearly visible on all the images without artifact, and the shape was round or oval with a sharp edge. The maximum diameter display error was 0.3 ± 0.2mm on CT and MRI images, and 1.0 ± 0.3mm on PET and SPECT images. In addition, the registration accuracy of the theca center among multi-mode images was less than 1mm. Conclusion: The application of EMB with MIVS improves the registration and fusion accuracy of multi-mode medical images. Furthermore, it has the potential to ameliorate disease diagnosis and treatment outcome.« less

Development of a decision support tool for seasonal water supply management incorporating system uncertainties and operational constraints

NASA Astrophysics Data System (ADS)

Wang, H.; Asefa, T.

2017-12-01

A real-time decision support tool (DST) for water supply system would consider system uncertainties, e.g., uncertain streamflow and demand, as well as operational constraints and infrastructure outage (e.g., pump station shutdown, an offline reservoir due to maintenance). Such DST is often used by water managers for resource allocation and delivery for customers. Although most seasonal DST used by water managers recognize those system uncertainties and operational constraints, most use only historical information or assume deterministic outlook of water supply systems. This study presents a seasonal DST that incorporates rainfall/streamflow uncertainties, seasonal demand outlook and system operational constraints. Large scale climate-information is captured through a rainfall simulator driven by a Bayesian non-homogeneous Markov Chain Monte Carlo model that allows non-stationary transition probabilities contingent on Nino 3.4 index. An ad-hoc seasonal demand forecasting model considers weather conditions explicitly and socio-economic factors implicitly. Latin Hypercube sampling is employed to effectively sample probability density functions of flow and demand. Seasonal system operation is modelled as a mixed-integer optimization problem that aims at minimizing operational costs. It embeds the flexibility of modifying operational rules at different components, e.g., surface water treatment plants, desalination facilities, and groundwater pumping stations. The proposed framework is illustrated at a wholesale water supplier in Southeastern United States, Tampa Bay Water. The use of the tool is demonstrated in proving operational guidance in a typical drawdown and refill cycle of a regional reservoir. The DST provided: 1) probabilistic outlook of reservoir storage and chance of a successful refill by the end of rainy season; 2) operational expectations for large infrastructures (e.g., high service pumps and booster stations) throughout the season. Other potential use of such DST is also discussed.

Importance of Peer Support and Tutor Involvement in Entrepreneurship Education for Overseas Bioscience Students

ERIC Educational Resources Information Center

Mitchell, P. C.; McKeown, A. E.

2004-01-01

An increasing number of Bioscience courses embed entrepreneurship learning outcomes within the curriculum, across a number of modules and/or within a dedicated module. The level 2, Developing People and Products module is one such example, involving students in 100 study effort hours over 7 weeks. This module was delivered to students (n = 37)…

Clinical Partnership at a Distance: A Design That Transforms Teaching and Leadership

ERIC Educational Resources Information Center

Adams, Alyson; Ross, Dorene D.

2014-01-01

In this article we describe a graduate program for practicing teachers at the University of Florida. Offered in a blended format (mostly online but supported by a local faculty member), the program embeds graduate work within school reform efforts in hard to staff schools in partner school districts up to 350 miles away from campus in order to…

Labor Conflict on the National Stage: Metaphoric Lenses in Israel's Teachers' Strike

ERIC Educational Resources Information Center

Shenkar, Miriam; Shenkar, Oded

2011-01-01

Teachers often embed their labor demands within a broader context to claim high moral ground and build community support. We analyze a recent teachers' strike in Israel, looking at how the strike played out in a country where the challenges of globalization collided with a socialist legacy in the face of an existential threat. The analysis reveals…

Using IEP Goals and Objectives to Teach Paragraph Writing to High School Students with Physical and Cognitive Disabilities

ERIC Educational Resources Information Center

Konrad, Moira; Trela, Katherine; Test, David W.

2006-01-01

Current research and legislation show a need for special education instruction to be more closely aligned with general education curriculum and develop strategies that support the development of self determination skills in students with disabilities. The present study embeds self-determination skills of writing annual goals and objectives in the…

The Incredible Years Teacher Classroom Management Program: Using Coaching to Support Generalization to Real-World Classroom Settings

ERIC Educational Resources Information Center

Reinke, Wendy M.; Stormont, Melissa; Webster-Stratton, Carolyn; Newcomer, Lori L.; Herman, Keith C.

2012-01-01

This article focuses on the Incredible Years Teacher Classroom Management Training (IY TCM) intervention as an example of an evidence-based program that embeds coaching within its design. First, the core features of the IY TCM program are described. Second, the IY TCM coaching model and processes utilized to facilitate high fidelity of…

Insect symbionts as valuable grist for the biotechnological mill: an alkaliphilic silkworm gut bacterium for efficient lactic acid production.

PubMed

Liang, Xili; Sun, Chao; Chen, Bosheng; Du, Kaiqian; Yu, Ting; Luang-In, Vijitra; Lu, Xingmeng; Shao, Yongqi

2018-06-01

Insects constitute the most abundant and diverse animal class and act as hosts to an extraordinary variety of symbiotic microorganisms. These microbes living inside the insects play critical roles in host biology and are also valuable bioresources. Enterococcus mundtii EMB156, isolated from the larval gut (gut pH >10) of the model organism Bombyx mori (Lepidoptera: Bombycidae), efficiently produces lactic acid, an important metabolite for industrial production of bioplastic materials. E. mundtii EMB156 grows well under alkaline conditions and stably converts various carbon sources into lactic acid, offering advantages in downstream fermentative processes. High-yield lactic acid production can be achieved by the strain EMB156 from renewable biomass substrates under alkaline pretreatments. Single-molecule real-time (SMRT) sequencing technology revealed its 3.01 Mbp whole genome sequence. A total of 2956 protein-coding sequences, 65 tRNA genes, and 6 rRNA operons were predicted in the EMB156 chromosome. Remarkable genomic features responsible for lactic acid fermentation included key enzymes involved in the pentose phosphate (PP)/glycolytic pathway, and an alpha amylase and xylose isomerase were characterized in EMB156. This genomic information coincides with the phenotype of E. mundtii EMB156, reflecting its metabolic flexibility in efficient lactate fermentation, and established a foundation for future biotechnological application. Interestingly, enzyme activities of amylase were quite stable in high-pH broths, indicating a possible mechanism for strong EMB156 growth in an alkaline environment, thereby facilitating lactic acid production. Together, these findings implied that valuable lactic acid-producing bacteria can be discovered efficiently by screening under the extremely alkaline conditions, as exemplified by gut microbial symbionts of Lepidoptera insects.

Consecutive emamectin benzoate and deltamethrin treatments affect the expressions and activities of detoxification enzymes in the rainbow trout (Oncorhynchus mykiss).

PubMed

Cárcamo, Juan Guillermo; Aguilar, Marcelo N; Carreño, Constanza F; Vera, Tamara; Arias-Darraz, Luis; Figueroa, Jaime E; Romero, Alex P; Alvarez, Marco; Yañez, Alejandro J

2017-01-01

Rainbow trout (Oncorhynchus mykiss) subjected to three consecutive, alternating treatments with emamectin benzoate (EMB) and deltamethrin (DM) during outbreaks of Caligus rogercresseyi in a farm located in southern Chile (Hornopiren, Chiloé), were studied to determine the effects of these treatments on the protein and enzymatic activity levels of cytochrome P450 1A (CYP1A), flavin-containing monooxygenase (FMO) and glutathione S-transferase (GST) in different tissues. Consecutive and alternating EMB/DM treatments resulted in a 10-fold increase and 3-fold decrease of CYP1A protein levels in the intestine and gills, respectively. Notably, CYP1A activity levels decreased in most of the analyzed tissues. FMO protein and activity levels markedly increased in the kidney and the intestine. GST was up-regulated in all tissues, either as protein or enzyme activity. When comparing consecutive EMB/DM treatments against previous studies of EMB treatment alone, CYP1A activity levels were similarly diminished, except in muscle. Likewise, FMO activity levels were increased in most of the analyzed tissues, particularly in the muscle, kidney, and intestine. The increases observed for GST were essentially unchanged between consecutive EMB/DM and EMB only treatments. These results indicate that consecutive EMB/DM treatments in rainbow trout induce the expression and activity of FMO and GST enzymes and decrease CYP1A activity. These altered activities of detoxification enzymes could generate imbalances in metabolic processes, synthesis, degradation of hormones and complications associated with drug interactions. It is especially important when analyzing possible effects of consecutive antiparasitic treatments on withholding periods and salmon farming yields. Copyright © 2016 Elsevier Inc. All rights reserved.

Anti-inflammatory effects of embelin in A549 cells and human asthmatic airway epithelial tissues.

PubMed

Lee, In-Seung; Cho, Dong-Hyuk; Kim, Ki-Suk; Kim, Kang-Hoon; Park, Jiyoung; Kim, Yumi; Jung, Ji Hoon; Kim, Kwanil; Jung, Hee-Jae; Jang, Hyeung-Jin

2018-02-01

Allergic asthma is the most common type in asthma, which is defined as a chronic inflammatory disease of the lung. In this study, we investigated whether embelin (Emb), the major component of Ardisia japonica BL. (AJB), exhibits anti-inflammatory effects on allergic asthma via inhibition of NF-κB activity using A549 cells and asthmatic airway epithelial tissues. Inflammation was induced in A549 cells, a human airway epithelial cell line, by IL-1β (10 ng/ml) treatment for 4 h. The effects of Emb on NF-κB activity and COX-2 protein expression in inflamed airway epithelial cells and human asthmatic airway epithelial tissues were analyzed via western blot. The secretion levels of NF-κB-mediated cytokines/chemokines, including IL-4, 6, 9, 13, TNF-α and eotaxin, were measured by a multiplex assay. Emb significantly blocked NF-κB activity in IL-1β-treated A549 cells and human asthmatic airway epithelial tissues. COX-2 expression was also reduced in both IL-1β-treated A549 cells and asthmatic tissues Emb application. Emb significantly reduced the secretion of IL-4, IL-6 and eotaxin in human asthmatic airway epithelial tissues by inhibiting activity of NF-κB. The results of this study suggest that Emb may be used as an anti-inflammatory agent via inhibition of NF-κB and related cytokines.

Synthesis and characterization of emamectin-benzoate slow-release microspheres with different surfactants.

PubMed

Wang, Yan; Wang, Anqi; Wang, Chunxin; Cui, Bo; Sun, Changjiao; Zhao, Xiang; Zeng, Zhanghua; Shen, Yue; Gao, Fei; Liu, Guoqiang; Cui, Haixin

2017-10-06

Pesticide slow-release formulations provide a way to increase the efficiency of active components by reducing the amount of pesticide that needs to be applied. Slow-release formulations also increase the stability and prolong the control effect of photosensitive pesticides. Surfactants are an indispensable part of pesticide formulations, and the choice of surfactant can strongly affect formulation performance. In this study, emamectin-benzoate (EMB) slow-release microspheres were prepared by the microemulsion polymerization method. We explored the effect of different surfactants on the particle size and dispersity of EMB in slow-release microspheres. The results indicated that the samples had uniform spherical shapes with an average diameter of 320.5 ±5.24 nm and good dispersity in the optimal formulation with the polymeric stabilizer polyvinyl alcohol (PVA) and composite non-ionic surfactant polyoxyethylene castor oil (EL-40). The optimal EMB pesticide slow-release microspheres had excellent anti-photolysis performance, stability, controlled release properties, and good leaf distribution. These results demonstrated that EMB slow-release microspheres are an attractive candidate for improving pesticide efficacy and prolonging the control effect of EMB in the environment.

Nonlinear oscillation and interfacial stability of an encapsulated microbubble under dual-frequency ultrasound

NASA Astrophysics Data System (ADS)

Calvisi, Michael; Liu, Yunqiao; Wang, Qianxi

2016-11-01

Encapsulated microbubbles (EMBs) are widely used in medical ultrasound imaging as contrast-enhanced agents. However, the potential damaging effects of violent, collapsing EMBs to cells and tissues in clinical practice have remained a concern. Dual-frequency ultrasound is a promising technique for improving the efficacy and safety of sonography. The EMB system modeled consists of the external liquid, membrane, and internal gases. The microbubble dynamics are simulated using a simple nonlinear interactive theory, considering the compressibility of the internal gas, viscosity of the liquid flow, and elasticity of the membrane. The radial oscillation and interfacial stability of an EMB under single and dual-frequency excitations are compared. The simulation results show that the dual-frequency technique produces larger backscatter pressure at higher harmonics of the primary driving frequency. This enriched acoustic spectrum can enhance blood-tissue contrast and improve sonographic image quality. The results further show that the acoustic pressure threshold associated with the onset of shape instability is greater for dual-frequency driving. This suggests that the dual-frequency technique stabilizes the EMB, thereby improving the efficacy and safety of contrast-enhanced agents.

Fibromyalgia

MedlinePlus

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Lupus

MedlinePlus

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Depth of manual dismantling analysis: A cost–benefit approach

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

Achillas, Ch., E-mail: c.achillas@ihu.edu.gr; Aidonis, D.; Vlachokostas, Ch.

Highlights: ► A mathematical modeling tool for OEMs. ► The tool can be used by OEMs, recyclers of electr(on)ic equipment or WEEE management systems’ regulators. ► The tool makes use of cost–benefit analysis in order to determine the optimal depth of product disassembly. ► The reusable materials and the quantity of metals and plastics recycled can be quantified in an easy-to-comprehend manner. - Abstract: This paper presents a decision support tool for manufacturers and recyclers towards end-of-life strategies for waste electrical and electronic equipment. A mathematical formulation based on the cost benefit analysis concept is herein analytically described in ordermore » to determine the parts and/or components of an obsolete product that should be either non-destructively recovered for reuse or be recycled. The framework optimally determines the depth of disassembly for a given product, taking into account economic considerations. On this basis, it embeds all relevant cost elements to be included in the decision-making process, such as recovered materials and (depreciated) parts/components, labor costs, energy consumption, equipment depreciation, quality control and warehousing. This tool can be part of the strategic decision-making process in order to maximize profitability or minimize end-of-life management costs. A case study to demonstrate the models’ applicability is presented for a typical electronic product in terms of structure and material composition. Taking into account the market values of the pilot product’s components, the manual disassembly is proven profitable with the marginal revenues from recovered reusable materials to be estimated at 2.93–23.06 €, depending on the level of disassembly.« less

Bleeding Disorders

MedlinePlus

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Menstrual Cycle

MedlinePlus

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Modeling Integrated Water-User Decisions with Intermittent Supplies

NASA Astrophysics Data System (ADS)

Lund, J. R.; Rosenberg, D.

2006-12-01

We present an economic-engineering method to estimate urban water use demands with intermittent water supplies. A two-stage, probabilistic optimization formulation includes a wide variety of water supply enhancement and conservation actions that individual households can adopt to meet multiple water quality uses with uncertain water availability. We embed the optimization in Monte-Carlo simulations to show aggregate effects at a utility (citywide) scale for a population of user conditions and decisions. Parametric analysis provides derivations of supply curves to subsidize conservation, demand responses to alternative pricing, and customer willingness-to-pay to avoid shortages. Results show a good empirical fit for the average and distribution of billed residential water use in Amman, Jordan. Additional outputs give likely market penetration rates for household conservation actions, associated water savings, and subsidies required to entice further adoption. We discuss new insights to size, target, market, and finance conservation programs and interpret a demand curve with block pricing.

Solving Constraint-Satisfaction Problems with Distributed Neocortical-Like Neuronal Networks.

PubMed

Rutishauser, Ueli; Slotine, Jean-Jacques; Douglas, Rodney J

2018-05-01

Finding actions that satisfy the constraints imposed by both external inputs and internal representations is central to decision making. We demonstrate that some important classes of constraint satisfaction problems (CSPs) can be solved by networks composed of homogeneous cooperative-competitive modules that have connectivity similar to motifs observed in the superficial layers of neocortex. The winner-take-all modules are sparsely coupled by programming neurons that embed the constraints onto the otherwise homogeneous modular computational substrate. We show rules that embed any instance of the CSP's planar four-color graph coloring, maximum independent set, and sudoku on this substrate and provide mathematical proofs that guarantee these graph coloring problems will convergence to a solution. The network is composed of nonsaturating linear threshold neurons. Their lack of right saturation allows the overall network to explore the problem space driven through the unstable dynamics generated by recurrent excitation. The direction of exploration is steered by the constraint neurons. While many problems can be solved using only linear inhibitory constraints, network performance on hard problems benefits significantly when these negative constraints are implemented by nonlinear multiplicative inhibition. Overall, our results demonstrate the importance of instability rather than stability in network computation and offer insight into the computational role of dual inhibitory mechanisms in neural circuits.

Apoptosis of leukemia K562 and Molt-4 cells induced by emamectin benzoate involving mitochondrial membrane potential loss and intracellular Ca2+ modulation.

PubMed

Yun, Xinming; Rao, Wenbing; Xiao, Ciying; Huang, Qingchun

2017-06-01

Leukemia threatens millions of people's health and lives, and the pesticide-induced leukemia has been increasingly concerned because of the etiologic exposure. In this paper, cytotoxic effect of emamectin benzoate (EMB), an excellent natural-product insecticide, was evaluated through monitoring cell viability, cell apoptosis, mitochondrial membrane potential and intracellular Ca 2+ concentration ([Ca 2+ ] i ) in leukemia K562 and Molt-4 cells. Following the exposure to EMB, cell viability was decreased and positive apoptosis of K562 and Molt-4 cells was increased in a concentration- and time- dependent fashion. In the treatment of 10μM EMB, apoptotic cells accounted for 93.0% to K562 cells and 98.9% to Molt-4 cells based on the control, meanwhile, 63.47% of K562 cells and 81.15% of Molt-4 cells exhibited late apoptotic and necrotic features with damaged cytoplasmic membrane. 48h exposure to 10μM EMB increased significantly the great number of cells with mitochondrial membrane potential (MMP) loss, and the elevation of [Ca 2+ ] i level was peaked and persisted within 70s in K562 cells whilst 50s in Molt-4 cells. Moreover, a stronger cytotoxicity of EMB was further observed than that of imatinib. The results authenticate the efficacious effect of EMB as a potential anti-leukemia agent and an inconsistency with regard to insecticide-induced leukemia. Copyright © 2017 Elsevier B.V. All rights reserved.

Scientific literacy for democratic decision-making

NASA Astrophysics Data System (ADS)

Yacoubian, Hagop A.

2018-02-01

Scientifically literate citizens must be able to engage in making decisions on science-based social issues. In this paper, I start by showing examples of science curricula and policy documents that capitalise the importance of engaging future citizens in decision-making processes whether at the personal or at the societal levels. I elucidate the ideological underpinnings behind a number of the statements within those documents that have defined the trajectory of scientific literacy and have shaped what ought to be considered as personal and societal benefits. I argue that science curricula and policy documents can truly endorse scientific literacy when they embed principles of democratic education at their core. The latter entails fostering learning experiences where some of the underlying assumptions and political ideologies are brought to the conscious level and future citizens encouraged to reflect upon them critically and explicitly. Such a proposal empowers the future citizens to engage in critical deliberation on science-based social issues without taking the underlying status quo for granted. I end up the paper by situating the preparation of scientifically literate citizens within a framework of democratic education, discuss conditions through which a curriculum for scientific literacy can serve democratic decision-making processes, and provide modest recommendations.

A phenomenological study into the impact of the sign-off mentor in the acute hospital setting.

PubMed

Hutchison, Trudy; Cochrane, Jill

2014-06-01

Mentoring provides an essential quality assurance mechanism within undergraduate support and assessment of nurses. Recent changes to the standards for supporting pre-registration learners in clinical practice have provided additional structure to this process. Existing evidence suggests there are numerous challenges such as balancing clinical and mentoring priorities and making appropriate decisions; evidence about the sign-off mentor role in particular is currently lacking. This study explores the impact of the sign-off mentor role within the acute setting utilising a phenomenological approach. A purposive sample of 6 sign-off mentors contributed to data collection via the use of semi-structured interviews. Data were collected using a digital tape recorder and transcribed verbatim. Analysis of findings allowed for the development of 3 main themes which are accountability, time and commitment. A key finding of this study is the change in focus for sign-off mentors to one of assessment of clinical competence and professional regulation as opposed to mentors who have concentrated on the teaching and pastoral aspects of this role. However, sustainability requires further investment in this new role from a managerial and educational perspective. Recommendations include further attempts to embed protected time into organisational processes, the consideration of limiting students to sign-off mentors when mentoring a final placement student and negotiating maximum number of exposures to this role within a set time frame. © 2013.

Characterization of industrial wastes as raw materials for Emulsified Modified Bitumen (EMB) formulation

NASA Astrophysics Data System (ADS)

Najib Razali, Mohd; Isa, Syarifah Nur Ezatie Mohd; Salehan, Noor Adilah Md; Musa, Musfafikri; Aziz, Mohd Aizudin Abd; Nour, Abdurahman Hamid; Yunus, Rosli Mohd

2018-04-01

This study was conducted to characterize industrial wastes for formulation of emulsified modified bitumen (EMB) in relation to their physical characteristic and elemental composition. This analysis will give information either raw materials from industrial wastes can be used for EMB formulation. Bitumen is produced from crude oil that is extracted from the ground which categorizes the crude oil as one of the non-renewable form of product. A vast environmental problem issues arises in Malaysia cause by the excessive manufacturing activity that lead to a miss-management of industrial waste has leads to the used of industrial waste in the EMB formulation. Industrial waste such as polystyrene, polyethylene and used automotive oil can be used as alternative to formulate bitumen. Then a suitable emulsifier needs to be added to produce the final product which is EMB. The emulsifier will yield a charge depends on its properties to bind the oily bitumen with water. Physical characteristic studies were performed by thermogravimetric Analysis (TGA), differential scanning calorimetry (DSC), flash point test, density rest and moisture content test. Fourier Transform Infrared Spectroscopy (FTIR) analysis was measured to determine the material’s molecular composition and structure.

Molecular structure of EmbR, a response element of Ser/Thr kinase signaling in Mycobacterium tuberculosis

PubMed Central

Alderwick, Luke J.; Molle, Virginie; Kremer, Laurent; Cozzone, Alain J.; Dafforn, Timothy R.; Besra, Gurdyal S.; Fütterer, Klaus

2006-01-01

Ser/Thr phosphorylation has emerged as a critical regulatory mechanism in a number of bacteria, including Mycobacterium tuberculosis. This problematic pathogen encodes 11 eukaryotic-like Ser/Thr kinases, yet few substrates or signaling targets have been characterized. Here, we report the structure of EmbR (2.0 Å), a putative transcriptional regulator of key arabinosyltransferases (EmbC, -A, and -B), and an endogenous substrate of the Ser/Thr-kinase PknH. EmbR presents a unique domain architecture: the N-terminal winged-helix DNA-binding domain forms an extensive interface with the all-helical central bacterial transcriptional activation domain and is positioned adjacent to the regulatory C-terminal forkhead-associated (FHA) domain, which mediates binding to a Thr-phosphorylated site in PknH. The structure in complex with a phospho-peptide (1.9 Å) reveals a conserved mode of phospho-threonine recognition by the FHA domain and evidence for specific recognition of the cognate kinase. The present structures suggest hypotheses as to how EmbR might propagate the phospho-relay signal from its cognate kinase, while serving as a template for the structurally uncharacterized Streptomyces antibiotic regulatory protein family of transcription factors. PMID:16477027

Early polymerase chain reaction detection of Chagas disease reactivation in heart transplant patients.

PubMed

da Costa, Priscilla Almeida; Segatto, Marcela; Durso, Danielle Fernandes; de Carvalho Moreira, Wagson José; Junqueira, Lucas Lodi; de Castilho, Fábio Morato; de Andrade, Silvio Amadeu; Gelape, Cláudio Léo; Chiari, Egler; Teixeira-Carvalho, Andréa; Junho Pena, Sergio Danilo; Machado, Carlos Renato; Franco, Gloria Regina; Filho, Geraldo Brasileiro; Vieira Moreira, Maria da Consolação; Mara Macedo, Andréa

2017-07-01

Heart transplantation is a valuable therapeutic option for Chagas disease patients with severe cardiomyopathy. During patient follow-up, the differential diagnosis between cardiac transplant rejection and Chagas disease infection reactivation remains a challenging task, which hinders rapid implementation of the appropriate treatment. Herein we investigate whether polymerase chain reaction (PCR) strategies could facilitate early detection of Trypanosoma cruzi (T cruzi) in transplanted endomyocardial biopsies (EMBs). In this study we analyzed 500 EMB specimens obtained from 58 chagasic cardiac transplant patients, using PCR approaches targeted to nuclear (rDNA 24Sα) and kinetoplastid (kDNA) markers, and compared the efficiency of these approaches with that of other tests routinely used. T cruzi DNA was detected in 112 EMB specimens derived from 39 patients (67.2%). The first positive result occurred at a median 1.0 month post-transplant. Conventional histopathologic, blood smear and hemoculture analyses showed lower sensitivity and higher median time to the first positive result. Patient follow-up revealed that 31 of 39 PCR-positive cases presented clinical reactivation of Chagas disease at different time-points after transplantation. PCR techniques showed considerable sensitivity (0.82) and specificity (0.60), with area under the receiver operating characteristic (ROC) curves of 0.708 (p = 0.001). Moreover, PCR techniques anticipated the clinical signs of Chagas disease reactivation by up to 36 months, with a median time of 6 months and an average of 9.1 months. We found a good association between the PCR diagnosis and the clinical signs of the disease, indicating that the PCR approaches used herein are suitable for early diagnosis of Chagas disease reactivation, with high potential to assist physicians in treatment decisions. For this purpose, an algorithm is proposed for surveillance based on the molecular tests. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Mental health service user participation in Chinese culture: a model of independence or interdependence?

PubMed

Tang, Jessica Pui-Shan; Tse, Samson Shu-Ki; Davidson, Larry; Cheng, Patrick

2017-12-22

Current models of user participation in mental health services were developed within Western culture and thus may not be applicable to Chinese communities. To present a new model of user participation, which emerged from research within a Chinese community, for understanding the processes of and factors influencing user participation in a non-Western culture. Multiple qualitative methods, including focus groups, individual in-depth interviews, and photovoice, were applied within the framework of constructivist grounded theory and collaborative research. Diverging from conceptualizations of user participation with emphasis on civil rights and the individual as a central agent, participants in the study highlighted the interpersonal dynamics between service users and different players affecting the participation intensity and outcomes. They valued a reciprocal relationship with their caregivers in making treatment decisions, cooperated with staff to observe power hierarchies and social harmony, identified the importance of peer support in enabling service engagement and delivery, and emphasized professional facilitation in advancing involvement at the policy level. User participation in Chinese culture embeds dynamic interdependence. The proposed model adds this new dimension to the existing frameworks and calls for attention to the complex local ecology and cultural consistency in realizing user participation.

Organizational determinants of evaluation practice in Australian prevention agencies.

PubMed

Schwarzman, J; Bauman, A; Gabbe, B; Rissel, C; Shilton, T; Smith, B J

2018-06-01

Program evaluation is essential to inform decision making, contribute to the evidence base for strategies, and facilitate learning in health promotion and disease prevention organizations. Theoretical frameworks of organizational learning, and studies of evaluation capacity building describe the organization as central to evaluation capacity. Australian prevention organizations recognize limitations to current evaluation effectiveness and are seeking guidance to build evaluation capacity. This qualitative study identifies organizational facilitators and barriers to evaluation practice, and explores their interactions in Australian prevention organizations. We conducted semi-structured interviews with 40 experienced practitioners from government and non-government organizations. Using thematic analysis, we identified seven key themes that influence evaluation practice: leadership, organizational culture, organizational systems and structures, partnerships, resources, workforce development and training and recruitment and skills mix. We found organizational determinants of evaluation to have multi-level interactions. Leadership and organizational culture influenced organizational systems, resource allocation and support of staff. Partnerships were important to overcome resource deficits, and systems were critical to embed evaluation within the organization. Organizational factors also influenced the opportunities for staff to develop skills and confidence. We argue that investment to improve these factors would allow organizations to address evaluation capacity at multiple levels, and ultimately facilitate effective evaluation practice.

Saguaro: A Distributed Operating System Based on Pools of Servers.

DTIC Science & Technology

1988-03-25

asynchronous message passing, multicast, and semaphores are supported. We have found this flexibility to be very useful for distributed programming. The...variety of communication primitives provided by SR has facilitated the research of Stella Atkins, who was a visiting professor at Arizona during Spring...data bits in a raw communication channel to help keep the source and destination synchronized , Psync explicitly embeds timing information drawn from the

Evidence for changes in the transcription levels of two putative P-glycoprotein genes in sea lice (Lepeophtheirus salmonis) in response to emamectin benzoate exposure.

PubMed

Tribble, Nicholas D; Burka, John F; Kibenge, Frederick S B

2007-05-01

Overexpression of P-glycoproteins (Pgps) is assumed to be a principal mechanism of resistance of nematodes and arthropods to macrocyclic lactones. Quantitative RT-PCR (Q-RT-PCR) was used to demonstrate changes in transcription levels of two putative P-glycoprotein genes, designated here as SL0525 and SL-Pgp1, in sea lice (Lepeophtheirus salmonis) following exposure to emamectin benzoate (EMB). Pre-adult L. salmonis were challenged in an EMB bioassay for 24h and gene expression was studied from lice surviving EMB concentrations of 0, 10, and 30ppb. Gene expression was measured using Q-RT-PCR with elongation factor 1 (eEF1alpha) as an internal reference gene. The results show that both target genes, SL0525 and SL-Pgp1, had significantly increased levels of expression with exposure to 10ppb EMB (p=0.11 and p=0.17, respectively) whereas the group exposed to 30ppb was on the verge of being significant (p=0.053) only in the expression of SL-Pgp1. Gene expression for SL0525 and SL-Pgp1 were increased over five-fold at 10ppb EMB. Therefore, the upregulation of these target genes may offer protection by increasing Pgp expression when lice are exposed to EMB. Our optimized Q-RT-PCR can be used to determine if over-expression of these genes could be the basis for development of resistance in sea lice and thus allow suitable alternative chemotherapeutic options to be assessed.

Value of Information and Prospect theory as tools to involve decision-makers in water-related design, operation and planning of water systems

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo

2013-04-01

The role of decision-makers is to take the outputs from hydrological and hydraulic analyses and, in some extent, use them as inputs to make decisions that are related to planning, design and operation of water systems. However, the use of these technical analyses is frequently limited, since there are other non-hydrological issues that must be considered, that may end up in very different solutions than those envisaged by the purely technical ones. A possibility to account for the nature of the human decisions under uncertainty is by exploring the use of concepts from decision theory and behavioural economics, such as Value of Information and Prospect Theory and embed them into the methodologies we use in the hydrology practice. Three examples are presented to illustrate these multidisciplinary interactions. The first one, for monitoring network design, uses Value of Information within a methodology to locate water level stations in a complex canal of networks in the Netherlands. The second example, for operation, shows how the Value of Information concept can be used to formulate alternative methods to evaluate flood risk according to the set of options available for decision-making during a flood event. The third example, for planning, uses Prospect Theory concepts to understand how the "losses hurt more than gains feel good" effect can determine the final decision of urbanise or not a flood-prone area. It is demonstrated that decision theory and behavioural economic principles are promising to evaluate the complex decision-making process in water-related issues.

Urban atmospheric pollution in the Eastern Mediterranean : lessons from the TRANSEMED initiative

NASA Astrophysics Data System (ADS)

Borbon, Agnes; Salameh, Therese; Gaimoz, Cecile; Sauvage, Stephane; Locoge, Nadine; Oztürk, Fatma; Cetin, Banu; Keles, Melek; Afif, Charbel

2016-04-01

The East Mediterranean Basin (EMB) is a highly sensitive environment under considerable pressures. Future decadal projections point to the EMB as a possible hot spot of poor air quality and predict a continual and gradual warming in the region, much stronger than other regions. The increase and accumulation of anthropogenic emissions of gaseous and particulate pollutants from surrounding urban areas, are suspected as one of the key compounding factors of those environmental impacts. The quantification of emission distribution is a challenge, and even more in cities of the EMB where local emission data are sparse. While some highly resolved inventories have been developed at the regional scale in the EMB area for Beirut and Istanbul, their uncertainties are unknown. The paucity of observations in this region, especially for VOCs and PM composition, is a strong limitation to the achievement of evaluated and accurate emission inventories. As part of the TRANSEMED initiative (https://charmex.lsce.ipsl.fr/index.php/sister-projects/transemed.html), one of our objectives is to develop a systematic source-receptor methodology for emission inventory evaluation. We combine existing and newly collected observations and complementary source-receptor approaches (ie., urban enhancement emission ratios, multivariate models like PMF) in representative areas of the EMB: Beirut (Lebanon), Istanbul (Turkey), Cairo (Egypt) and, more recently, Athens (Greece). Over the past five years a very detailed database of ambient and near-source observations has been built-up especially regarding the composition of gaseous organic carbon. Results show (i) the extremely high levels of pollution for organics, (ii) the dominance of traffic emissions on VOC concentration levels, (iii) the relative poor spatial variability of speciated hydrocarbon traffic emissions regardless of the region, and (iv) the high uncertainty on global emission inventories when compared to observations. For the latter, and from a global perspective, the relative importance of Eastern Mediterranean emissions is suspected to be largely underestimated compared to other regions worldwide: they could be as significant for VOC and NOx as the ones of Europe and North America or even higher for PM2.5. This work was supported by the ENVIMED and ChArMEx programmes within MISTRALS. The author would like to thank Thierry Leonardis for his technical support. References: Borbon et al., Composition of gaseous organic carbon during ECOCEM in Beirut, Lebanon: new observational constraints for VOC/OVOC anthropogenic emission evaluation in the Middle East region. In preparation for ACP. Salameh et al., Source apportionment vs. emission inventories of non-methane hydrocarbons (NMHC) in an urban area of the Middle East: local and global perspectives, in revision for ACP, 2016. http://www.atmos-chem-phys-discuss.net/15/26795/2015/acpd-15-26795-2015.html Salameh et al., Exploring the seasonal NMHC distribution in an urban area of the Middle East during ECOCEM campaigns: very high loadings dominated by local emissions and dynamics. Environ. Chem. 12 (3), 316 - 328. doi : 10.1071/EN14154, 2015. Salameh et al., Speciation of Non-Methane Hydrocarbons (NMHC) from anthropogenic sources in Beirut, Lebanon, Environ Sci. Pollut. Res., 21, 10867 - 10877. DOI: 10.1007/s11356-014-2978-5, 2014.

Harnessing the bio-mineralization ability of urease producing Serratia marcescens and Enterobacter cloacae EMB19 for remediation of heavy metal cadmium (II).

PubMed

Bhattacharya, Amrik; Naik, S N; Khare, S K

2018-06-01

In the present study, urease positive Serratia marcescens (NCIM2919) and Enterobacter cloacae EMB19 (MTCC10649) were individually evaluated for remediation of cadmium (II) using ureolysis-induced calcium carbonate precipitation. Both the cultures were observed to efficiently remove cadmium from the media through co-precipitation of Cd (II) and Ca (II). S. marcescens and E. cloacae EMB19, respectively showed 96 and 98% removal of initial 5.0 mg L -1 soluble Cd (II) from the urea and CaCl 2 laden media at 96 h of incubation period. At higher Cd (II) concentrations of 10 and 15 mg L -1 , cadmium removal efficiency was much higher in case of E. cloacae EMB19 compared to S. marcescens. In-vitro cadmium (II) remediation study using urease containing cell-free culture supernatant of S. marcescens and E. cloacae EMB19 showed respective 98 and 53% removal of initial 50 mg L -1  Cd (II) from the reaction mixtures in co-presence of Ca (II). While in sole presence of Cd (II), only 16 and 8% removal of Cd (II) were detected for S. marcescens and E. cloacae EMB19, respectively. The elemental analysis of the co-precipitated mineral products using Energy Dispersive X-ray spectroscopy (EDX) clearly showed the prevalence of Ca and Cd ions. The morphology Cd-Ca composites formed with respect to both the cultures were observed to be of different shape and size as revealed through Scanning Electron Microscopy (SEM). Entire study hence comes out with a sustainable bioremediation option which could be effectively used to tackle Cd (II) or other heavy metal pollution. Copyright © 2018 Elsevier Ltd. All rights reserved.

Revisiting Transitions in the Arab World, Spring or Fall?

DTIC Science & Technology

2012-01-01

Further, how might democracy arrive, embed, and survive in Middle  Eastern Arab states? Conversely, might the passions for accountable  gover - nance...ment “Democracy  [is]  preferable  to other  forms of  government.”4 These results mirror other findings of widespread support for accountable gover ...Lithuania, and Ukraine. After years of turbulent democratic gover - nance, individuals preferring democracy to a strong leader fell from 51 to 29

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

Fazalare, R.W.; Hayes, S.J.

One decision hydro project designers and developers make when building a new facility is what method to use to embed the turbine spiral case in the powerhouse concrete. The type of technique chosen often is based on the long-standing practice or individual preference of the plant owner. However, according to a recent industry survey, any method can be used successfully if proper design and installation procedures are followed. Although pressurized embedment has been the prominent method in the past, especially in the US, the bare deflated casing method is gaining popularity throughout the world because it can reduce cost andmore » construction time. This method has been the primary technique used with apparent success in Japan and Scandinavia.« less

Curriculum Mapping to Embed Graduate Capabilities

ERIC Educational Resources Information Center

Spencer, David; Riddle, Matthew; Knewstubb, Bernadette

2012-01-01

Graduate capabilities are an essential aspect of undergraduate development in higher education. Accordingly, La Trobe University's "Design for learning" has identified particular university-wide graduate capabilities and required all faculties to explicitly embed these in their curricula. The Faculty of Law and Management developed an approach to…

Mono-2-ethylhexyl phthalate disrupts neurulation and modifies the embryonic redox environment and gene expression

PubMed Central

Sant, Karilyn E.; Dolinoy, Dana C.; Jilek, Joseph L.; Sartor, Maureen A.; Harris, Craig

2016-01-01

Mono-2-ethylhexl phthalate (MEHP) is the primary metabolite of di-2-ethylhexyl phthalate (DEHP), a ubiquitous contaminant in plastics. This study sought to determine how structural defects caused by MEHP in mouse whole embryo culture were related to temporal and spatial patterns of redox state and gene expression. MEHP reduced morphology scores along with increased incidence of neural tube defects. Glutathione (GSH) and cysteine (Cys) concentrations fluctuated spatially and temporally in embryo (EMB) and visceral yolk sac (VYS) across the 24h culture. Redox potentials (Eh) for GSSG/GSH were increased by MEHP in EMB (12h) but not in VYS. CySS/CyS Eh in EMB and VYS were significantly increased at 3h and 24h, respectively. Gene expression at 6h showed that MEHP induced selective alterations in EMB and VYS for oxidative phosphorylation and energy metabolism pathways. Overall, MEHP affects neurulation, alters Eh, and spatially alters the expression of metabolic genes in the early organogenesis-stage mouse conceptus. PMID:27167697

NASA Standard for Models and Simulations: Credibility Assessment Scale

NASA Technical Reports Server (NTRS)

Babula, Maria; Bertch, William J.; Green, Lawrence L.; Hale, Joseph P.; Mosier, Gary E.; Steele, Martin J.; Woods, Jody

2009-01-01

As one of its many responses to the 2003 Space Shuttle Columbia accident, NASA decided to develop a formal standard for models and simulations (M&S). Work commenced in May 2005. An interim version was issued in late 2006. This interim version underwent considerable revision following an extensive Agency-wide review in 2007 along with some additional revisions as a result of the review by the NASA Engineering Management Board (EMB) in the first half of 2008. Issuance of the revised, permanent version, hereafter referred to as the M&S Standard or just the Standard, occurred in July 2008. Bertch, Zang and Steeleiv provided a summary review of the development process of this standard up through the start of the review by the EMB. A thorough recount of the entire development process, major issues, key decisions, and all review processes are available in Ref. v. This is the second of a pair of papers providing a summary of the final version of the Standard. Its focus is the Credibility Assessment Scale, a key feature of the Standard, including an example of its application to a real-world M&S problem for the James Webb Space Telescope. The companion paper summarizes the overall philosophy of the Standard and an overview of the requirements. Verbatim quotes from the Standard are integrated into the text of this paper, and are indicated by quotation marks.

Mechanisms of nascent fiber formation during avian skeletal muscle hypertrophy

NASA Technical Reports Server (NTRS)

McCormick, K. M.; Schultz, E.

1992-01-01

This study examined two putative mechanisms of new fiber formation in postnatal skeletal muscle, namely longitudinal fragmentation of existing fibers and de novo formation. The relative contributions of these two mechanisms to fiber formation in hypertrophying anterior latissimus dorsi (ALD) muscle were assessed by quantitative analysis of their nuclear populations. Muscle hypertrophy was induced by wing-weighting for 1 week. All nuclei formed during the weighting period were labeled by continuous infusion of 5-bromo-2'-deoxyuridine (BrdU), a thymidine analog, and embryonic-like fibers were identified using an antibody to ventricular-like embryonic (V-EMB) myosin. The number of BrdU-labeled and unlabeled nuclei in V-EMB-positive fibers were counted. Wing-weighting resulted in significant muscle enlargement and the appearance of many V-EMB+ fibers. The majority of V-EMB+ fibers were completely independent of mature fibers and had a nuclear density characteristics of developing fibers. Furthermore, nearly 100% of the nuclei in independent V-EMB+ fibers were labeled. These findings strongly suggest that most V-EMB+ fibers were nascent fibers formed de novo during the weighting period by satellite cell activation and fusion. Nascent fibers were found primarily in the space between fascicles where they formed a complex anastomosing network of fibers running at angles to one another. Although wing-weighting induced an increase in the number of branched fibers, there was no evidence that V-EMB+ fibers were formed by longitudinal fragmentation. The location of newly formed fibers in wing-weighted and regenerating ALD muscle was compared to determine whether satellite cells in the ALD muscle were unusual in that, if stimulated to divide, they would form fibers in the inter- and intrafascicular space. In contrast to wing-weighted muscle, nascent fibers were always found closely associated with necrotic fibers. These results suggest that wing-weighting is not simply another model of regeneration, but rather produces a unique environment which induces satellite cell migration and subsequent fiber formation in the interfascicular space. De novo fiber formation is apparently the principal mechanism for the hyperplasia reported to occur in the ALD muscle undergoing hypertrophy induced by wing-weighting.

Alternative Fuels Data Center: Virginia Transportation Data for Alternative

Science.gov Websites

://www.youtube.com/embed/1S7JJHQpc1w Video thumbnail for Propane Buses Save Money for Virginia Schools Propane Buses Save Money for Virginia Schools Feb. 25, 2010 https://www.youtube.com/embed/enxaQ_QooWE Chart Data

Drug policy, intravenous drug use, and heroin addiction in the UK.

PubMed

Geraghty, Jemell

In order to fully understand and appreciate today's drug problem in the UK, the foundations of drug legislation and the history of drug evolution require exploration. This paper critically examines the history of drug policy and the growth of heroin addiction from the perspective of a novice researcher who works closely with intravenous drug users in relation to leg ulceration and wound care in the acute setting. Today's drug policy has come a long way in understanding the problems of heroin addiction and establishing services to meet intravenous drug users' needs and the needs of society. This paper highlights the early warning signs of drug addiction and growth within the UK from an early stage with key areas such as who the early users were and how addiction grew so rapidly between 1920 and 1960. Current policy and decision makers as well as clinicians and researchers in this field must understand the impacts of past policy and embed it within their decisions surrounding drug policy today.

Probabilistic Reward- and Punishment-based Learning in Opioid Addiction: Experimental and Computational Data

PubMed Central

Myers, Catherine E.; Sheynin, Jony; Baldson, Tarryn; Luzardo, Andre; Beck, Kevin D.; Hogarth, Lee; Haber, Paul; Moustafa, Ahmed A.

2016-01-01

Addiction is the continuation of a habit in spite of negative consequences. A vast literature gives evidence that this poor decision-making behavior in individuals addicted to drugs also generalizes to laboratory decision making tasks, suggesting that the impairment in decision-making is not limited to decisions about taking drugs. In the current experiment, opioid-addicted individuals and matched controls with no history of illicit drug use were administered a probabilistic classification task that embeds both reward-based and punishment-based learning trials, and a computational model of decision making was applied to understand the mechanisms describing individuals’ performance on the task. Although behavioral results showed thatopioid-addicted individuals performed as well as controls on both reward- and punishment-based learning, the modeling results suggested subtle differences in how decisions were made between the two groups. Specifically, the opioid-addicted group showed decreased tendency to repeat prior responses, meaning that they were more likely to “chase reward” when expectancies were violated, whereas controls were more likely to stick with a previously-successful response rule, despite occasional expectancy violations. This tendency to chase short-term reward, potentially at the expense of developing rules that maximize reward over the long term, may be a contributing factor to opioid addiction. Further work is indicated to better understand whether this tendency arises as a result of brain changes in the wake of continued opioid use/abuse, or might be a pre-existing factor that may contribute to risk for addiction. PMID:26381438

The Essential Gene EMB1611 Maintains Shoot Apical Meristem Function During Arabidopsis Development

USDA-ARS?s Scientific Manuscript database

The Arabidopsis thaliana genome contains hundreds of genes essential for seed development. Because null mutations in these genes cause embryo lethality, their specific molecular and developmental functions are largely unknown. Here, we identify a role for EMB1611/MEE22, an essential gene in Arabidop...

Embedding learning from adverse incidents: a UK case study.

PubMed

Eshareturi, Cyril; Serrant, Laura

2017-04-18

Purpose This paper reports on a regionally based UK study uncovering what has worked well in learning from adverse incidents in hospitals. The purpose of this paper is to review the incident investigation methodology used in identifying strengths or weaknesses and explore the use of a database as a tool to embed learning. Design/methodology/approach Documentary examination was conducted of all adverse incidents reported between 1 June 2011 and 30 June 2012 by three UK National Health Service hospitals. One root cause analysis report per adverse incident for each individual hospital was sent to an advisory group for a review. Using terms of reference supplied, the advisory group feedback was analysed using an inductive thematic approach. The emergent themes led to the generation of questions which informed seven in-depth semi-structured interviews. Findings "Time" and "work pressures" were identified as barriers to using adverse incident investigations as tools for quality enhancement. Methodologically, a weakness in approach was that no criteria influenced the techniques which were used in investigating adverse incidents. Regarding the sharing of learning, the use of a database as a tool to embed learning across the region was not supported. Practical implications Softer intelligence from adverse incident investigations could be usefully shared between hospitals through a regional forum. Originality/value The use of a database as a tool to facilitate the sharing of learning from adverse incidents across the health economy is not supported.

78 FR 11555 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Design Roll Maneuver for Electronic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

...; Design Roll Maneuver for Electronic Flight Controls AGENCY: Federal Aviation Administration (FAA), DOT... design roll maneuver for electronic flight controls, specifically an electronic flight control system... control surfaces. The Model EMB-550 airplane is designed for 8 passengers, with a maximum of 12 passengers...

77 FR 57481 - Special Conditions: Embraer S.A., Models EMB-135 and EMB-145 Series; Airplane Seats with Non...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-18

... Series; Airplane Seats with Non-Traditional, Large, Non-Metallic Panels AGENCY: Federal Aviation... have a novel or unusual design feature associated with the airplane seats that have non-traditional, large, non-metallic panels that would affect survivability during a post-crash fire event. The...

78 FR 63847 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Airplane Electronic System Security...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... design feature associated with the architecture and connectivity capabilities of the airplanes' computer... the comment for an association, business, labor union, etc.). DOT's complete Privacy Act Statement can... architecture for the Embraer Model EMB-550 series of airplanes is composed of several connected networks. This...

78 FR 31838 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Flight Envelope Protection: General...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

... new control architecture and a full digital flight control system which provides flight envelope... Administrator considers necessary to establish a level of safety equivalent to that established by the existing... metal with composite empennage and control surfaces. The Model EMB-550 airplane is designed for 8...

76 FR 5298 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

...-200. Related Information (h) Refer to MCAI AG[Ecirc]NCIA NACIONAL DE AVIA[Ccedil][Atilde]O CIVIL... de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes AGENCY: Federal Aviation Administration (FAA... mandatory continuing airworthiness information (MCAI) originated by an aviation authority of another country...

Intelligent video storage of visual evidences on site in fast deployment

NASA Astrophysics Data System (ADS)

Desurmont, Xavier; Bastide, Arnaud; Delaigle, Jean-Francois

2004-07-01

In this article we present a generic, flexible, scalable and robust approach for an intelligent real-time forensic visual system. The proposed implementation could be rapidly deployable and integrates minimum logistic support as it embeds low complexity devices (PCs and cameras) that communicate through wireless network. The goal of these advanced tools is to provide intelligent video storage of potential video evidences for fast intervention during deployment around a hazardous sector after a terrorism attack, a disaster, an air crash or before attempt of it. Advanced video analysis tools, such as segmentation and tracking are provided to support intelligent storage and annotation.

Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach

PubMed Central

Huang, Marilyn; Sun, Charlotte; Boyd-Rogers, Stephanie; Burzawa, Jennifer; Milbourne, Andrea; Keeler, Elizabeth; Yzquierdo, Rebecca; Lynch, Patrick; Peterson, Susan K.; Lu, Karen

2011-01-01

Background: Endometrial and colorectal cancers are the most common cancers in Lynch syndrome. Consensus guidelines recommend annual endometrial biopsy (EMB) and regular colonoscopies. We assessed the feasibility of concurrently performing EMB and colonoscopy and evaluated women's perception of pain, satisfaction, and acceptability. Methods: From July 2002 to December 2009, women who had a gene mutation for Lynch syndrome, met the Amsterdam II criteria, or had a high-risk situation that required screening were prospectively enrolled. After conscious sedation, the procedures were sequentially performed. Patients completed pre- and postprocedure questionnaires assessing pain, level of satisfaction, and acceptability. The Wilcoxon rank test and Mann-Whitney test were used to compare pain scores. Results: Forty-two women completed the study. Median age was 37 years (range, 25 to 73). Nineteen had previously had an EMB in the office setting. Women reported significantly lower median levels of pain in the combined procedure compared with previous office setting biopsies (P < .001). Regardless of parity, women reported significantly less pain for an EMB as part of the combined screen compared with an office EMB (parous, P = .003; nulliparous, P = .026). Women also reported a high level of satisfaction and more convenience in the combined procedure. All participants preferred combined to separately scheduled procedures and would recommend the combined procedure to their relatives. Conclusion: Combined colon and endometrial cancer screening is a patient-centered approach that is feasible, acceptable, and may improve adherence to Lynch syndrome screening recommendations. PMID:21532810

Mental health and psychosocial support in humanitarian emergencies.

PubMed

van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P

2015-09-28

Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.

Randomized pilot trial of gene expression profiling versus heart biopsy in the first year after heart transplant: early invasive monitoring attenuation through gene expression trial.

PubMed

Kobashigawa, Jon; Patel, Jignesh; Azarbal, Babak; Kittleson, Michelle; Chang, David; Czer, Lawrence; Daun, Tiffany; Luu, Minh; Trento, Alfredo; Cheng, Richard; Esmailian, Fardad

2015-05-01

The endomyocardial biopsy (EMB) is considered the gold standard in rejection surveillance post cardiac transplant, but is invasive, with risk of complications. A previous trial suggested that the gene expression profiling (GEP) blood test was noninferior to EMB between 6 and 60 months post transplant. As most rejections occur in the first 6 months, we conducted a single-center randomized trial of GEP versus EMB starting at 55 days post transplant (when GEP is valid). Sixty heart transplant patients meeting inclusion criteria were randomized beginning at 55 days post transplant to either GEP or EMB arms. A positive GEP ≥30 between 2 and 6 months, or ≥34 after 6 months, prompted a follow-up biopsy. The primary end point included a composite of death/retransplant, rejection with hemodynamic compromise or graft dysfunction at 18 months post transplant. A coprimary end point included change in first-year maximal intimal thickness by intravascular ultrasound, a recognized surrogate for long-term outcome. Corticosteroid weaning was assessed in both the groups. The composite end point was similar between the GEP and EMB groups (10% versus 17%; log-rank P=0.44). The coprimary end point of first-year intravascular ultrasound change demonstrated no difference in mean maximal intimal thickness (0.35±0.36 versus 0.36±0.26 mm; P=0.944). Steroid weaning was successful in both the groups (91% versus 95%). In this pilot study, GEP starting at 55 days post transplant seems comparable with EMB for rejection surveillance in selected heart transplant patients and does not result in increased adverse outcomes. GEP also seems useful to guide corticosteroid weaning. Larger randomized trials are required to confirm these findings. URL: http://www.clinicaltrials.gov. Unique identifier: NCT014182482377. © 2015 American Heart Association, Inc.

Insulin and branched-chain amino acid depletion during mouse preimplantation embryo culture programmes body weight gain and raised blood pressure during early postnatal life.

PubMed

Velazquez, Miguel A; Sheth, Bhavwanti; Smith, Stephanie J; Eckert, Judith J; Osmond, Clive; Fleming, Tom P

2018-02-01

Mouse maternal low protein diet exclusively during preimplantation development (Emb-LPD) is sufficient to programme altered growth and cardiovascular dysfunction in offspring. Here, we use an in vitro model comprising preimplantation culture in medium depleted in insulin and branched-chain amino acids (BCAA), two proposed embryo programming inductive factors from Emb-LPD studies, to examine the consequences for blastocyst organisation and, after embryo transfer (ET), postnatal disease origin. Two-cell embryos were cultured to blastocyst stage in defined KSOM medium supplemented with four combinations of insulin and BCAA concentrations. Control medium contained serum insulin and uterine luminal fluid amino acid concentrations (including BCAA) found in control mothers from the maternal diet model (N-insulin+N-bcaa). Experimental medium (three groups) contained 50% reduction in insulin and/or BCAA (L-insulin+N-bcaa, N-insulin+L-bcaa, and L-insulin+N-bcaa). Lineage-specific cell numbers of resultant blastocysts were not affected by treatment. Following ET, a combined depletion of insulin and BCAA during embryo culture induced a non sex-specific increase in birth weight and weight gain during early postnatal life. Furthermore, male offspring displayed relative hypertension and female offspring reduced heart/body weight, both characteristics of Emb-LPD offspring. Combined depletion of metabolites also resulted in a strong positive correlation between body weight and glucose metabolism that was absent in the control group. Our results support the notion that composition of preimplantation culture medium can programme development and associate with disease origin affecting postnatal growth and cardiovascular phenotypes and implicate two important nutritional mediators in the inductive mechanism. Our data also have implications for human assisted reproductive treatment (ART) practice. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Refusal of recommended maternity care: Time to make a pact with women?

PubMed

Jenkinson, Bec; Kruske, Sue; Kildea, Sue

2018-03-28

The right to refuse medical treatment can be contentious in maternity care. Professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy, but there is little guidance available to clinicians about the appropriate clinical responses when women decline recommended care. We propose a comprehensive, woman-centred, systems-level framework for documentation and communication with the goal of supporting women, clinicians and health services in situations of maternal refusal. We term this the Personalised Alternative Care and Treatment framework. The Personalised Alternative Care and Treatment framework addresses Australian policy, practice, education and professional issues to underpin woman-centred care in the context of maternal refusal. It embeds Respectful Maternity Care in system-level maternity care policy; highlights the woman's role as decision maker about her maternity care; documents information exchanged with women; creates a 'living' plan that respects the woman's birth intentions and can be reviewed as circumstances change; enables communication between clinicians; permits flexible initiation pathways; provides for professional education for clinicians, and incorporates a mediation role to act as a failsafe. The Personalised Alternative Care and Treatment framework has the potential to meet the needs of women, clinicians and health services when pregnant women decline recommended maternity care. Copyright © 2018. Published by Elsevier Ltd.

International Data Archive

DTIC Science & Technology

1971-01-01

ARBOR, MICHIGAN A8104 © y Technical Progress Report // 4 1 January through 30 June 1971 ooO\\ Prepared in connection with research supported by...34? SSr^ ^ IRA ^ WEIS data from Janu- y . 1^66 though The data and source of each item is included in the analytic deck Also included is a descriptive...WEIGHTED, WEIGHTED, CHINESE: EXrrtA-SYSTEM ALL SIDES IN QUARREL BXTHA-nEGIONAL EXTRA-SYSTEH EXTRAS EG 10NAL (!1 EMB ER) E X T H A. J Y S T

76 FR 10213 - Special Conditions: Embraer Model EMB-135BJ (Legacy 650) Airplanes, Limit Engine Torque Loads for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... criteria for the more-severe events would no longer be a pure static torque-load condition, but would... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 25 [Docket No. NM449; Notice No. 25-420-SC] Special Conditions: Embraer Model EMB-135BJ (Legacy 650) Airplanes, Limit Engine...

76 FR 65101 - Special Conditions: Embraer S.A.; Model EMB 500; Single-Place Side Facing Seat Dynamic Test...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

... anthropomorphic test dummy (ATD) or its equivalent, undeformed floor, no yaw, and with all lateral structural... Side Facing Seat Dynamic Test Requirements AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... installation of a single-place side facing seat on Embraer S.A. EMB 500 aircraft. Side- facing seats are...

77 FR 69573 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Electronic Flight Control System...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... airplane will have a novel or unusual design feature(s) associated with an electronic flight control system... empennage and control surfaces. The Model EMB-550 airplane is designed for 8 passengers, with a maximum of... flight control design feature within the normal operational envelope in which sidestick deflection in the...

75 FR 53609 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes AGENCY... proposed AD. Discussion The AG[Ecirc]NCIA NACIONAL DE AVIA[Ccedil][Atilde]O CIVIL--BRAZIL (ANAC), which is... in the AD docket. Relevant Service Information Empresa Brasileira de Aeron[aacute]utica S.A. (EMBRAER...

75 FR 45558 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... de Aeronautica S.A. (EMBRAER) Model EMB-500 Airplanes AGENCY: Federal Aviation Administration (FAA... proposed AD. Discussion The AG[Ecirc]NCIA NACIONAL DE AVIA[Ccedil][Atilde]O CIVIL--BRAZIL, which is the... MCAI in the AD docket. Relevant Service Information Empresa Brasileira de Aeron[aacute]utica S.A...

Uncertainty quantification in downscaling procedures for effective decisions in energy systems

NASA Astrophysics Data System (ADS)

Constantinescu, E. M.

2010-12-01

Weather is a major driver both of energy supply and demand, and with the massive adoption of renewable energy sources and changing economic and producer-consumer paradigms, the management of the next-generation energy systems is becoming ever more challenging. The operational and planning decisions in energy systems are guided by efficiency and reliability, and therefore a central role in these decisions will be played by the ability to obtain weather condition forecasts with accurate uncertainty estimates. The appropriate temporal and spatial resolutions needed for effective decision-making, be it operational or planning, is not clear. It is arguably certain however, that such temporal scales as hourly variations of temperature or wind conditions and ramp events are essential in this process. Planning activities involve decade or decades-long projections of weather. One sensible way to achieve this is to embed regional weather models in a global climate system. This strategy acts as a downscaling procedure. Uncertainty modeling techniques must be developed in order to quantify and minimize forecast errors as well as target variables that impact the decision-making process the most. We discuss the challenges of obtaining a realistic uncertainty quantification estimate using mathematical algorithms based on scalable matrix-free computations and physics-based statistical models. The process of making decisions for energy management systems based on future weather scenarios is a very complex problem. We shall focus on the challenges in generating wind power predictions based on regional weather predictions, and discuss the implications of making the common assumptions about the uncertainty models.

Probabilistic reward- and punishment-based learning in opioid addiction: Experimental and computational data.

PubMed

Myers, Catherine E; Sheynin, Jony; Balsdon, Tarryn; Luzardo, Andre; Beck, Kevin D; Hogarth, Lee; Haber, Paul; Moustafa, Ahmed A

2016-01-01

Addiction is the continuation of a habit in spite of negative consequences. A vast literature gives evidence that this poor decision-making behavior in individuals addicted to drugs also generalizes to laboratory decision making tasks, suggesting that the impairment in decision-making is not limited to decisions about taking drugs. In the current experiment, opioid-addicted individuals and matched controls with no history of illicit drug use were administered a probabilistic classification task that embeds both reward-based and punishment-based learning trials, and a computational model of decision making was applied to understand the mechanisms describing individuals' performance on the task. Although behavioral results showed that opioid-addicted individuals performed as well as controls on both reward- and punishment-based learning, the modeling results suggested subtle differences in how decisions were made between the two groups. Specifically, the opioid-addicted group showed decreased tendency to repeat prior responses, meaning that they were more likely to "chase reward" when expectancies were violated, whereas controls were more likely to stick with a previously-successful response rule, despite occasional expectancy violations. This tendency to chase short-term reward, potentially at the expense of developing rules that maximize reward over the long term, may be a contributing factor to opioid addiction. Further work is indicated to better understand whether this tendency arises as a result of brain changes in the wake of continued opioid use/abuse, or might be a pre-existing factor that may contribute to risk for addiction. Copyright © 2015 Elsevier B.V. All rights reserved.

On formally integrating science and policy: walking the walk

USGS Publications Warehouse

Nichols, James D.; Johnson, Fred A.; Williams, Byron K.; Boomer, G. Scott

2015-01-01

The contribution of science to the development and implementation of policy is typically neither direct nor transparent.  In 1995, the U.S. Fish and Wildlife Service (FWS) made a decision that was unprecedented in natural resource management, turning to an unused and unproven decision process to carry out trust responsibilities mandated by an international treaty.  The decision process was adopted for the establishment of annual sport hunting regulations for the most economically important duck population in North America, the 6 to 11 million mallards Anas platyrhynchos breeding in the mid-continent region of north-central United States and central Canada.  The key idea underlying the adopted decision process was to formally embed within it a scientific process designed to reduce uncertainty (learn) and thus make better decisions in the future.  The scientific process entails use of models to develop predictions of competing hypotheses about system response to the selected action at each decision point.  These prediction not only are used to select the optimal management action, but also are compared with the subsequent estimates of system state variables, providing evidence for modifying degrees of confidence in, and hence relative influence of, these models at the next decision point.  Science and learning in one step are formally and directly incorporated into the next decision, contrasting with the usual ad hoc and indirect use of scientific results in policy development and decision-making.  Application of this approach over the last 20 years has led to a substantial reduction in uncertainty, as well as to an increase in transparency and defensibility of annual decisions and a decrease in the contentiousness of the decision process.  As resource managers are faced with increased uncertainty associated with various components of global change, this approach provides a roadmap for the future scientific management of natural resources.  

Alternative Fuels Data Center: Fleet Application for School Transportation

Science.gov Websites

/_kZz_IxCsQA Video thumbnail for Natural Gas School Buses Help Kansas City Save Money Natural Gas School Buses Help Kansas City Save Money Nov. 12, 2011 https://www.youtube.com/embed/VYbBFQEKKCs Video thumbnail for , 2011 https://www.youtube.com/embed/ZJVXELFPywI Video thumbnail for Propane Buses Save Money for

78 FR 49655 - Special Conditions: Embraer, S.A., Model EMB-550 Airplane; Side-Facing Seats; Installation of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

.... Discussion The FAA has been conducting research to develop an acceptable method of compliance with Title 14...;to and codified in the Code of Federal Regulations, which is published #0;under 50 titles pursuant to....A. Model EMB-550 airplane. This airplane will have a novel or unusual design feature associated with...

Crowd-driven Ecosystem for Evolutionary Design

DTIC Science & Technology

2012-07-28

also embeds social media connections to maximize crowd engagement. Within such an environment, experts and non- traditional contributors (crowd) can...process.” The CEED platform also embeds social media connections to maximize crowd engagement. When completed, the software developed under the...track a project of interest online through other social media (namely RSS, Facebook, and Twitter) as well as on the vehicleforge website itself

Nonlinear oscillation and interfacial stability of an encapsulated microbubble under dual-frequency ultrasound

NASA Astrophysics Data System (ADS)

Liu, Yunqiao; Calvisi, Michael L.; Wang, Qianxi

2017-04-01

Encapsulated microbubbles (EMBs) are widely used in medical ultrasound imaging as contrast-enhanced agents. However, the potential damaging effects of violent collapsing EMBs to cells and tissues in clinical settings have remained a concern. Dual-frequency ultrasound is a promising technique for improving the efficacy and safety of sonography. The system modeled consists of the external liquid, membrane and internal gases of an EMB. The microbubble dynamics are simulated using a simple nonlinear interactive theory, considering the compressibility of the internal gas, viscosity of the liquid flow and viscoelasticity of the membrane. The radial oscillation and interfacial stability of an EMB under single- and dual-frequency excitations are compared. The simulation results show that the dual-frequency technique produces larger backscatter pressure at higher harmonics of the primary driving frequency—this enriched acoustic spectrum can enhance blood-tissue contrast and improve the quality of sonographic images. The results further show that the acoustic pressure threshold associated with the onset of shape instability is greater for dual-frequency driving. This suggests that the dual-frequency technique stabilizes the encapsulated bubble, thereby improving the efficacy and safety of contrast-enhanced agents.

EmbRS a new two-component system that inhibits biofilm formation and saves Rubrivivax gelatinosus from sinking.

PubMed

Steunou, Anne Soisig; Liotenberg, Sylviane; Soler, Marie-Noêlle; Briandet, Romain; Barbe, Valérie; Astier, Chantal; Ouchane, Soufian

2013-06-01

Photosynthetic bacteria can switch from planktonic lifestyle to phototrophic biofilm in mats in response to environmental changes. The mechanisms of phototrophic biofilm formation are, however, not characterized. Herein, we report a two-component system EmbRS that controls the biofilm formation in a photosynthetic member of the Burkholderiales order, the purple bacterium Rubrivivax gelatinosus. EmbRS inactivation results in cells that form conspicuous bacterial veils and fast-sinking aggregates in liquid. Biofilm analyses indicated that EmbRS represses the production of an extracellular matrix and biofilm formation. Mapping of transposon mutants that partially or completely restore the wild-type (WT) phenotype allowed the identification of two gene clusters involved in polysaccharide synthesis, one fully conserved only in Thauera sp., a floc-forming wastewater bacterium. A second two-component system BmfRS and a putative diguanylate cyclase BdcA were also identified in this screen suggesting their involvement in biofilm formation in this bacterium. The role of polysaccharides in sinking of microorganisms and organic matter, as well as the importance and the evolution of such regulatory system in phototrophic microorganisms are discussed. © 2013 The Authors. Microbiology Open published by John Wiley & Sons Ltd.

Attenuation of Typical Sex Differences in 800 Adults with Autism vs. 3,900 Controls

PubMed Central

Baron-Cohen, Simon; Cassidy, Sarah; Auyeung, Bonnie; Allison, Carrie; Achoukhi, Maryam; Robertson, Sarah; Pohl, Alexa; Lai, Meng-Chuan

2014-01-01

Sex differences have been reported in autistic traits and systemizing (male advantage), and empathizing (female advantage) among typically developing individuals. In individuals with autism, these cognitive-behavioural profiles correspond to predictions from the “extreme male brain” (EMB) theory of autism (extreme scores on autistic traits and systemizing, below average on empathizing). Sex differences within autism, however, have been under-investigated. Here we show in 811 adults (454 females) with autism and 3,906 age-matched typical control adults (2,562 females) who completed the Empathy Quotient (EQ), the Systemizing Quotient-Revised (SQ-R), and the Autism Spectrum Quotient (AQ), that typical females on average scored higher on the EQ, typical males scored higher on the SQ-R and AQ, and both males and females with autism showed a shift toward the extreme of the “male profile” on these measures and in the distribution of “brain types” (the discrepancy between standardized EQ and SQ-R scores). Further, normative sex differences are attenuated but not abolished in adults with autism. The findings provide strong support for the EMB theory of autism, and highlight differences between males and females with autism. PMID:25029203

Philanthropy at the intersection of health and the environment.

PubMed

Fortunato, Karla; Sessions, Kathryn

2011-05-01

Scores of foundations are supporting efforts to improve the environmental conditions that affect health outcomes. Environmental health philanthropy has grown from a few foundations in 1999 to more than 100 today, and to annual investments of at least $70 million. This dynamic area of philanthropy is assisting disaster-stricken communities in the Gulf Coast, supporting a national movement to reform chemicals policy, defending clean air and water standards, and underwriting environmental justice work in low-income communities and communities of color. We argue that these investments are yielding sizable returns, but more funding opportunities exist to deepen understanding of hazards, clean up communities, reform policies, and embed environmental health in new economic development.

If "One Size Does Not Fit All" when Embedding Adult Literacy in the Workplace, How Can We Identify "What Works"?

ERIC Educational Resources Information Center

Zepke, Nick

2011-01-01

This article discusses the results of funded research that investigated how an industry training organisation in Aotearoa New Zealand embeds literacy in the workplace. Results confirm a "common-sense view" that there is not one right way to embed workplace literacy. They also reveal a number of findings about what works effectively when…

Aircraft accident report : in-flight loss of propeller blade forced landing, and collision with terrain Atlantic Southeast Airlines, Inc., Flight 529 Embraer EMB-120RT, N256AS Carrollton, Georgia August 21, 1995

DOT National Transportation Integrated Search

1995-08-21

This report explains the accident involving Atlantic Southeast Airlines flight 529, an EMB-120RT airplane, which experienced the loss of a propeller blade and crashed during an emergency landing near Carrollton, Georgia, on August 21, 1995. Safety is...

75 FR 8557 - Airworthiness Directives; Empresa Brasileira de Aeronautica S.A. (EMBRAER) Model EMB-135ER...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

..., -145ER, -145LR, -145MP, and - 145MR airplanes: Revise the Airworthiness Limitations (ALS) of the... EMBRAER Model EMB-145EP, -145ER, -145LR, -145MR, and - 145MP airplanes: Revise the ALS of the ICA to... Limitation Requirements, of the MRBR. (3) For all airplanes: Revise the ALS of the ICA to incorporate Tasks...

Increased major bleeding complications related to triple antithrombotic therapy usage in patients with atrial fibrillation undergoing percutaneous coronary artery stenting.

PubMed

Manzano-Fernández, Sergio; Pastor, Francisco J; Marín, Francisco; Cambronero, Francisco; Caro, Cesar; Pascual-Figal, Domingo A; Garrido, Iris P; Pinar, Eduardo; Valdés, Mariano; Lip, Gregory Y H

2008-09-01

The optimal antithrombotic therapy strategy for atrial fibrillation (AF) patients who undergo percutaneous coronary intervention with stent implantation (PCI-S) is unknown. We assessed the safety of antithrombotic therapy strategies in AF patients with indication for oral anticoagulation (OAC) undergoing PCI-S. We studied consecutive AF patients with indication for OAC who underwent PCI-S. We compared patients that received triple antithrombotic therapy (TT) [aspirin, clopidogrel, and coumadin] against other regimes (non-TT) after PCI-S. The primary end point was defined as the occurrence of major bleeding complications that were termed as early major bleeding (EMB) [< or = 48 h] or late major bleeding (LMB) [> 48 h]. Clinical follow-up was performed, and complications were recorded. We studied 104 patients (mean age +/- SD, 72 +/- 8 years; 70% men); TT was used in 51 patients (49%). TT was associated with a higher incidence of LMB (21.6% vs non-TT, 3.8%; p = 0.006) but not of EMB (5.8% vs non-TT, 11.3%; p = 0.33). In multivariate analyses, glycoprotein (GP) IIb/IIIa inhibitor use (hazard ratio [HR], 13.5; 95% confidence interval [CI], 1.7 to 108.3; p = 0.014) and PCI-S of three vessels or left main artery disease (HR, 7.9; 95% CI, 1.6 to 39.2; p = 0.01) were independent predictors for EMB. TT use (HR, 7.1; 95% CI, 1.5 to 32.4; p = 0.012), the occurrence of EMB (HR, 6.7; 95% CI, 1.8 to 25.3; p = 0.005), and baseline anemia (HR, 3.8; 95% CI, 1.2 to 12.5; p = 0.027) were independent predictors for LMB. No differences in major cardiovascular events were observed in patients treated with TT vs non-TT (25.5% vs 21.0%; p = 0.53). A high rate of major bleeding is observed in AF patients with indication for OAC undergoing PCI-S who receive TT. GP IIb/IIIa inhibitor use and multivessel/left main artery disease during PCI-S were independent predictors for EMB, while TT use, occurrence of EMB, and baseline anemia were independent predictors for LMB.

Expandable Micro-motor Bur, design of a new device for least invasive extraction of broken teeth roots

PubMed Central

2013-01-01

Background Extraction of a broken tooth root is often a traumatic experience for both the practitioner and the patient. To extract broken roots, generally invasive approaches as open window surgeries or mucoperiosteal flap and/or removal of buccal bone are performed. Presentation of the hypothesis Expandable micro-motor bur (EMB) is a hypothetical design of a dental instrument proposed for removal of broken teeth roots that cannot be extracted by the routine closed methods and in which common instrumentations cannot afford to accomplish. Implication of EMB would introduce a new technique in removal of broken teeth roots in which surgical trauma is minimized and so post-extraction disorders. It would eliminate surgical invasion to the surrounding tissues; and also it would eliminate profound hand forces by the practitioner, consequently reduces stress for both the practitioner and the patient. It would eliminate high risk aftermaths such as operative morbidity (due to bone loss), maxillary sinus exposure and probable need for additional surgery as are indicative of some conventional open access approaches. Testing the hypothesis Further studies are needed to confirm its effect in clinical cases. The effectiveness of EMB should be verified firstly by animal experiments. The likelihood of its negative influence on nearby vascular and nerve system should be well evaluated. Implications of the hypothesis Implication of EMB would be of interest to both patients and the surgeon due to the following main achievements: a) no need for mucoperiosteal flap, hence preservation of soft tissue, b) no need for osteotomy, hence retention of buccal bone, c) less risk of sinus exposure, d) minimum chance of post operative infections due to eliminated surgeries in soft tissues and bones and e) in terms of esthetics, it will have a special meaning for immediate placement of dental implants. EMB’s structural components include Bur head, Spacers and Bur base. A micro motor would power its spin. In contrast to conventional surgical approaches, EMB procedure is conservative. It is anticipated that EMB would provide less traumatic and least post-operative complications in extraction of broken teeth roots. PMID:23497515

New paradigms in telemedicine: ambient intelligence, wearable, pervasive and personalized.

PubMed

Rubel, Paul; Fayn, Jocelyne; Simon-Chautemps, Lucas; Atoui, Hussein; Ohlsson, Mattias; Telisson, David; Adami, Stefano; Arod, Sébastien; Forlini, Marie Claire; Malossi, Cesare; Placide, Joël; Ziliani, Gian Luca; Assanelli, Deodato; Chevalier, Philippe

2004-01-01

After decades of development of information systems dedicated to health professionals, there is an increasing demand for personalized and non-hospital based care. An especially critical domain is cardiology: almost two third of cardiac deaths occur out of hospital, and victims do not survive long enough to benefit from in-hospital treatments. We need to reduce the time before treatment. But symptoms are often interpreted wrongly. The only immediate diagnostic tool to assess the possibility of a cardiac event is the electrocardiogram (ECG). Event and transtelephonic ECG recorders are used to improve decision making but require setting up new infrastructures. The European EPI-MEDICS project has developed an intelligent Personal ECG Monitor (PEM) for the early detection of cardiac events. The PEM embeds advanced decision making techniques, generates different alarm levels and forwards alarm messages to the relevant care providers by means of new generation wireless communication. It is cost saving, involving care provider only if necessary and requiring no specific infrastructure. This solution is a typical example of pervasive computing and ambient intelligence that demonstrates how personalized, wearable, ubiquitous devices could improve healthcare.

FUNGIBILITY AND CONSUMER CHOICE: EVIDENCE FROM COMMODITY PRICE SHOCKS.

PubMed

Hastings, Justine S; Shapiro, Jesse M

2013-11-01

We formulate a test of the fungibility of money based on parallel shifts in the prices of different quality grades of a commodity. We embed the test in a discrete-choice model of product quality choice and estimate the model using panel microdata on gasoline purchases. We find that when gasoline prices rise consumers substitute to lower octane gasoline, to an extent that cannot be explained by income effects. Across a wide range of specifications, we consistently reject the null hypothesis that households treat "gas money" as fungible with other income. We compare the empirical fit of three psychological models of decision-making. A simple model of category budgeting fits the data well, with models of loss aversion and salience both capturing important features of the time series.

Fast converging minimum probability of error neural network receivers for DS-CDMA communications.

PubMed

Matyjas, John D; Psaromiligkos, Ioannis N; Batalama, Stella N; Medley, Michael J

2004-03-01

We consider a multilayer perceptron neural network (NN) receiver architecture for the recovery of the information bits of a direct-sequence code-division-multiple-access (DS-CDMA) user. We develop a fast converging adaptive training algorithm that minimizes the bit-error rate (BER) at the output of the receiver. The adaptive algorithm has three key features: i) it incorporates the BER, i.e., the ultimate performance evaluation measure, directly into the learning process, ii) it utilizes constraints that are derived from the properties of the optimum single-user decision boundary for additive white Gaussian noise (AWGN) multiple-access channels, and iii) it embeds importance sampling (IS) principles directly into the receiver optimization process. Simulation studies illustrate the BER performance of the proposed scheme.

FUNGIBILITY AND CONSUMER CHOICE: EVIDENCE FROM COMMODITY PRICE SHOCKS*

PubMed Central

Hastings, Justine S.; Shapiro, Jesse M.

2015-01-01

We formulate a test of the fungibility of money based on parallel shifts in the prices of different quality grades of a commodity. We embed the test in a discrete-choice model of product quality choice and estimate the model using panel microdata on gasoline purchases. We find that when gasoline prices rise consumers substitute to lower octane gasoline, to an extent that cannot be explained by income effects. Across a wide range of specifications, we consistently reject the null hypothesis that households treat “gas money” as fungible with other income. We compare the empirical fit of three psychological models of decision-making. A simple model of category budgeting fits the data well, with models of loss aversion and salience both capturing important features of the time series. PMID:26937053

Transcriptomic responses to emamectin benzoate in Pacific and Atlantic Canada salmon lice Lepeophtheirus salmonis with differing levels of drug resistance.

PubMed

Sutherland, Ben J G; Poley, Jordan D; Igboeli, Okechukwu O; Jantzen, Johanna R; Fast, Mark D; Koop, Ben F; Jones, Simon R M

2015-02-01

Salmon lice Lepeophtheirus salmonis are an ecologically and economically important parasite of wild and farmed salmon. In Scotland, Norway, and Eastern Canada, L. salmonis have developed resistance to emamectin benzoate (EMB), one of the few parasiticides available for salmon lice. Drug resistance mechanisms can be complex, potentially differing among populations and involving multiple genes with additive effects (i.e., polygenic resistance). Indicators of resistance development may enable early detection and countermeasures to avoid the spread of resistance. Here, we collect sensitive Pacific L. salmonis and sensitive and resistant Atlantic L. salmonis from salmon farms, propagate in laboratory (F1), expose to EMB in bioassays, and evaluate either baseline (Atlantic only) or induced transcriptomic differences between populations. In all populations, induced responses were minor and a cellular stress response was not identified. Pacific lice did not upregulate any genes in response to EMB, but downregulated degradative enzymes and transport proteins at 50 ppb EMB. Baseline differences between sensitive and now resistant Atlantic lice were much greater than responses to exposures. All resistant lice overexpressed degradative enzymes, and resistant males, the most resistant group, overexpressed collagenases to the greatest extent. These results indicate an accumulation of baseline expression differences related to resistance.

Transcriptomic responses to emamectin benzoate in Pacific and Atlantic Canada salmon lice Lepeophtheirus salmonis with differing levels of drug resistance

PubMed Central

Sutherland, Ben J G; Poley, Jordan D; Igboeli, Okechukwu O; Jantzen, Johanna R; Fast, Mark D; Koop, Ben F; Jones, Simon R M

2015-01-01

Salmon lice Lepeophtheirus salmonis are an ecologically and economically important parasite of wild and farmed salmon. In Scotland, Norway, and Eastern Canada, L. salmonis have developed resistance to emamectin benzoate (EMB), one of the few parasiticides available for salmon lice. Drug resistance mechanisms can be complex, potentially differing among populations and involving multiple genes with additive effects (i.e., polygenic resistance). Indicators of resistance development may enable early detection and countermeasures to avoid the spread of resistance. Here, we collect sensitive Pacific L. salmonis and sensitive and resistant Atlantic L. salmonis from salmon farms, propagate in laboratory (F1), expose to EMB in bioassays, and evaluate either baseline (Atlantic only) or induced transcriptomic differences between populations. In all populations, induced responses were minor and a cellular stress response was not identified. Pacific lice did not upregulate any genes in response to EMB, but downregulated degradative enzymes and transport proteins at 50 ppb EMB. Baseline differences between sensitive and now resistant Atlantic lice were much greater than responses to exposures. All resistant lice overexpressed degradative enzymes, and resistant males, the most resistant group, overexpressed collagenases to the greatest extent. These results indicate an accumulation of baseline expression differences related to resistance. PMID:25685190

Screening, Isolation and Identification of Probiotic Producing Lactobacillus acidophilus Strains EMBS081 & EMBS082 by 16S rRNA Gene Sequencing.

PubMed

Chandok, Harshpreet; Shah, Pratik; Akare, Uday Raj; Hindala, Maliram; Bhadoriya, Sneha Singh; Ravi, G V; Sharma, Varsha; Bandaru, Srinivas; Rathore, Pragya; Nayarisseri, Anuraj

2015-09-01

16S rDNA sequencing which has gained wide popularity amongst microbiologists for the molecular characterization and identification of newly discovered isolates provides accurate identification of isolates down to the level of sub-species (strain). Its most important advantage over the traditional biochemical characterization methods is that it can provide an accurate identification of strains with atypical phenotypic characters as well. The following work is an application of 16S rRNA gene sequencing approach to identify a novel species of Probiotic Lactobacillus acidophilus. The sample was collected from pond water samples of rural and urban areas of Krishna district, Vijayawada, Andhra Pradesh, India. Subsequently, the sample was serially diluted and the aliquots were incubated for a suitable time period following which the suspected colony was subjected to 16S rDNA sequencing. The sequence aligned against other species was concluded to be a novel, Probiotic L. acidophilus bacteria, further which were named L. acidophilus strain EMBS081 & EMBS082. After the sequence characterization, the isolate was deposited in GenBank Database, maintained by the National Centre for Biotechnology Information NCBI. The sequence can also be retrieve from EMBL and DDBJ repositories with accession numbers JX255677 and KC150145.

Assessing the role of learning devices and geovisualisation tools for collective action in natural resource management: Experiences from Vietnam.

PubMed

Castella, Jean-Christophe

2009-02-01

In northern Vietnam uplands the successive policy reforms that accompanied agricultural decollectivisation triggered very rapid changes in land use in the 1990s. From a centralized system of natural resource management, a multitude of individual strategies emerged which contributed to new production interactions among farming households, changes in landscape structures, and conflicting strategies among local stakeholders. Within this context of agrarian transition, learning devices can help local communities to collectively design their own course of action towards sustainable natural resource management. This paper presents a collaborative approach combining a number of participatory methods and geovisualisation tools (e.g., spatially explicit multi-agent models and role-playing games) with the shared goal to analyse and represent the interactions between: (i) decision-making processes by individual farmers based on the resource profiles of their farms; (ii) the institutions which regulate resource access and usage; and (iii) the biophysical and socioeconomic environment. This methodological pathway is illustrated by a case study in Bac Kan Province where it successfully led to a communication platform on natural resource management. In a context of rapid socioeconomic changes, learning devices and geovisualisation tools helped embed the participatory approach within a process of community development. The combination of different tools, each with its own advantages and constraints, proved highly relevant for supporting collective natural resource management.

An approach to medical knowledge sharing in a hospital information system using MCLink.

PubMed

Shibuya, Akiko; Inoue, Ryusuke; Nakayama, Masaharu; Kasahara, Shin; Maeda, Yukihiro; Umesato, Yoshimasa; Kondo, Yoshiaki

2013-08-01

Clinicians often need access to electronic information resources that answer questions that occur in daily clinical practice. This information generally comes from publicly available resources. However, clinicians also need knowledge on institution-specific information (e.g., institution-specific guidelines, choice of drug, choice of laboratory test, information on adverse events, and advice from professional colleagues). This information needs to be available in real time. This study characterizes these needs in order to build a prototype hospital information system (HIS) that can help clinicians get timely answers to questions. We previously designed medical knowledge units called Medical Cells (MCs). We developed a portal server of MCs that can create and store medical information such as institution-specific information. We then developed a prototype HIS that embeds MCs as links (MCLink); these links are based on specific terms (e.g., drug, laboratory test, and disease). This prototype HIS presents clinicians with institution-specific information. The HIS clients (e.g., clinicians, nurses, pharmacists, and laboratory technicians) can also create an MCLink in the HIS using the portal server in the hospital. The prototype HIS allowed efficient sharing and use of institution-specific information to clinicians at the point of care. This study included institution-specific information resources and advice from professional colleagues, both of which might have an important role in supporting good clinical decision making.

Using computer decision support systems in NHS emergency and urgent care: ethnographic study using normalisation process theory

PubMed Central

2013-01-01

Background Information and communication technologies (ICTs) are often proposed as ‘technological fixes’ for problems facing healthcare. They promise to deliver services more quickly and cheaply. Yet research on the implementation of ICTs reveals a litany of delays, compromises and failures. Case studies have established that these technologies are difficult to embed in everyday healthcare. Methods We undertook an ethnographic comparative analysis of a single computer decision support system in three different settings to understand the implementation and everyday use of this technology which is designed to deal with calls to emergency and urgent care services. We examined the deployment of this technology in an established 999 ambulance call-handling service, a new single point of access for urgent care and an established general practice out-of-hours service. We used Normalization Process Theory as a framework to enable systematic cross-case analysis. Results Our data comprise nearly 500 hours of observation, interviews with 64 call-handlers, and stakeholders and documents about the technology and settings. The technology has been implemented and is used distinctively in each setting reflecting important differences between work and contexts. Using Normalisation Process Theory we show how the work (collective action) of implementing the system and maintaining its routine use was enabled by a range of actors who established coherence for the technology, secured buy-in (cognitive participation) and engaged in on-going appraisal and adjustment (reflexive monitoring). Conclusions Huge effort was expended and continues to be required to implement and keep this technology in use. This innovation must be understood both as a computer technology and as a set of practices related to that technology, kept in place by a network of actors in particular contexts. While technologies can be ‘made to work’ in different settings, successful implementation has been achieved, and will only be maintained, through the efforts of those involved in the specific settings and if the wider context continues to support the coherence, cognitive participation, and reflective monitoring processes that surround this collective action. Implementation is more than simply putting technologies in place – it requires new resources and considerable effort, perhaps on an on-going basis. PMID:23522021

Environmental Sensor Technologies and Procedures for Detecting and Identifying Indoor Air Pollution

DTIC Science & Technology

1992-03-01

problem of radon or biological contaminants. Radon daughters --the radioactive decay products of radon gas-are most dangerous when they attach to a...entry points. Radon itself decays into radon daughters which are dangerous when they bond with dust particles that allow them to embed in the lining...because it contains respirable particles to which radon daughters can attach and embed in the lungs. The most direct way to check the ETS level is to

Whole-Organism Transcriptomic Analysis Provides Mechanistic Insight into the Acute Toxicity of Emamectin Benzoate in Daphnia magna.

PubMed

Song, You; Rundberget, Jan Thomas; Evenseth, Linn Mari; Xie, Li; Gomes, Tânia; Høgåsen, Tore; Iguchi, Taisen; Tollefsen, Knut Erik

2016-11-01

Emamectin benzoate (EMB) is an antisea lice chemical widely used in the aquaculture that may also unintentionally affect nontarget crustaceans in the environment. Although the adverse effects of this compound are well documented in various species, the full modes of action (MoAs) are still not well characterized. The current study was therefore conducted to characterize the MoAs of EMB and link perturbations of key toxicological pathways to adverse effects in the model freshwater crustacean Daphnia magna. Effects on molting and survival were determined after 48 h exposure to EMB, whereas global transcriptional changes and the ecdysone receptor (EcR) binding potency was determined to characterize the MoA. The results showed that the molting frequency and survival of D. magna decreased in a concentration-dependent manner, and the observed changes could not be attributed to direct interactions with the EcR. Major MoAs such as activation of glutamate-gated chloride channels and gamma-aminobutyric acid signaling, disruption of neuroendocrine regulation of molting, perturbation of energy homeostasis, suppression of DNA repair and induction of programmed cell death were observed by transcriptional analysis and successfully linked to the adverse effects. This study has demonstrated that acute exposure to intermediate and high pM levels of EMB may pose hazards to nontarget crustaceans in the aquatic environment.

Variability in regional background aerosols within the Mediterranean

NASA Astrophysics Data System (ADS)

Querol, X.; Alastuey, A.; Pey, J.; Cusack, M.; Pérez, N.; Mihalopoulos, N.; Theodosi, C.; Gerasopoulos, E.; Kubilay, N.; Koçak, M.

2009-04-01

The main objective of this study is the identification of major factors controlling levels and chemical composition of aerosols in the regional background (RB) along the Mediterranean Basin (MB). To this end, data on PM levels and speciation from Montseny (MSY, Northeastern Spain), Finokalia (FKL, Southern Greece) and Erdemli (ERL, Southern Turkey) for the period 2001 to 2008 are evaluated. Important differences on PM levels and composition are evident when comparing the Western and Eastern MBs. The results manifest W-E and N-S PM10 and PM2.5 gradients along the MB, attributed to the higher frequency and intensity of African dust outbreaks in the EMB, while for PM1 very similar levels are encountered. PM in the EMB is characterized by higher levels of crustal material and sulphate as compared to WMB (and central European sites), however, RB nitrate and OC+EC levels are relatively constant across the Mediterranean and lower than other European sites. Marked seasonal trends are evidenced for PM levels, nitrate (WMB), ammonium and sulphate. Also relatively higher levels of V and Ni (WMB) are measured in the Mediterranean basin, probably as a consequence of high emissions from fuel-oil combustion (power generation, industrial and shipping emissions). Enhanced sulphate levels in EMB compared to WMB were measured. The high levels of sulphate in the EMB may deplete the available gas-phase NH3 so that little ammonium nitrate can form due to the low NH3 levels. This study illustrates the existence of three very important features within the Mediterranean that need to be accounted for when modeling climate effects of aerosols in the area, namely: (a) the increasing gradient of dust from WMB to EMB; (b) the change of hygroscopic behavior of mineral aerosols (dust) via nitration and sulphation; and (c) the abundance of highly hygroscopic aerosols during high insolation (low cloud formation) periods.

Variability in regional background aerosols within the Mediterranean

NASA Astrophysics Data System (ADS)

Querol, X.; Alastuey, A.; Pey, J.; Cusack, M.; Pérez, N.; Mihalopoulos, N.; Theodosi, C.; Gerasopoulos, E.; Kubilay, N.; Koçak, M.

2009-07-01

The main objective of this study is the identification of major factors controlling levels and chemical composition of aerosols in the regional background (RB) along the Mediterranean Basin (MB). To this end, data on PM levels and speciation from Montseny (MSY, NE Spain), Finokalia (FKL, Southern Greece) and Erdemli (ERL, Southern Turkey) for the period 2001 to 2008 are evaluated. Important differences on PM levels and composition are evident when comparing the Western and Eastern MBs. The results manifest W-E and N-S PM10 and PM2.5 gradients along the MB, attributed to the higher frequency and intensity of African dust outbreaks in the EMB, while for PM1 very similar levels are encountered. PM in the EMB is characterized by higher levels of crustal material and sulphate as compared to WMB (and central European sites), however, RB nitrate and OC + EC levels are relatively constant across the Mediterranean and lower than other European sites. Marked seasonal trends are evidenced for PM levels, nitrate (WMB), ammonium and sulphate. Also relatively higher levels of V and Ni (WMB) are measured in the Mediterranean basin, probably as a consequence of high emissions from fuel-oil combustion (power generation, industrial and shipping emissions). Enhanced sulphate levels in EMB compared to WMB were measured. The high levels of sulphate in the EMB may deplete the available gas-phase NH3 so that little ammonium nitrate can form due to the low NH3 levels. This study illustrates the existence of three very important features within the Mediterranean that need to be accounted for when modeling climate effects of aerosols in the area, namely: a) the increasing gradient of dust from WMB to EMB; b) the change of hygroscopic behavior of mineral aerosols (dust) via nitration and sulfation; and c) the abundance of highly hygroscopic aerosols during high insolation (low cloud formation) periods.

Comparison of patients' reported pain following office hysteroscopy with and without endometrial biopsy: a prospective study.

PubMed

New, Erika P; Sarkar, Papri; Sappenfield, Elisabeth; Mikhail, Emad; Plosker, Shayne; Imudia, Anthony N

2018-05-31

When performing office based gynecologic procedures, one must provide patients with appropriate counseling on anticipated pain prior to the procedure. The goal of this study was to investigate whether there is any difference in patients' pain perception when office hysteroscopy (OH) is performed alone compared with when it is performed with endometrial biopsy (EMB) for various gynecologic indications. A prospective study was performed of patients undergoing office hysteroscopy alone or in combination with endometrial biopsy between October 2015 and February 2017. Procedures were performed using standard gynecologic techniques. Patients described their post procedural pain using the visual analogue scale from 0-10 and data was compared between groups using SPSS version 24. Group 1 had OH alone (n=243) and group 2 had OH combined with EMB (n=80). Patients who underwent both procedures had significantly higher reported median (range) pain scores than those undergoing OH alone [7 (0-10) vs 5 (0-10), p=.004]. The patients in-group 2 were significantly older than those in group 1 (42.6±7.6 vs 36.6±6.5, p<.0001). The patients in group 2 had higher gravidity (2 vs 1, p=.04), were more likely to have a tenaculum used during the procedure (36.3% vs 21.4%, p=.01) and were more likely to be diagnosed with uterine fibroids (73% vs 31%, p<.0001). After controlling for patients age, gravidity, tenaculum use and diagnosis of fibroids using a multivariable regression model, patients undergoing OH with EMB had a 0.51-unit pain score greater than those that had OH alone; however, this difference was not statistically significant [95% CI (-0.32,1.33 p=.23)]. Patients undergoing both OH and EMB appear to report similar pain scores as those undergoing OH alone after controlling for confounding variables. The presence of fibroids was found to contribute to higher reported pain in the patients having OH in combination with EMB.

Use of mathematical modelling to assess the impact of vaccines on antibiotic resistance.

PubMed

Atkins, Katherine E; Lafferty, Erin I; Deeny, Sarah R; Davies, Nicholas G; Robotham, Julie V; Jit, Mark

2018-06-01

Antibiotic resistance is a major global threat to the provision of safe and effective health care. To control antibiotic resistance, vaccines have been proposed as an essential intervention, complementing improvements in diagnostic testing, antibiotic stewardship, and drug pipelines. The decision to introduce or amend vaccination programmes is routinely based on mathematical modelling. However, few mathematical models address the impact of vaccination on antibiotic resistance. We reviewed the literature using PubMed to identify all studies that used an original mathematical model to quantify the impact of a vaccine on antibiotic resistance transmission within a human population. We reviewed the models from the resulting studies in the context of a new framework to elucidate the pathways through which vaccination might impact antibiotic resistance. We identified eight mathematical modelling studies; the state of the literature highlighted important gaps in our understanding. Notably, studies are limited in the range of pathways represented, their geographical scope, and the vaccine-pathogen combinations assessed. Furthermore, to translate model predictions into public health decision making, more work is needed to understand how model structure and parameterisation affects model predictions and how to embed these predictions within economic frameworks. Copyright © 2018 Elsevier Ltd. All rights reserved.

Design of Urban Public Spaces: Intent vs. Reality

PubMed Central

Martin, W. Mike; Stewart, Tom; Troelsen, Jens

2018-01-01

This study investigated how two public spaces for sport and recreation were utilized by different user groups, and how this aligned with the initial design objectives for these spaces. Two newly built urban spaces situated in Copenhagen, Denmark, provided the context for this investigation. The System for Observing Play and Recreation in Communities (SOPARC) was used to examine the physical activity of users in these two urban spaces. The architects responsible for designing each space were interviewed to ascertain the intended target group of each space and to unravel the reasons behind the design decisions. The SOPARC observations revealed that males were more vigorously active than females when using the recreation facilities, and the observed users did not align with the intended target groups. The interviews suggested that design decisions were based on minimal interdisciplinary knowledge, and that expert knowledge was chosen randomly. These findings point to a systematic lack of evidence-based practice when designing sport and recreational facilities. This article has implications for landscape architects and urban planners; a new method must be developed to embed interdisciplinary knowledge in the planning process of future sport and recreation projects. This must be done in a systematic way to make the design process transparent. PMID:29690509

Employing Model-Based Reasoning in Interdisciplinary Research Teams: Evidence-Based Practices for Integrating Knowledge Across Systems

NASA Astrophysics Data System (ADS)

Pennington, D. D.; Vincent, S.

2017-12-01

The NSF-funded project "Employing Model-Based Reasoning in Socio-Environmental Synthesis (EMBeRS)" has developed a generic model for exchanging knowledge across disciplines that is based on findings from the cognitive, learning, social, and organizational sciences addressing teamwork in complex problem solving situations. Two ten-day summer workshops for PhD students from large, NSF-funded interdisciplinary projects working on a variety of water issues were conducted in 2016 and 2017, testing the model by collecting a variety of data, including surveys, interviews, audio/video recordings, material artifacts and documents, and photographs. This presentation will introduce the EMBeRS model, the design of workshop activities based on the model, and results from surveys and interviews with the participating students. Findings suggest that this approach is very effective for developing a shared, integrated research vision across disciplines, compared with activities typically provided by most large research projects, and that students believe the skills developed in the EMBeRS workshops are unique and highly desireable.

A deep-learning classifier identifies patients with clinical heart failure using whole-slide images of H&E tissue

PubMed Central

Peyster, Eliot G.; Frank, Renee; Margulies, Kenneth B.; Feldman, Michael D.

2018-01-01

Over 26 million people worldwide suffer from heart failure annually. When the cause of heart failure cannot be identified, endomyocardial biopsy (EMB) represents the gold-standard for the evaluation of disease. However, manual EMB interpretation has high inter-rater variability. Deep convolutional neural networks (CNNs) have been successfully applied to detect cancer, diabetic retinopathy, and dermatologic lesions from images. In this study, we develop a CNN classifier to detect clinical heart failure from H&E stained whole-slide images from a total of 209 patients, 104 patients were used for training and the remaining 105 patients for independent testing. The CNN was able to identify patients with heart failure or severe pathology with a 99% sensitivity and 94% specificity on the test set, outperforming conventional feature-engineering approaches. Importantly, the CNN outperformed two expert pathologists by nearly 20%. Our results suggest that deep learning analytics of EMB can be used to predict cardiac outcome. PMID:29614076

A deep-learning classifier identifies patients with clinical heart failure using whole-slide images of H&E tissue.

PubMed

Nirschl, Jeffrey J; Janowczyk, Andrew; Peyster, Eliot G; Frank, Renee; Margulies, Kenneth B; Feldman, Michael D; Madabhushi, Anant

2018-01-01

Over 26 million people worldwide suffer from heart failure annually. When the cause of heart failure cannot be identified, endomyocardial biopsy (EMB) represents the gold-standard for the evaluation of disease. However, manual EMB interpretation has high inter-rater variability. Deep convolutional neural networks (CNNs) have been successfully applied to detect cancer, diabetic retinopathy, and dermatologic lesions from images. In this study, we develop a CNN classifier to detect clinical heart failure from H&E stained whole-slide images from a total of 209 patients, 104 patients were used for training and the remaining 105 patients for independent testing. The CNN was able to identify patients with heart failure or severe pathology with a 99% sensitivity and 94% specificity on the test set, outperforming conventional feature-engineering approaches. Importantly, the CNN outperformed two expert pathologists by nearly 20%. Our results suggest that deep learning analytics of EMB can be used to predict cardiac outcome.

Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

NASA Astrophysics Data System (ADS)

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2007-02-01

In this paper we describe our research using a multi-user virtual environment, Quest Atlantis, to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment gaming engine to establish a virtual world through which students learned about science inquiry, water quality concepts, and the challenges in balancing scientific and socio-economic factors. Overall, students were clearly engaged, participated in rich scientific discourse, submitted quality work, and learned science content. Further, through participation in this narrative, students developed a rich perceptual, conceptual, and ethical understanding of science. This study suggests that multi-user virtual worlds can be effectively leveraged to support academic content learning.

Erratum to: Relating Narrative, Inquiry, and Inscriptions: Supporting Consequential Play

NASA Astrophysics Data System (ADS)

Barab, Sasha A.; Sadler, Troy D.; Heiselt, Conan; Hickey, Daniel; Zuiker, Steven

2010-08-01

In this paper we describe our research using a multi-user virtual environment, Quest Atlantis, to embed fourth grade students in an aquatic habitat simulation. Specifically targeted towards engaging students in a rich inquiry investigation, we layered a socio-scientific narrative and an interactive rule set into a multi-user virtual environment gaming engine to establish a virtual world through which students learned about science inquiry, water quality concepts, and the challenges in balancing scientific and socio-economic factors. Overall, students were clearly engaged, participated in rich scientific discourse, submitted quality work, and learned science content. Further, through participation in this narrative, students developed a rich perceptual, conceptual, and ethical understanding of science. This study suggests that multi-user virtual worlds can be effectively leveraged to support academic content learning.

Comparison of semi-automated commercial rep-PCR fingerprinting, spoligotyping, 12-locus MIRU-VNTR typing and single nucleotide polymorphism analysis of the embB gene as molecular typing tools for Mycobacterium bovis.

PubMed

Armas, Federica; Camperio, Cristina; Coltella, Luana; Selvaggini, Serena; Boniotti, Maria Beatrice; Pacciarini, Maria Lodovica; Di Marco Lo Presti, Vincenzo; Marianelli, Cinzia

2017-08-04

Highly discriminatory genotyping strategies are essential in molecular epidemiological studies of tuberculosis. In this study we evaluated, for the first time, the efficacy of the repetitive sequence-based PCR (rep-PCR) DiversiLab Mycobacterium typing kit over spoligotyping, 12-locus mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and embB single nucleotide polymorphism (SNP) analysis for Mycobacterium bovis typing. A total of 49 M. bovis animal isolates were used. DNA was extracted and genomic DNA was amplified using the DiversiLab Mycobacterium typing kit. The amplified fragments were separated and detected using a microfluidics chip with Agilent 2100. The resulting rep-PCR-based DNA fingerprints were uploaded to and analysed using web-based DiversiLab software through Pearson's correlation coefficient. Rep-PCR DiversiLab grouped M. bovis isolates into ten different clusters. Most isolates sharing identical spoligotype, MIRU-VNTR profile or embB gene polymorphism were grouped into different rep-PCR clusters. Rep-PCR DiversiLab displayed greater discriminatory power than spoligotyping and embB SNP analysis but a lower resolution power than the 12-locus MIRU-VNTR analysis. MIRU-VNTR confirmed that it is superior to the other PCR-based methods tested here. In combination with spoligotyping and 12-locus MIRU-VNTR analysis, rep-PCR improved the discriminatory power for M. bovis typing.

Mouse maternal protein restriction during preimplantation alone permanently alters brain neuron proportion and adult short-term memory.

PubMed

Gould, Joanna M; Smith, Phoebe J; Airey, Chris J; Mort, Emily J; Airey, Lauren E; Warricker, Frazer D M; Pearson-Farr, Jennifer E; Weston, Eleanor C; Gould, Philippa J W; Semmence, Oliver G; Restall, Katie L; Watts, Jennifer A; McHugh, Patrick C; Smith, Stephanie J; Dewing, Jennifer M; Fleming, Tom P; Willaime-Morawek, Sandrine

2018-06-25

Maternal protein malnutrition throughout pregnancy and lactation compromises brain development in late gestation and after birth, affecting structural, biochemical, and pathway dynamics with lasting consequences for motor and cognitive function. However, the importance of nutrition during the preimplantation period for brain development is unknown. We have previously shown that maternal low-protein diet (LPD) confined to the preimplantation period (Emb-LPD) in mice, with normal nutrition thereafter, is sufficient to induce cardiometabolic and locomotory behavioral abnormalities in adult offspring. Here, using a range of in vivo and in vitro techniques, we report that Emb-LPD and sustained LPD reduce neural stem cell (NSC) and progenitor cell numbers at E12.5, E14.5, and E17.5 through suppressed proliferation rates in both ganglionic eminences and cortex of the fetal brain. Moreover, Emb-LPD causes remaining NSCs to up-regulate the neuronal differentiation rate beyond control levels, whereas in LPD, apoptosis increases to possibly temper neuron formation. Furthermore, Emb-LPD adult offspring maintain the increase in neuron proportion in the cortex, display increased cortex thickness, and exhibit short-term memory deficit analyzed by the novel-object recognition assay. Last, we identify altered expression of fragile X family genes as a potential molecular mechanism for adverse programming of brain development. Collectively, these data demonstrate that poor maternal nutrition from conception is sufficient to cause abnormal brain development and adult memory loss.

Research on Factors Influencing Individual's Behavior of Energy Management

NASA Astrophysics Data System (ADS)

Fan, Yanfeng

With the rapid rise of distributed generation, Internet of Things, and mobile Internet, both U.S. and European smart home manufacturers have developed energy management solutions for individual usage. These applications help people manage their energy consumption more efficiently. Domestic manufacturers have also launched similar products. This paper focuses on the factors influencing Energy Management Behaviour (EMB) at the individual level. By reviewing academic literature, conducting surveys in Beijing, Shanghai and Guangzhou, the author builds an integrated behavioural energy management model of the Chinese energy consumers. This paper takes the vague term of EMB and redefines it as a function of two separate behavioural concepts: Energy Management Intention (EMI), and the traditional Energy Saving Intention (ESI). Secondly, the author conducts statistical analyses on these two behavioural concepts. EMI is the main driver behind an individual's EMB. EMI is affected by Behavioural Attitudes, Subjective Norms, and Perceived Behavioural Control (PBC). Among these three key factors, PBC exerts the strongest influence. This implies that the promotion of the energy management concept is mainly driven by good application user experience (UX). The traditional ESI also demonstrates positive influence on EMB, but its impact is weaker than the impacts arising under EMI's three factors. In other words, the government and manufacturers may not be able to change an individual's energy management behaviour if they rely solely on their traditional promotion strategies. In addition, the study finds that the government may achieve better promotional results by launching subsidies to the manufacturers of these kinds of applications and smart appliances.

Nursing and midwifery use, perceptions and barriers to evidence-based practice: a cross-sectional survey.

PubMed

Fry, Margaret; Attawet, Jutharat

2018-03-01

The study aimed to explore how nurses and midwives obtain, use and embed evidence in everyday practice. The study design was cross-sectional survey method. The setting was one local health district in metropolitan Sydney, Australia. All nurses and midwives working within the local health district, with access to an email account, were invited to participate in the study. An online survey questionnaire was distributed to explore how evidence is obtained, used and embedded within the clinical setting. The data were analysed using descriptive statistics (frequency and percentages). Pearson's Chi-square tests were used for comparison between groups. There were 204 survey respondents. The findings identified that the majority (n = 157; 76.96%) of respondents obtained evidence primarily from clinical practice guidelines. The majority (n = 149; 73.04%) of respondents reportedly searched databases and used evidence related to general clinical practice. There was a statistical difference (χ = 17.069; df = 8; P = 0.029) when comparing leadership positions and other registered practitioner groups in the frequency of searching for evidence. Most respondents (n = 138; 67.65%) were confident in their ability to change practice on the basis of available evidence. Thematic analysis identified four barriers to sustaining evidence-based practice, which included: the need for time; the need for organizational and management support; the need for educational opportunities and challenges to accessing evidence. The study provided an understanding of how nurses and midwives obtain, use and embed evidence into everyday practice. More importantly, the role of leadership is significant to support a process of knowledge generation, research translation and the implementation of evidence into clinical settings.

Applying talent management to nursing.

PubMed

Haines, Sue

To deliver the chief nursing officer for England's vision for compassionate care and embed the 6Cs effectively, the NHS must attract, develop and retain talented nurses with a diverse range of skills. This is particularly important given the predicted shortage of nurses and evidence that NHS providers need to increase skill mix ratios to deliver safe patient care. "Talent management" is increasingly discussed within the health service; we recently asked nurses and student nurses to identify their priorities for talent development. They highlighted the importance of strong ward leadership, effective personal appraisal, clearer career pathways, increased staff engagement and involvement in decision making, as well as a need for greater emphasis on the recognition and reward of nursing achievements. We concluded that these factors are crucial to attracting, retaining and developing talent in nursing. Nurse leaders can learn approaches to developing talent from business and wider healthcare settings.

Why research-informed teaching in engineering education? A review of the evidence

NASA Astrophysics Data System (ADS)

Bubou, Gordon Monday; Offor, Ibebietei Temple; Bappa, Abubakar Saddiq

2017-05-01

Challenges of today's engineering education (EE) are emergent, necessitating calls for its reformation to empower future engineers function optimally as innovative leaders, in both local and international contexts. These challenges: keeping pace with technological dynamism; high attrition; and most importantly, quality teaching/learning require multifaceted approaches. But how can EE respond to the growing demand for relevant teaching? What can we do for engineering faculties to leverage on quality teaching? How do we embed quality teaching in EE? Scholarship of teaching and learning is advocated as one viable approach. It uses evidence-based teaching (EBT) strategies, and research-informed evidence to guide educational decisions regarding teaching and learning. We review the theories underpinning EBT, the scientific evidence on which it is based, and innovative instructional strategies that enhance active learning. Some of these issues have been discussed already, largely through developing countries lens. Nevertheless, linkages to equivalent global perspectives are presented here.

Utility of C4d immunostaining in the first year after pediatric and young adult heart transplantation.

PubMed

Xu, Ying; Galambos, Csaba; Reyes-Múgica, Miguel; Miller, Susan A; Zeevi, Adriana; Webber, Steven A; Feingold, Brian

2013-01-01

C4d assessment of endomyocardial biopsies (EMBs) after heart transplantation (HTx) has been widely adopted to aid in the diagnosis of antibody-mediated rejection (AMR), yet it remains unclear whether or not to assess all patients routinely and with what frequency/duration. In this study we sought to evaluate the utility of routine C4d immunostaining in the first year after pediatric and young adult HTx. We reviewed pre-transplant alloantibody and clinical data, including serial EMB reports, on all 51 patients who received HTx at our center since we instituted routine C4d staining of all first-year EMBs. C4d was considered positive if diffuse capillary staining (≥ 2(+)) was present. Rare/focal capillary staining or absence of staining was considered negative. Twenty-six of 406 first-year EMBs (6%) were C4d(+) in 6 (12%) patients. Sixty-five percent of all C4d(+) EMBs occurred by 30 days post-transplant. Five of 6 patients had pre-transplant donor-specific antibody (DSA) ≥ 4,000 MFI. The sixth patient had neither pre-transplant anti-HLA antibodies nor a positive donor-specific cytotoxicity crossmatch (DSXM), but there was clinical concern for AMR. Among the entire cohort, 5 of 10 patients with pre-transplant DSA ≥ 4,000 MFI and/or a positive DSXM were C4d(+) compared with only 1 of 41 without (50% vs 2%; p = 0.001). In the first year after HTx, C4d(+) occurred early and only in children and young adults with pre-transplant DSA or with clinical suspicion of AMR. Although our data suggest that assessment limited to the first 90 days post-transplant in patients with pre-transplant DSA ≥ 4,000 MFI may be appropriate in the absence of clinical concern for AMR, further research is needed to determine the optimum strategy for post-transplant surveillance. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Quality optimized medical image information hiding algorithm that employs edge detection and data coding.

PubMed

Al-Dmour, Hayat; Al-Ani, Ahmed

2016-04-01

The present work has the goal of developing a secure medical imaging information system based on a combined steganography and cryptography technique. It attempts to securely embed patient's confidential information into his/her medical images. The proposed information security scheme conceals coded Electronic Patient Records (EPRs) into medical images in order to protect the EPRs' confidentiality without affecting the image quality and particularly the Region of Interest (ROI), which is essential for diagnosis. The secret EPR data is converted into ciphertext using private symmetric encryption method. Since the Human Visual System (HVS) is less sensitive to alterations in sharp regions compared to uniform regions, a simple edge detection method has been introduced to identify and embed in edge pixels, which will lead to an improved stego image quality. In order to increase the embedding capacity, the algorithm embeds variable number of bits (up to 3) in edge pixels based on the strength of edges. Moreover, to increase the efficiency, two message coding mechanisms have been utilized to enhance the ±1 steganography. The first one, which is based on Hamming code, is simple and fast, while the other which is known as the Syndrome Trellis Code (STC), is more sophisticated as it attempts to find a stego image that is close to the cover image through minimizing the embedding impact. The proposed steganography algorithm embeds the secret data bits into the Region of Non Interest (RONI), where due to its importance; the ROI is preserved from modifications. The experimental results demonstrate that the proposed method can embed large amount of secret data without leaving a noticeable distortion in the output image. The effectiveness of the proposed algorithm is also proven using one of the efficient steganalysis techniques. The proposed medical imaging information system proved to be capable of concealing EPR data and producing imperceptible stego images with minimal embedding distortions compared to other existing methods. In order to refrain from introducing any modifications to the ROI, the proposed system only utilizes the Region of Non Interest (RONI) in embedding the EPR data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sub-micron accurate track navigation method ``Navi'' for the analysis of Nuclear Emulsion

NASA Astrophysics Data System (ADS)

Yoshioka, T.; Yoshida, J.; Kodama, K.

2011-03-01

Sub-micron accurate track navigation in Nuclear Emulsion is realized by using low energy signals detected by automated Nuclear Emulsion read-out systems. Using those much dense ``noise'', about 104 times larger than the real tracks, the accuracy of the track position navigation reaches to be sub micron only by using the information of a microscope field of view, 200 micron times 200 micron. This method is applied to OPERA analysis in Japan, i.e. support of human eye checks of the candidate tracks, confirmation of neutrino interaction vertexes and to embed missing track segments to the track data read-out by automated systems.

Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success.

PubMed

Garrido, Nicolás; Bellver, José; Remohí, José; Simón, Carlos; Pellicer, Antonio

2011-07-01

To report the use of cumulative live-birth rates (CLBRs) per ovarian stimulation cycle to measure the success of IVF is proving to be the most accurate method for advising couples who failed to conceive, although the accuracy yielded is relatively low, and cycle outcome is highly dependent on the number of embryos replaced. Our aim with this work is to report the CLBRs of IVF as a function of the number of embryos required to reach a live birth (EmbR), considering age, day of ET, and infertility etiology. Survival curves and Kaplan-Meier methods to analyze CLBR in a retrospective cohort with respect to the number of EmbR. University-affiliated infertility center. Infertile couples undergoing IVF using own oocytes. None. CLBR per embryo transferred. CLBRs increase rapidly between 1 and 5 EmbR, moderately between 5 and 15, and slowly thereafter. Live-birth rates rise more slowly when embryos are transferred on days 2-3 rather than on days 5-6, with comparable long-term results. Women's age is a negative factor from 35 to 37 years old, with a dramatic decrease in live-birth rates beyond age 40 years. In addition, there are significant worse results in endometriosis patients. The relationship between CLBR and number of EmbR provides realistic and precise information regarding IVF success and can be used to guide couples and practitioners. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Collaborative Occupational Therapy: Teachers' Impressions of the Partnering for Change (P4C) Model.

PubMed

Wilson, A L; Harris, S R

2018-05-01

Occupational therapists (OTs) often face barriers when trying to collaborate with teachers in school-based settings. Partnering for change (P4C), a collaborative practice model designed to support children with developmental coordination disorder, could potentially support all students with special needs. Therefore, the aim of this study was to explore how teachers experience OT services delivered using the P4C model to support children with a variety of special needs. P4C was implemented at one elementary school in Courtenay, British Columbia. Eleven teachers participated in two focus groups and a one-on-one interview to gather descriptive, qualitative data. Grounded theory techniques were used for data analysis. Four themes (collaborating in the thick of it all, learning and taking risks, managing limited time and resources, and appreciating responsive OT support) represented teachers' experiences of P4C. Teachers strongly preferred collaborative OT services based on the P4C model. Students with a variety of special needs were supported within their classrooms as teachers learned new strategies from the OT and found ways to embed these strategies into their daily routines.

Creating healthier graduates, campuses and communities: Why Australia needs to invest in health promoting universities.

PubMed

Taylor, Patricia; Saheb, Rowena; Howse, Eloise

2018-05-13

Higher education is an important and influential setting for embedding health promotion principles and practice. Universities have a responsibility to their communities and more broadly as leaders in society. Settings-based health promotion is an effective method for increasing healthy environments and an organisational culture that supports health. "Healthy Universities" and the Okanagan Charter aim to embed health within the university structure through committed policies and programs. Collaboration across Australia can support this sector-wide adoption. Leadership is required from Australian universities to invest in health promotion. This is the time for higher education in Australia to consider its role in shaping the health of its local and global communities. © 2018 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.

Adapting an embedded model of librarianship, college by college.

PubMed

Blake, Lindsay; Mears, Kim; Davies, Kathy; Ballance, Darra; Shipman, Peter; Connolly-Brown, Maryska; Gaines, Julie K

2014-01-01

Librarians are increasingly moving out of the library and into the wider university setting as patrons spend more time seeking information online and less time visiting the library. The move to embed librarians in colleges, departments, or customer groups has been going on for some time but has recently received more attention as libraries work to find new ways to reach patrons that no longer need to come to the physical library. Few universities have attempted to embed all their librarians. This case study describes how one group of health sciences librarians dispersed its professional staff throughout its campuses and medical centers.

A work-centered cognitively based architecture for decision support: the work-centered infomediary layer (WIL) model

NASA Astrophysics Data System (ADS)

Zachary, Wayne; Eggleston, Robert; Donmoyer, Jason; Schremmer, Serge

2003-09-01

Decision-making is strongly shaped and influenced by the work context in which decisions are embedded. This suggests that decision support needs to be anchored by a model (implicit or explicit) of the work process, in contrast to traditional approaches that anchor decision support to either context free decision models (e.g., utility theory) or to detailed models of the external (e.g., battlespace) environment. An architecture for cognitively-based, work centered decision support called the Work-centered Informediary Layer (WIL) is presented. WIL separates decision support into three overall processes that build and dynamically maintain an explicit context model, use the context model to identify opportunities for decision support and tailor generic decision-support strategies to the current context and offer them to the system-user/decision-maker. The generic decision support strategies include such things as activity/attention aiding, decision process structuring, work performance support (selective, contextual automation), explanation/ elaboration, infosphere data retrieval, and what if/action-projection and visualization. A WIL-based application is a work-centered decision support layer that provides active support without intent inferencing, and that is cognitively based without requiring classical cognitive task analyses. Example WIL applications are detailed and discussed.

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

A fast combination method in DSmT and its application to recommender system

PubMed Central

Liu, Yihai

2018-01-01

In many applications involving epistemic uncertainties usually modeled by belief functions, it is often necessary to approximate general (non-Bayesian) basic belief assignments (BBAs) to subjective probabilities (called Bayesian BBAs). This necessity occurs if one needs to embed the fusion result in a system based on the probabilistic framework and Bayesian inference (e.g. tracking systems), or if one needs to make a decision in the decision making problems. In this paper, we present a new fast combination method, called modified rigid coarsening (MRC), to obtain the final Bayesian BBAs based on hierarchical decomposition (coarsening) of the frame of discernment. Regarding this method, focal elements with probabilities are coarsened efficiently to reduce computational complexity in the process of combination by using disagreement vector and a simple dichotomous approach. In order to prove the practicality of our approach, this new approach is applied to combine users’ soft preferences in recommender systems (RSs). Additionally, in order to make a comprehensive performance comparison, the proportional conflict redistribution rule #6 (PCR6) is regarded as a baseline in a range of experiments. According to the results of experiments, MRC is more effective in accuracy of recommendations compared to original Rigid Coarsening (RC) method and comparable in computational time. PMID:29351297

Ethanol Attenuates Histiotrophic Nutrition Pathways and Alters the Intracellular Redox Environment and Thiol Proteome during Rat Organogenesis

PubMed Central

Jilek, Joseph L.; Sant, Karilyn E.; Cho, Katherine H.; Reed, Matthew S.; Pohl, Jan; Hansen, Jason M.; Harris, Craig

2015-01-01

Ethanol (EtOH) is a reactive oxygen-generating teratogen involved in the etiology of structural and functional developmental defects. Embryonic nutrition, redox environment, and changes in the thiol proteome following EtOH exposures (1.56.0 mg/ml) were studied in rat whole embryo culture. Glutathione (GSH) and cysteine (Cys) concentrations with their respective intracellular redox potentials (Eh) were determined using high-performance liquid chromatography. EtOH reduced GSH and Cys concentrations in embryo (EMB) and visceral yolk sac (VYS) tissues, and also in yolk sac and amniotic fluids. These changes produced greater oxidation as indicated by increasingly positive Eh values. EtOH reduced histiotrophic nutrition pathway activities as measured by the clearance of fluorescin isothiocyanate (FITC)-albumin from culture media. A significant decrease in total FITC clearance was observed at all concentrations, reaching approximately 50% at the highest dose. EtOH-induced changes to the thiol proteome were measured in EMBs and VYSs using isotope-coded affinity tags. Decreased concentrations for specific proteins from cytoskeletal dynamics and endocytosis pathways (α-actinin, α-tubulin, cubilin, and actin-related protein 2); nuclear translocation (Ran and RanBP1); and maintenance of receptor-mediated endocytosis (cubilin) were observed. Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis also identified a decrease in ribosomal proteins in both EMB and VYS. Results show that EtOH interferes with nutrient uptake to reduce availability of amino acids and micronutrients required by the conceptus. Intracellular antioxidants such as GSH and Cys are depleted following EtOH and Eh values increase. Thiol proteome analysis in the EMB and VYS show selectively altered actin/cytoskeleton, endocytosis, ribosome biogenesis and function, nuclear transport, and stress-related responses. PMID:26185205

Apoptosis in the Ovine Fetal Brain Following Placental Embolization and Intermittent Umbilical Cord Occlusion.

PubMed

Aksoy, Tuba; Richardson, Bryan S; Han, Victor K; Gagnon, Robert

2016-02-01

The purpose of this study was to compare the regional distribution of apoptotic cells in the near term ovine fetal brain caused by prolonged moderate hypoxia, as seen in placental insufficiency, and intermittent severe hypoxia, as seen in umbilical cord compression, which may then contribute to adverse neurodevelopment in the postnatal life. We hypothesized that apoptosis in the fetal brain will be increased in response to both prolonged moderate hypoxia and intermittent severe hypoxia. Twenty-one near term (126-127 days) sheep were divided into 3 groups: control (CON; n = 7), placental embolization (EMB; n = 7), and umbilical cord occlusion (UCO; n = 8). The EMB group had microsphere injections into the umbilical arterial circulation until the oxygen content was at 50% of baseline value. The UCO group had complete cord occlusion for 2 minutes every hour, 6 times a day for 2 consecutive days. At 4 pm on day 2, the animals were euthanized; fetal brains were fixed and prepared for apoptosis staining using the terminal uridine deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay method. In the cerebellar white matter, there was a 3-fold increase in the number of TUNEL positive cells per 1000 cells in both EMB and UCO animals as compared to CON (P = .017). There was also a significant increase in the frontal cortical grey matter (layers 1-3) in EMB animals as compared to CON (P = .014). As such, apoptosis in the near term fetal sheep brain is altered with both sustained moderate hypoxia and intermittent severe hypoxia in the latter part of pregnancy, with potential for long-term neurological sequelae. © The Author(s) 2015.

Impact of food intake on the pharmacokinetics of first-line antituberculosis drugs in Taiwanese tuberculosis patients.

PubMed

Lin, Hsien-Chun; Yu, Ming-Chih; Liu, Hsing-Jin; Bai, Kuan-Jen

2014-05-01

Under the directly observed treatment, short course (DOTS) program, antituberculosis (anti-TB) medications were possibly taken at random time, regardless of whether it was prior to or after meals. This study was to evaluate the impact of food intake on pharmacokinetic profiles of first-line TB drugs in Taiwanese TB patients, as well as the relationship between drug levels and pharmacogenetics. This open-label, randomized, cross-over study included newly diagnosed Taiwanese TB patients treated between January 2010 and February 2011 at Taipei Medical University-Wan Fang Hospital. Rifater [a fixed-dose combination formulation of isoniazid (INH), rifampicin (RIF), and pyrazinamide (PZA)] and ethambutol (EMB) were given according to national TB guidelines. Blood samples were collected prior to and 1 hour, 2 hours, 4 hours, 6 hours, and 10 hours after dosing under fasting or postprandial conditions. Pharmacokinetic parameters of the maximum serum concentration (Cmax), time to Cmax, and area under the serum concentration-time curve from the beginning to the 10(th) hour (AUC0-10) were calculated. Sixteen TB patients were included and received anti-TB treatment under the DOTS program after discharge. The overall effects showed that food intake reduced the mean Cmax (INH: 40.6%, RIF: 40.2%, EMB 34.4%, PZA: 24.4%) and AUC0-10 (INH: 21.3%, RIF: 26.4%, EMB: 12.2%, PZA: 12.0%). Meanwhile, food increased the time to Cmax (INH: 78.1%, RIF: 151.3%, EMB: 41.4%, PZA: 148.9%). Significantly lower serum drug concentrations were observed under postprandial conditions than fasting conditions for INH, RIF, and PZA. The impact of taking random anti-TB drugs under the DOTS program instead of taking drugs regularly prior to meals requires further study. Copyright © 2014. Published by Elsevier B.V.

Detection of Multidrug Resistance in Mycobacterium tuberculosis▿

PubMed Central

Sekiguchi, Jun-ichiro; Miyoshi-Akiyama, Tohru; Augustynowicz-Kopeć, Ewa; Zwolska, Zofia; Kirikae, Fumiko; Toyota, Emiko; Kobayashi, Intetsu; Morita, Koji; Kudo, Koichiro; Kato, Seiya; Kuratsuji, Tadatoshi; Mori, Toru; Kirikae, Teruo

2007-01-01

We developed a DNA sequencing-based method to detect mutations in the genome of drug-resistant Mycobacterium tuberculosis. Drug resistance in M. tuberculosis is caused by mutations in restricted regions of the genome. Eight genome regions associated with drug resistance, including rpoB for rifampin (RIF), katG and the mabA (fabG1)-inhA promoter for isoniazid (INH), embB for ethambutol (EMB), pncA for pyrazinamide (PZA), rpsL and rrs for streptomycin (STR), and gyrA for levofloxacin, were amplified simultaneously by PCR, and the DNA sequences were determined. It took 6.5 h to complete all procedures. Among the 138 clinical isolates tested, 55 were resistant to at least one drug. Thirty-four of 38 INH-resistant isolates (89.5%), 28 of 28 RIF-resistant isolates (100%), 15 of 18 EMB-resistant isolates (83.3%), 18 of 30 STR-resistant isolates (60%), and 17 of 17 PZA-resistant isolates (100%) had mutations related to specific drug resistance. Eighteen of these mutations had not been reported previously. These novel mutations include one in rpoB, eight in katG, one in the mabA-inhA regulatory region, two in embB, five in pncA, and one in rrs. Escherichia coli isolates expressing individually five of the eight katG mutations showed loss of catalase and INH oxidation activities, and isolates carrying any of the five pncA mutations showed no pyrazinamidase activity, indicating that these mutations are associated with INH and PZA resistance, respectively. Our sequencing-based method was also useful for testing sputa from tuberculosis patients and for screening of mutations in Mycobacterium bovis. In conclusion, our new method is useful for rapid detection of multiple-drug-resistant M. tuberculosis and for identifying novel mutations in drug-resistant M. tuberculosis. PMID:17108078

Incubation at room temperature may be an independent factor that induces chlamydospore production in Candida dubliniensis.

PubMed

Sancak, Banu; Colakoglu, Sule; Acikgoz, Ziya Cibali; Arikan, Sevtap

2005-08-01

Production of chlamydospores is one of the phenotypic features used to differentiate Candida albicans and Candida dubliniensis. C. albicans produces few chlamydospores on only cornmeal/rice-Tween agar at room temperature, whereas C. dubliniensis produces abundant chlamydospores at this temperature both on cornmeal agar and some other commonly used media. We tried to determine whether the room temperature is the main factor that induces chlamydospore production of C. dubliniensis, regardless of the medium used. For this purpose, 100 C. albicans and 24 C. dubliniensis isolates were tested for chlamydospore production at room temperature and at 37 degrees C on some routinely used media, including eosin-methylene blue agar (EMB), nutrient agar (NA), nutrient broth (NB), and also on an investigational medium, phenol red agar (PR). At 37 degrees C, none of the isolates produced chlamydospores on any of the tested media. At 26 degrees C, all C. dubliniensis isolates produced abundant chlamydospores and pseudohyphae after 24-48 h on all tested media. At this incubation temperature, all C. albicans isolates failed to produce chlamydospores and pseudohyphae on EMB, NA, and NB, whereas 2 of the C. albicans isolates produced a few chlamydospores on PR. We also observed that all C. dubliniensis isolates tested on EMB and PR produced rough colonies with a hyphal fringe around the colonies, whereas none of the C. albicans isolates showed this property. In conclusion, incubation at 26 degrees C may play the key role for production of abundant chlamydospores and pseudohyphae by C. dubliniensis. Comprehensive molecular studies are needed to clarify the genetic basis of this observation. Using EMB and PR may be an inexpensive, a time-saving, and a simple way of presumptive identification of C. dubliniensis based on chlamydospore formation and colony morphology.

Immune function surveillance: association with rejection, infection and cardiac allograft vasculopathy.

PubMed

Heikal, N M; Bader, F M; Martins, T B; Pavlov, I Y; Wilson, A R; Barakat, M; Stehlik, J; Kfoury, A G; Gilbert, E M; Delgado, J C; Hill, H R

2013-01-01

Rejection, cardiac allograft vasculopathy (CAV), and infection are significant causes of mortality in heart transplantation recipients. Assessing the immune status of a particular patient remains challenging. Although endomyocardial biopsy (EMB) and angiography are effective for the identification of rejection and CAV, respectively, these are expensive, invasive, and may have numerous complications. The aim of this study was to evaluate the immune function and assess its utility in predicting rejection, CAV, and infection in heart transplantation recipients. We prospectively obtained samples at the time of routine EMB and when clinically indicated for measurement of the ImmuKnow assay (IM), 12 cytokines and soluble CD30 (sCD30). EMB specimens were evaluated for acute cellular rejection, and antibody-mediated rejection (AMR). CAV was diagnosed by the development of angiographic coronary artery disease. Infectious episodes occurring during the next 30 days after testing were identified by the presence of positive bacterial or fungal cultures and/or viremia that prompted treatment with antimicrobials. We collected 162 samples from 56 cardiac transplant recipients. There were 31 infection episodes, 7 AMR, and 4 CAV cases. The average IM value was significantly lower during infection, (P = .04). Soluble CD30 concentrations showed significantly positive correlation with infection episodes, (P = .001). Significant positive correlation was observed between interleukin-5(IL-5) and AMR episodes (P = .008). Tumor necrosis factor-α and IL-8 showed significant positive correlation with CAV (P = .001). Immune function monitoring appears promising in predicting rejection, CAV, and infection in cardiac transplantation recipients. This approach may help in more individualized immunosuppression and it may also minimize unnecessary EMBs and cardiac angiographies. Published by Elsevier Inc.

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

PubMed

Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight

2007-01-01

Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

From Rosalind Franklin to Barack Obama: Data Sharing Challenges and Solutions in Genomics and Personalised Medicine

PubMed Central

Lawler, Mark; Maughan, Tim

2017-01-01

The collection, storage and use of genomic and clinical data from patients and healthy individuals is a key component of personalised medicine enterprises such as the Precision Medicine Initiative, the Cancer Moonshot and the 100,000 Genomes Project. In order to maximise the value of this data, it is important to embed a culture within the scientific, medical and patient communities that supports the appropriate sharing of genomic and clinical information. However, this aspiration raises a number of ethical, legal and regulatory challenges that need to be addressed. The Global Alliance for Genomics and Health, a worldwide coalition of researchers, healthcare professionals, patients and industry partners, is developing innovative solutions to support the responsible and effective sharing of genomic and clinical data. This article identifies the challenges that a data sharing culture poses and highlights a series of practical solutions that will benefit patients, researchers and society. PMID:28517986

From Rosalind Franklin to Barack Obama: Data Sharing Challenges and Solutions in Genomics and Personalised Medicine.

PubMed

Lawler, Mark; Maughan, Tim

2017-04-01

The collection, storage and use of genomic and clinical data from patients and healthy individuals is a key component of personalised medicine enterprises such as the Precision Medicine Initiative, the Cancer Moonshot and the 100,000 Genomes Project. In order to maximise the value of this data, it is important to embed a culture within the scientific, medical and patient communities that supports the appropriate sharing of genomic and clinical information. However, this aspiration raises a number of ethical, legal and regulatory challenges that need to be addressed. The Global Alliance for Genomics and Health, a worldwide coalition of researchers, healthcare professionals, patients and industry partners, is developing innovative solutions to support the responsible and effective sharing of genomic and clinical data. This article identifies the challenges that a data sharing culture poses and highlights a series of practical solutions that will benefit patients, researchers and society.

Modelling Safe Interface Interactions in Web Applications

NASA Astrophysics Data System (ADS)

Brambilla, Marco; Cabot, Jordi; Grossniklaus, Michael

Current Web applications embed sophisticated user interfaces and business logic. The original interaction paradigm of the Web based on static content pages that are browsed by hyperlinks is, therefore, not valid anymore. In this paper, we advocate a paradigm shift for browsers and Web applications, that improves the management of user interaction and browsing history. Pages are replaced by States as basic navigation nodes, and Back/Forward navigation along the browsing history is replaced by a full-fledged interactive application paradigm, supporting transactions at the interface level and featuring Undo/Redo capabilities. This new paradigm offers a safer and more precise interaction model, protecting the user from unexpected behaviours of the applications and the browser.

Memory Circuit Fault Simulator

NASA Technical Reports Server (NTRS)

Sheldon, Douglas J.; McClure, Tucker

2013-01-01

Spacecraft are known to experience significant memory part-related failures and problems, both pre- and postlaunch. These memory parts include both static and dynamic memories (SRAM and DRAM). These failures manifest themselves in a variety of ways, such as pattern-sensitive failures, timingsensitive failures, etc. Because of the mission critical nature memory devices play in spacecraft architecture and operation, understanding their failure modes is vital to successful mission operation. To support this need, a generic simulation tool that can model different data patterns in conjunction with variable write and read conditions was developed. This tool is a mathematical and graphical way to embed pattern, electrical, and physical information to perform what-if analysis as part of a root cause failure analysis effort.

Fifth Congress of Industrial Cell Technology 2014.

PubMed

Rasch, Anja

2015-01-01

The highly specialized and informative Fifth Congress of Industrial Cell Technology took place in Luebeck, close to Hamburg, on 11-12 September 2014. It was organized by the Fraunhofer Institution for Marine Biotechnology (EMB), Luebeck and supported by the cluster agency Life Science Nord Management GmbH as well as the Luebeck Chamber of Industry and Commerce. The central aim of the congress was to promote the name-giving platform applications of industrial cell technologies, in other words, the development of complex cell culture systems, analyzing technologies, innovative instruments and materials, etc. This year's sessions were: smart cell culture, bioreactor systems and cell goods including 3D bioprinting. This article highlights selected presentations of the congress.

Decision Support | Solar Research | NREL

Science.gov Websites

informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

Simple Backdoors on RSA Modulus by Using RSA Vulnerability

NASA Astrophysics Data System (ADS)

Sun, Hung-Min; Wu, Mu-En; Yang, Cheng-Ta

This investigation proposes two methods for embedding backdoors in the RSA modulus N=pq rather than in the public exponent e. This strategy not only permits manufacturers to embed backdoors in an RSA system, but also allows users to choose any desired public exponent, such as e=216+1, to ensure efficient encryption. This work utilizes lattice attack and exhaustive attack to embed backdoors in two proposed methods, called RSASBLT and RSASBES, respectively. Both approaches involve straightforward steps, making their running time roughly the same as that of normal RSA key-generation time, implying that no one can detect the backdoor by observing time imparity.

Embedding spiritual value through science learning

NASA Astrophysics Data System (ADS)

Johan, H.; Suhandi, A.; Wulan, A. R.; Widiasih; Ruyani, A.; Karyadi, B.; Sipriyadi

2018-05-01

The purpose of this study was to embed spiritual value through science learning program especially earth planet. Various phenomena in earth planet describe a divinity of super power. This study used quasi experimental method with one group pre-test-post-test design. Convenience sampling was conducted in this study. 23 pre-service physics teacher was involved. Pre-test and post-test used a questionnaire had been conducted to collected data of spiritual attitude. Open ended question had been utilized at post-test to collected data. A fourth indicators of spiritual value related to divinity of God was used to embed spiritual value. The results show a shifted of students’ awareness to divinity of God. Before implementing the earth planet learning, 85.8% of total students strongly agree that learning activity embed spiritual value while after learning process, it increased be 93.4%. After learning earth planet, it known that students’ spiritual value was influenced by character of earth planet concept which unobservable and media visual which display each incredible phenomena process in our earth planet. It can be concluded that spiritual value can be embedded through unobservable phenomena of during learning earth planet process.

The assessment of changes to the nontuberculous mycobacterial metabolome in response to anti-TB drugs.

PubMed

Drapal, Margit; Wheeler, Paul R; Fraser, Paul D

2018-06-26

Mycobacterium species can cause a range of nontuberculous infections of healthy and immunocompromised people as well as infect people during and after surgical procedures. The similarity of nontuberculous mycobacteria (NTM) to the tuberculosis bacilli (TB) could ultimately enable the use of anti-TB drugs for the genus. Hence, three NTM (M. smegmatis, M. phlei and M. avium) were cultured under different lab conditions, causing two mycobacterial phenotypes (active and dormant), and treated with isoniazid (INH) and ethambutol (EMB) independently or in combination. Metabolite profiling was applied to facilitate the investigation and characterisation of intracellular targets affected by the antibiotics. Aliquots of the cell culture were taken over the treatment period and the metabolite profile of the cells analysed by GC/MS. Comparative analysis of the metabolite levels to untreated mycobacteria confirmed the successful action of the antibiotics on the metabolism of all three species. Furthermore, single metabolites and metabolite pathways affected by the antibiotics could be identified and included, besides the known target sites for INH and EMB on mycobacterial cells, changes in e.g. nucleotide and saccharide levels. The combined treatment highlighted the property of EMB to enhance the effects of INH even under hypoxic culture conditions.

Capacity-optimized mp2 audio watermarking

NASA Astrophysics Data System (ADS)

Steinebach, Martin; Dittmann, Jana

2003-06-01

Today a number of audio watermarking algorithms have been proposed, some of them at a quality making them suitable for commercial applications. The focus of most of these algorithms is copyright protection. Therefore, transparency and robustness are the most discussed and optimised parameters. But other applications for audio watermarking can also be identified stressing other parameters like complexity or payload. In our paper, we introduce a new mp2 audio watermarking algorithm optimised for high payload. Our algorithm uses the scale factors of an mp2 file for watermark embedding. They are grouped and masked based on a pseudo-random pattern generated from a secret key. In each group, we embed one bit. Depending on the bit to embed, we change the scale factors by adding 1 where necessary until it includes either more even or uneven scale factors. An uneven group has a 1 embedded, an even group a 0. The same rule is later applied to detect the watermark. The group size can be increased or decreased for transparency/payload trade-off. We embed 160 bits or more in an mp2 file per second without reducing perceived quality. As an application example, we introduce a prototypic Karaoke system displaying song lyrics embedded as a watermark.

Salmon lice (Lepeophtheirus salmonis) showing varying emamectin benzoate susceptibilities differ in neuronal acetylcholine receptor and GABA-gated chloride channel mRNA expression

PubMed Central

2013-01-01

Background Caligid copepods, also called sea lice, are fish ectoparasites, some species of which cause significant problems in the mariculture of salmon, where the annual cost of infection is in excess of €300 million globally. At present, caligid control on farms is mainly achieved using medicinal treatments. However, the continued use of a restricted number of medicine actives potentially favours the development of drug resistance. Here, we report transcriptional changes in a laboratory strain of the caligid Lepeophtheirus salmonis (Krøyer, 1837) that is moderately (~7-fold) resistant to the avermectin compound emamectin benzoate (EMB), a component of the anti-salmon louse agent SLICE® (Merck Animal Health). Results Suppression subtractive hybridisation (SSH) was used to enrich transcripts differentially expressed between EMB-resistant (PT) and drug-susceptible (S) laboratory strains of L. salmonis. SSH libraries were subjected to 454 sequencing. Further L. salmonis transcript sequences were available as expressed sequence tags (EST) from GenBank. Contiguous sequences were generated from both SSH and EST sequences and annotated. Transcriptional responses in PT and S salmon lice were investigated using custom 15 K oligonucleotide microarrays designed using the above sequence resources. In the absence of EMB exposure, 359 targets differed in transcript abundance between the two strains, these genes being enriched for functions such as calcium ion binding, chitin metabolism and muscle structure. γ-aminobutyric acid (GABA)-gated chloride channel (GABA-Cl) and neuronal acetylcholine receptor (nAChR) subunits showed significantly lower transcript levels in PT lice compared to S lice. Using RT-qPCR, the decrease in mRNA levels was estimated at ~1.4-fold for GABA-Cl and ~2.8-fold for nAChR. Salmon lice from the PT strain showed few transcriptional responses following acute exposure (1 or 3 h) to 200 μg L-1 of EMB, a drug concentration tolerated by PT lice, but toxic for S lice. Conclusions Avermectins are believed to exert their toxicity to invertebrates through interaction with glutamate-gated and GABA-gated chloride channels. Further potential drug targets include other Cys-loop ion channels such as nAChR. The present study demonstrates decreased transcript abundances of GABA-Cl and nAChR subunits in EMB-resistant salmon lice, suggesting their involvement in avermectin toxicity in caligids. PMID:23773482

Salmon lice (Lepeophtheirus salmonis) showing varying emamectin benzoate susceptibilities differ in neuronal acetylcholine receptor and GABA-gated chloride channel mRNA expression.

PubMed

Carmichael, Stephen N; Bron, James E; Taggart, John B; Ireland, Jacqueline H; Bekaert, Michaël; Burgess, Stewart Tg; Skuce, Philip J; Nisbet, Alasdair J; Gharbi, Karim; Sturm, Armin

2013-06-18

Caligid copepods, also called sea lice, are fish ectoparasites, some species of which cause significant problems in the mariculture of salmon, where the annual cost of infection is in excess of €300 million globally. At present, caligid control on farms is mainly achieved using medicinal treatments. However, the continued use of a restricted number of medicine actives potentially favours the development of drug resistance. Here, we report transcriptional changes in a laboratory strain of the caligid Lepeophtheirus salmonis (Krøyer, 1837) that is moderately (~7-fold) resistant to the avermectin compound emamectin benzoate (EMB), a component of the anti-salmon louse agent SLICE® (Merck Animal Health). Suppression subtractive hybridisation (SSH) was used to enrich transcripts differentially expressed between EMB-resistant (PT) and drug-susceptible (S) laboratory strains of L. salmonis. SSH libraries were subjected to 454 sequencing. Further L. salmonis transcript sequences were available as expressed sequence tags (EST) from GenBank. Contiguous sequences were generated from both SSH and EST sequences and annotated. Transcriptional responses in PT and S salmon lice were investigated using custom 15 K oligonucleotide microarrays designed using the above sequence resources. In the absence of EMB exposure, 359 targets differed in transcript abundance between the two strains, these genes being enriched for functions such as calcium ion binding, chitin metabolism and muscle structure. γ-aminobutyric acid (GABA)-gated chloride channel (GABA-Cl) and neuronal acetylcholine receptor (nAChR) subunits showed significantly lower transcript levels in PT lice compared to S lice. Using RT-qPCR, the decrease in mRNA levels was estimated at ~1.4-fold for GABA-Cl and ~2.8-fold for nAChR. Salmon lice from the PT strain showed few transcriptional responses following acute exposure (1 or 3 h) to 200 μg L-1 of EMB, a drug concentration tolerated by PT lice, but toxic for S lice. Avermectins are believed to exert their toxicity to invertebrates through interaction with glutamate-gated and GABA-gated chloride channels. Further potential drug targets include other Cys-loop ion channels such as nAChR. The present study demonstrates decreased transcript abundances of GABA-Cl and nAChR subunits in EMB-resistant salmon lice, suggesting their involvement in avermectin toxicity in caligids.

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

PubMed

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-04-01

To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

PubMed

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

Knowledge exchange in the Pacific: The TROPIC (Translational Research into Obesity Prevention Policies for Communities) project

PubMed Central

2012-01-01

Background Policies targeting obesogenic environments and behaviours are critical to counter rising obesity rates and lifestyle-related non-communicable diseases (NCDs). Policies are likely to be most effective and enduring when they are based on the best available evidence. Evidence-informed policy making is especially challenging in countries with limited resources. The Pacific TROPIC (Translational Research for Obesity Prevention in Communities) project aims to implement and evaluate a tailored knowledge-brokering approach to evidence-informed policy making to address obesity in Fiji, a Pacific nation challenged by increasingly high rates of obesity and concomitant NCDs. Methods The TROPIC project draws on the concept of ‘knowledge exchange’ between policy developers (individuals; organisations) and researchers to deliver a knowledge broking programme that maps policy environments, conducts workshops on evidence-informed policy making, supports the development of evidence-informed policy briefs, and embeds evidence-informed policy making into organisational culture. Recruitment of government and nongovernment organisational representatives will be based on potential to: develop policies relevant to obesity, reach broad audiences, and commit to resourcing staff and building a culture that supports evidence-informed policy development. Workshops will increase awareness of both obesity and policy cycles, as well as develop participants’ skills in accessing, assessing and applying relevant evidence to policy briefs. The knowledge-broking team will then support participants to: 1) develop evidence-informed policy briefs that are both commensurate with national and organisational plans and also informed by evidence from the Pacific Obesity Prevention in Communities project and elsewhere; and 2) collaborate with participating organisations to embed evidence-informed policy making structures and processes. This knowledge broking initiative will be evaluated via data from semi-structured interviews, a validated self-assessment tool, process diaries and outputs. Discussion Public health interventions have rarely targeted evidence-informed policy making structures and processes to reduce obesity and NCDs. This study will empirically advance understanding of knowledge broking processes to extend evidence-informed policy making skills and develop a suite of national obesity-related policies that can potentially improve population health outcomes. PMID:22830984

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

Amino Acid Starvation Induced by Protease Inhibition Produces Differential Alterations in Redox Status and the Thiol Proteome in Organogenesis-Stage Rat Embryos and Visceral Yolk Sacs

PubMed Central

Harris, Craig; Jilek, Joseph L.; Sant, Karilyn E.; Pohl, Jan; Reed, Matthew; Hansen, Jason M.

2015-01-01

The process of embryonic nutrition in rodent conceptuses during organogenesis has been shown to involve a dominant histiotrophic mechanism where essential developmental substrates and micronutrients are supplied as whole maternal proteins or cargoes associated with proteins. The histiotrophic nutrition pathways (HNP) responsible for uptake and initial processing of proteins across maternal-conceptal interfaces involve uptake via receptor mediated endocytosis and protein degradation via lysosomal proteolysis. Chemical inhibition of either process can lead to growth deficits and malformation in the embryo (EMB), but selective inhibition of either HNP component will elicit a different subset of developmental perturbations. In vitro, whole embryo culture (WEC) exposure of GD10 or GD11 rat conceptuses to the natural protease inhibitor, leupeptin, leads to significant reductions in all measured embryonic growth parameters as well as a myriad of other effects. Leupeptin doses of 10 μM or 20 μM over a 26 hr period (GD10-GD11) and 50 μM over a 3 hr pulse period produced significant decreases in the clearance of FITC-albumin from culture media. The near complete loss of acid soluble fluorescence and increased total visceral yolk sac (VYS) protein content confirmed the selective inhibition of proteolysis. Inhibition of lysosomal proteolysis thus deprives the developing EMB of essential nutrient amino acids producing conditions akin to amino acid starvation, but may also cause direct effects on pathways critical for normal growth and differentiation. Following leupeptin exposure for 26 or 6 hr, total glutathione (GSH) concentrations dropped significantly in the VYS, but only slightly in yolk sac (YSF) and amniotic (AF) fluids. Cys concentrations increased in VYS and EMB, but dropped in YSF and AF fluids. Redox potentials (Eh) for the GSSG/GSH redox couple trended significantly toward the positive, confirming the net oxidation of conceptual tissues following leupeptin treatment. Analysis of the thiol proteome showed few alterations to specific pathways mapped to the KEGG Pathway database, but did reveal significant increases in concentrations of proteins associated with glycolysis/gluconeogenesis in the VYS and decreased concentrations proteins associated with ribosome biogenesis and function in the EMB. A subset of proteins elevated by >2-23 fold in the VYS were identified as serum (blood) proteins and represent the maternal-side proteins captured by the VYS and which are not degraded in the lysosomes as a result of leupeptin’s inhibitory action. The observed constellation of proteins decreased in the EMB by leupeptin represent proteins from several adaptive pathways that are commonly altered in responses to amino acid starvation. These studies show clear differential responses to protease inhibition in VYS and EMB during organogenesis and suggest the possibility for additional roles of redox regulation, cellular adaptations and metabolic insufficiency caused by protease inhibition. PMID:26365578

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

PubMed Central

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-01-01

OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

Towards a differentiated understanding of active travel behaviour: Using social theory to explore everyday commuting

PubMed Central

Guell, C.; Panter, J.; Jones, N.R.; Ogilvie, D.

2012-01-01

Fostering physical activity is an established public health priority for the primary prevention of a variety of chronic diseases. One promising population approach is to seek to embed physical activity in everyday lives by promoting walking and cycling to and from work (‘active commuting’) as an alternative to driving. Predominantly quantitative epidemiological studies have investigated travel behaviours, their determinants and how they may be changed towards more active choices. This study aimed to depart from narrow behavioural approaches to travel and investigate the social context of commuting with qualitative social research methods. Within a social practice theory framework, we explored how people describe their commuting experiences and make commuting decisions, and how travel behaviour is embedded in and shaped by commuters' complex social worlds. Forty-nine semi-structured interviews and eighteen photo-elicitation interviews with accompanying field notes were conducted with a subset of the Commuting and Health in Cambridge study cohort, based in the UK. The findings are discussed in terms of three particularly pertinent facets of the commuting experience. Firstly, choice and decisions are shaped by the constantly changing and fluid nature of commuters' social worlds. Secondly, participants express ambiguities in relation to their reasoning, ambitions and identities as commuters. Finally, commuting needs to be understood as an embodied and emotional practice. With this in mind, we suggest that everyday decision-making in commuting requires the tactical negotiation of these complexities. This study can help to explain the limitations of more quantitative and static models and frameworks in predicting travel behaviour and identify future research directions. PMID:22486840

Electronic decision support for diagnostic imaging in a primary care setting

PubMed Central

Reed, Martin H

2011-01-01

Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines. Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software. Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. PMID:21486884

Supporting end of life decision making: Case studies of relational closeness in supported decision making for people with severe or profound intellectual disability.

PubMed

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-11-01

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. Five people with severe or profound intellectual disability's experiences of supported decision making were examined. This article is particularly focused on one participant's experiences at the end of his life. All five case studies identified that supporters were most effective in providing decision-making support for participants when they were relationally close to the person and had knowledge of the person's life story, particularly in relation to events that demonstrated preference. Findings from this study provide new understandings of supported decision making for people with severe or profound intellectual disability and have particular relevance for supporting decision making at the end of life. © 2017 John Wiley & Sons Ltd.

Precise delay measurement through combinatorial logic

NASA Technical Reports Server (NTRS)

Burke, Gary R. (Inventor); Chen, Yuan (Inventor); Sheldon, Douglas J. (Inventor)

2010-01-01

A high resolution circuit and method for facilitating precise measurement of on-chip delays for FPGAs for reliability studies. The circuit embeds a pulse generator on an FPGA chip having one or more groups of LUTS (the "LUT delay chain"), also on-chip. The circuit also embeds a pulse width measurement circuit on-chip, and measures the duration of the generated pulse through the delay chain. The pulse width of the output pulse represents the delay through the delay chain without any I/O delay. The pulse width measurement circuit uses an additional asynchronous clock autonomous from the main clock and the FPGA propagation delay can be displayed on a hex display continuously for testing purposes.

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Photoinactivation of mcr-1 positive Escherichia coli

NASA Astrophysics Data System (ADS)

Caires, C. S. A.; Leal, C. R. B.; Rodrigues, A. C. S.; Lima, A. R.; Silva, C. M.; Ramos, C. A. N.; Chang, M. R.; Arruda, E. J.; Oliveira, S. L.; Nascimento, V. A.; Caires, A. R. L.

2018-01-01

The emergence of plasmid-mediated colistin resistance in Enterobacteriaceae, mostly in Escherichia coli due to the mcr-1 gene, has revealed the need to develop alternative approaches in treating mcr-1 positive bacterial infections. This is because colistin is a broad-spectrum antibiotic and one of the ‘last-resort’ antibiotics for multidrug resistant bacteria. The present study evaluated for the first time, to the best of our knowledge, the efficacy of photoinactivation processes to kill a known mcr-1 positive E. coli strain. Eosin methylene-blue (EMB) was investigated as a photoantimicrobial agent for inhibiting the growth of a mcr-1 positive E. coli strain obtained from a patient with a diabetic foot infection. The photoantimicrobial activity of EMB was also tested in a non-multidrug resistant E. coli strain. The photoinactivation process was tested using light doses in the 30-45 J cm-2 range provided by a LED device emitting at 625 nm. Our findings demonstrate that a mcr-1 positive E. coli strain is susceptible to photoinactivation. The results show that the EMB was successfully photoactivated, regardless of the bacterial multidrug resistance; inactivating the bacterial growth by oxidizing the cells in accordance with the generation of the oxygen reactive species. Our results suggest that bacterial photoinactivation is an alternative and effective approach to kill mcr-1 positive bacteria.

Development and Validation of an HPLC Method for Simultaneous Determination of Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol Hydrochloride in Pharmaceutical Formulations.

PubMed

Chellini, Paula R; Lages, Eduardo B; Franco, Pedro H C; Nogueira, Fernando H A; César, Isabela C; Pianetti, Gerson A

2015-01-01

Tuberculosis treatment consists of a fixed dose combination of rifampicin (RIF), isoniazid (INH), pyrazinamide (PYZ), and ethambutol hydrochloride (EMB). The combined treatment using various drugs is necessary for patient curing, without recrudescence, and for prevention of drug-resistant mutants, which may occur during treatment. An HPLC-diode array detector (DAD) method for the simultaneous determination of RIF, INH, PYZ, and EMB in fixed dose combination tablets was developed and validated. Chromatographic experiments were performed on an Agilent 1200 HPLC system, and the separation was carried out on a Purospher STAR RP18e (250×4.6 mm id, 5 μm, Merck) analytical column. Gradient elution was carried out with a mobile phase of 20 mM monobasic sodium phosphate buffer with 0.2% triethylamine (pH 7.0) and acetonitrile at a flow rate of 1.5 mL/min. The total run time was 12 min, and the re-equilibration time was 5 min. EMB detection was performed at 210 nm, and RIF, INH, and PYZ were detected at 238 nm, using a DAD. The method proved to be specific, linear (r2>0.99), precise (RSD<2%), accurate, and robust and may be applied to the QC analysis of pharmaceutical formulations.

Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

ERIC Educational Resources Information Center

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-01-01

Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

Treesearch

Erin K. Noonan-Wright; Tonja S. Opperman

2015-01-01

In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

Decision support for clinical laboratory capacity planning.

PubMed

van Merode, G G; Hasman, A; Derks, J; Goldschmidt, H M; Schoenmaker, B; Oosten, M

1995-01-01

The design of a decision support system for capacity planning in clinical laboratories is discussed. The DSS supports decisions concerning the following questions: how should the laboratory be divided into job shops (departments/sections), how should staff be assigned to workstations and how should samples be assigned to workstations for testing. The decision support system contains modules for supporting decisions at the overall laboratory level (concerning the division of the laboratory into job shops) and for supporting decisions at the job shop level (assignment of staff to workstations and sample scheduling). Experiments with these modules are described showing both the functionality and the validity.

Features of computerized clinical decision support systems supportive of nursing practice: a literature review.

PubMed

Lee, Seonah

2013-10-01

This study aimed to organize the system features of decision support technologies targeted at nursing practice into assessment, problem identification, care plans, implementation, and outcome evaluation. It also aimed to identify the range of the five stage-related sequential decision supports that computerized clinical decision support systems provided. MEDLINE, CINAHL, and EMBASE were searched. A total of 27 studies were reviewed. The system features collected represented the characteristics of each category from patient assessment to outcome evaluation. Several features were common across the reviewed systems. For the sequential decision support, all of the reviewed systems provided decision support in sequence for patient assessment and care plans. Fewer than half of the systems included problem identification. There were only three systems operating in an implementation stage and four systems in outcome evaluation. Consequently, the key steps for sequential decision support functions were initial patient assessment, problem identification, care plan, and outcome evaluation. Providing decision support in such a full scope will effectively help nurses' clinical decision making. By organizing the system features, a comprehensive picture of nursing practice-oriented computerized decision support systems was obtained; however, the development of a guideline for better systems should go beyond the scope of a literature review.

Pressure Measurement Sensor

NASA Technical Reports Server (NTRS)

1997-01-01

FFPI Industries Inc. is the manufacturer of fiber-optic sensors that furnish accurate pressure measurements in internal combustion chambers. Such an assessment can help reduce pollution emitted by these engines. A chief component in the sensor owes its seven year- long development to Lewis Research Center funding to embed optical fibers and sensors in metal parts. NASA support to Texas A&M University played a critical role in developing this fiber optic technology and led to the formation of FFPI Industries and the production of fiber sensor products. The simple, rugged design of the sensor offers the potential for mass production at low cost. Widespread application of the new technology is forseen, from natural gas transmission, oil refining and electrical power generation to rail transport and the petrochemical paper product industry.

A hierarchical distributed control model for coordinating intelligent systems

NASA Technical Reports Server (NTRS)

Adler, Richard M.

1991-01-01

A hierarchical distributed control (HDC) model for coordinating cooperative problem-solving among intelligent systems is described. The model was implemented using SOCIAL, an innovative object-oriented tool for integrating heterogeneous, distributed software systems. SOCIAL embeds applications in 'wrapper' objects called Agents, which supply predefined capabilities for distributed communication, control, data specification, and translation. The HDC model is realized in SOCIAL as a 'Manager'Agent that coordinates interactions among application Agents. The HDC Manager: indexes the capabilities of application Agents; routes request messages to suitable server Agents; and stores results in a commonly accessible 'Bulletin-Board'. This centralized control model is illustrated in a fault diagnosis application for launch operations support of the Space Shuttle fleet at NASA, Kennedy Space Center.

Unveiling the Role of the Magnetic Field at the Smallest Scales of Star Formation

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

Hull, Charles L. H.; Mocz, Philip; Burkhart, Blakesley

We report Atacama Large Millimeter/submillimeter Array (ALMA) observations of polarized dust emission from the protostellar source Ser-emb 8 at a linear resolution of 140 au. Assuming models of dust-grain alignment hold, the observed polarization pattern gives a projected view of the magnetic field structure in this source. Contrary to expectations based on models of strongly magnetized star formation, the magnetic field in Ser-emb 8 does not exhibit an hourglass morphology. Combining the new ALMA data with previous observational studies, we can connect magnetic field structure from protostellar core (∼80,000 au) to disk (∼100 au) scales. We compare our observations withmore » four magnetohydrodynamic gravo-turbulence simulations made with the AREPO code that have initial conditions ranging from super-Alfvénic (weakly magnetized) to sub-Alfvénic (strongly magnetized). These simulations achieve the spatial dynamic range necessary to resolve the collapse of protostars from the parsec scale of star-forming clouds down to the ∼100 au scale probed by ALMA. Only in the very strongly magnetized simulation do we see both the preservation of the field direction from cloud to disk scales and an hourglass-shaped field at <1000 au scales. We conduct an analysis of the relative orientation of the magnetic field and the density structure in both the Ser-emb 8 ALMA observations and the synthetic observations of the four AREPO simulations. We conclude that the Ser-emb 8 data are most similar to the weakly magnetized simulations, which exhibit random alignment, in contrast to the strongly magnetized simulation, where the magnetic field plays a role in shaping the density structure in the source. In the weak-field case, it is turbulence—not the magnetic field—that shapes the material that forms the protostar, highlighting the dominant role that turbulence can play across many orders of magnitude in spatial scale.« less

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

EPA Science Inventory

NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

SANDS: an architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2007-10-11

A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.

Future of electronic health records: implications for decision support.

PubMed

Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

2012-01-01

The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data in real-time for decision support and process automation has the potential to both reduce costs and improve the quality of patient care. © 2012 Mount Sinai School of Medicine.

Wavelet-based audio embedding and audio/video compression

NASA Astrophysics Data System (ADS)

Mendenhall, Michael J.; Claypoole, Roger L., Jr.

2001-12-01

Watermarking, traditionally used for copyright protection, is used in a new and exciting way. An efficient wavelet-based watermarking technique embeds audio information into a video signal. Several effective compression techniques are applied to compress the resulting audio/video signal in an embedded fashion. This wavelet-based compression algorithm incorporates bit-plane coding, index coding, and Huffman coding. To demonstrate the potential of this audio embedding and audio/video compression algorithm, we embed an audio signal into a video signal and then compress. Results show that overall compression rates of 15:1 can be achieved. The video signal is reconstructed with a median PSNR of nearly 33 dB. Finally, the audio signal is extracted from the compressed audio/video signal without error.

Toward a Multilingual, Experiential Environment for Learning Decision Technology.

ERIC Educational Resources Information Center

Yeo, Gee Kin; Tan, Seng Teen

1999-01-01

Describes work at the National University of Singapore on the Internet in expanding a simulation game used in supporting a course in decision technology. Topics include decision support systems, multilingual support for cross-cultural decision studies, process support in a World Wide Web-enhanced multiuser domain (MUD) learning environment, and…

Maintenance and operations decision support tool : Clarus regional demonstrations.

DOT National Transportation Integrated Search

2011-01-01

Weather affects almost all maintenance activity decisions. The Federal Highway Administration (FHWA) tested a new decision support system for maintenance in Iowa, Indiana, and Illinois called the Maintenance and Operations Decision Support System (MO...

The Role of Health Care Provider and Partner Decisional Support in Patients' Cancer Treatment Decision-Making Satisfaction.

PubMed

Palmer-Wackerly, Angela L; Krieger, Janice L; Rhodes, Nancy D

2017-01-01

Cancer patients rely on multiple sources of support when making treatment decisions; however, most research studies examine the influence of health care provider support while the influence of family member support is understudied. The current study fills this gap by examining the influence of health care providers and partners on decision-making satisfaction. In a cross-sectional study via an online Qualtrics panel, we surveyed cancer patients who reported that they had a spouse or romantic partner when making cancer treatment decisions (n = 479). Decisional support was measured using 5-point, single-item scales for emotional support, informational support, informational-advice support, and appraisal support. Decision-making satisfaction was measured using Holmes-Rovner and colleagues' (1996) Satisfaction With Decision Scale. We conducted a mediated regression analysis to examine treatment decision-making satisfaction for all participants and a moderated mediation analysis to examine treatment satisfaction among those patients offered a clinical trial. Results indicated that partner support significantly and partially mediated the relationship between health care provider support and patients' decision-making satisfaction but that results did not vary by enrollment in a clinical trial. This study shows how and why decisional support from partners affects communication between health care providers and cancer patients.

Uncertainty and probability in wildfire management decision support: An example from the United States [Chapter 4

Treesearch

Matthew Thompson; David Calkin; Joe H. Scott; Michael Hand

2017-01-01

Wildfire risk assessment is increasingly being adopted to support federal wildfire management decisions in the United States. Existing decision support systems, specifically the Wildland Fire Decision Support System (WFDSS), provide a rich set of probabilistic and risk‐based information to support the management of active wildfire incidents. WFDSS offers a wide range...

Interprofessional practice and decision support: an organizational framework applied to a mental health setting.

PubMed

Campbell, Susan; Stowe, Karen; Ozanne, Elissa M

2011-11-01

Decision support as a means to assist people in making healthcare decisions has been discussed extensively in the medical literature. However, the potential for use of decision support and decision aids with people with psychiatric disabilities in order to promote recovery has only begun to be researched and discussed in the mental health literature. Organizational factors that foster interprofessional practice within a decision support environment focused on mental health issues are examined in this paper.

Implementation of workflow engine technology to deliver basic clinical decision support functionality.

PubMed

Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

2011-04-10

Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform.

An integrated decision support system for diagnosing and managing patients with community-acquired pneumonia.

PubMed Central

Aronsky, D.; Haug, P. J.

1999-01-01

Decision support systems that integrate guidelines have become popular applications to reduce variation and deliver cost-effective care. However, adverse characteristics of decision support systems, such as additional and time-consuming data entry or manually identifying eligible patients, result in a "behavioral bottleneck" that prevents decision support systems to become part of the clinical routine. This paper describes the design and the implementation of an integrated decision support system that explores a novel approach for bypassing the behavioral bottleneck. The real-time decision support system does not require health care providers to enter additional data and consists of a diagnostic and a management component. Images Fig. 1 Fig. 2 Fig. 3 PMID:10566348

Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

USGS Publications Warehouse

Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

2016-01-01

Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.

Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

PubMed

Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

2014-06-01

This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

Development of a decision support system for analysis and solutions of prolonged standing in the workplace.

PubMed

Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

2014-06-01

Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.

Development of a Decision Support System for Analysis and Solutions of Prolonged Standing in the Workplace

PubMed Central

Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

2014-01-01

Background Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. Methods The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Results Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. Conclusion The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially. PMID:25180141

Developing the U.S. Wildland Fire Decision Support System

Treesearch

Erin Noonan-Wright; Tonja S. Opperman; Mark A. Finney; Tom Zimmerman; Robert C. Seli; Lisa M. Elenz; David E. Calkin; John R. Fiedler

2011-01-01

A new decision support tool, the Wildland Fire Decision Support System (WFDSS) has been developed to support risk-informed decision-making for individual fires in the United States. WFDSS accesses national weather data and forecasts, fire behavior prediction, economic assessment, smoke management assessment, and landscape databases to efficiently formulate and apply...

Decision Support for Ecosystem Management (Chapter 28)

Treesearch

Keith Reynolds; Jennifer Bjork; Rachel Riemann Hershey; Dan Schmoldt; John Payne; Susan King; Lee DeCola; Mark J. Twery; Pat Cunningham

1999-01-01

This chapter presents a management perspective on decision support for ecosystem management.The Introduction provides a brief historical overview of decision support technology as it has been used in natural resource management, discusses the role of decision support in ecosystem management as we see it, and summarizes the current state of the technology.

Towards a differentiated understanding of active travel behaviour: using social theory to explore everyday commuting.

PubMed

Guell, C; Panter, J; Jones, N R; Ogilvie, D

2012-07-01

Fostering physical activity is an established public health priority for the primary prevention of a variety of chronic diseases. One promising population approach is to seek to embed physical activity in everyday lives by promoting walking and cycling to and from work ('active commuting') as an alternative to driving. Predominantly quantitative epidemiological studies have investigated travel behaviours, their determinants and how they may be changed towards more active choices. This study aimed to depart from narrow behavioural approaches to travel and investigate the social context of commuting with qualitative social research methods. Within a social practice theory framework, we explored how people describe their commuting experiences and make commuting decisions, and how travel behaviour is embedded in and shaped by commuters' complex social worlds. Forty-nine semi-structured interviews and eighteen photo-elicitation interviews with accompanying field notes were conducted with a subset of the Commuting and Health in Cambridge study cohort, based in the UK. The findings are discussed in terms of three particularly pertinent facets of the commuting experience. Firstly, choice and decisions are shaped by the constantly changing and fluid nature of commuters' social worlds. Secondly, participants express ambiguities in relation to their reasoning, ambitions and identities as commuters. Finally, commuting needs to be understood as an embodied and emotional practice. With this in mind, we suggest that everyday decision-making in commuting requires the tactical negotiation of these complexities. This study can help to explain the limitations of more quantitative and static models and frameworks in predicting travel behaviour and identify future research directions. Copyright © 2012 Elsevier Ltd. All rights reserved.

SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

PubMed

Wright, Adam; Sittig, Dean F

2008-12-01

In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2013-01-01

To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

Toward the Modularization of Decision Support Systems

NASA Astrophysics Data System (ADS)

Raskin, R. G.

2009-12-01

Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

Intermittent tuberculosis treatment for patients with isoniazid intolerance or drug resistance.

PubMed

Reves, R; Heilig, C M; Tapy, J M; Bozeman, L; Kyle, R P; Hamilton, C D; Bock, N; Narita, M; Wing, D; Hershfield, E; Goldberg, S V

2014-05-01

Twenty tuberculosis (TB) clinics in the United States and Canada. To evaluate the efficacy and safety of a 6-month intermittent regimen of rifampin (RMP), pyrazinamide (PZA) and ethambutol (EMB) in human immunodeficiency virus (HIV) negative patients with culture-confirmed pulmonary or extra-pulmonary tuberculosis and either isoniazid (INH) resistance or INH intolerance. Patients were enrolled in a single-arm clinical trial to receive intermittent dosing after at least 14 initial daily doses of RMP+PZA+EMB. Treatment was continued twice (BIW) or thrice weekly (TIW) per physician/patient preference for a total of 6 months, with 2 years of follow-up for relapse after treatment. From 1999 to 2004, 98 patients were enrolled, 78 with reported INH resistance and 20 with INH intolerance. BIW dosing was used in 77 and TIW in 21. Study treatment was completed in 73 (74%). Reasons for discontinuation were hepatic adverse events (n= 12), other adverse effects (n= 3) and other reasons (n= 10). Failure (n= 1) and relapse (n= 2) occurred in 3 (3.5%, 95%CI 1.2-9.8) of 86 patients eligible for efficacy analysis, all occurring in patients with cavitary, acid-fast bacilli smear-positive pulmonary TB. Intermittent RMP+PZA+EMB appears to be effective in HIV-negative patients, but the regimen is poorly tolerated, possibly due to the prolonged use of PZA. Alternative regimens of lower toxicity are needed.

Applying value sensitive design (VSD) to wind turbines and wind parks: an exploration.

PubMed

Oosterlaken, Ilse

2015-04-01

Community acceptance still remains a challenge for wind energy projects. The most popular explanation for local opposition, the Not in My Backyard effect, has received fierce criticism in the past decade. Critics argue that opposition is not merely a matter of selfishness or ignorance, but that moral, ecological and aesthetic values play an important role. In order to better take such values into account, a more bottom-up, participatory decision process is usually proposed. Research on this topic focusses on either stakeholder motivations/attitudes, or their behavior during project implementation. This paper proposes a third research focus, namely the 'objects' which elicit certain behavioral responses and attitudes-the wind turbine and parks. More concretely, this paper explores Value Sensitive Design (VSD) as way to arrive at wind turbines and parks that better embed or reflect key values. After a critical discussion of the notion of acceptance versus acceptability and support, the paper discusses existing literature on ecology and aesthetics in relation to wind turbine/park design, which could serve as 'building blocks' of a more integral VSD approach of the topic. It also discusses the challenge of demarcating wind park projects as VSD projects. A further challenge is that VSD has been applied mainly at the level of technical artifacts, whereas wind parks can best be conceptualized as socio-technical system. This new application would therefore expand the current practice of VSD, and may as a consequence also lead to interesting new insights for the VSD community. The paper concludes that such an outcome-oriented approach of wind turbines and park is worth exploring further, as a supplement to rather than a replacement of the process-oriented approach that is promoted by the current literature on community acceptance of wind parks.

How to guide - transit operations decision support systems (TODSS).

DOT National Transportation Integrated Search

2014-12-01

Transit Operations Decision Support Systems (TODSS) are decision support systems designed to support dispatchers in real-time bus operations management in response to incidents, special events, and other changing conditions in order to restore servic...

CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

PubMed Central

Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

2015-01-01

Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options. PMID:25848413

CorRECTreatment: a web-based decision support tool for rectal cancer treatment that uses the analytic hierarchy process and decision tree.

PubMed

Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C

2015-01-01

The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.

Energy Decision Science and Informatics | Integrated Energy Solutions |

Science.gov Websites

Science Advanced decision science methods include multi-objective and multi-criteria decision support. Our decision science methods, including multi-objective and multi-criteria decision support. For example, we

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed

Martinez, Kathryn A; Resnicow, Ken; Williams, Geoffrey C; Silva, Marlene; Abrahamse, Paul; Shumway, Dean A; Wallner, Lauren P; Katz, Steven J; Hawley, Sarah T

2016-12-01

Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed Central

Resnicow, Ken; Williams, Geoffrey C.; Silva, Marlene; Abrahamse, Paul; Shumway, Dean; Wallner, Lauren; Katz, Steven; Hawley, Sarah

2016-01-01

Objective Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Methods Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Results Among the 1,690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Conclusion Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Practice Implications Autonomy-supportive communication by cancer doctors can improve patients’ perceived decision quality. PMID:27395750

Towards ethical decision support and knowledge management in neonatal intensive care.

PubMed

Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

2004-01-01

Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

Implementation of workflow engine technology to deliver basic clinical decision support functionality

PubMed Central

2011-01-01

Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform. PMID:21477364

An Internationally Consented Standard for Nursing Process-Clinical Decision Support Systems in Electronic Health Records.

PubMed

Müller-Staub, Maria; de Graaf-Waar, Helen; Paans, Wolter

2016-11-01

Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.

The cosmic web in CosmoGrid void regions

NASA Astrophysics Data System (ADS)

Rieder, Steven; van de Weygaert, Rien; Cautun, Marius; Beygu, Burcu; Portegies Zwart, Simon

2016-10-01

We study the formation and evolution of the cosmic web, using the high-resolution CosmoGrid ΛCDM simulation. In particular, we investigate the evolution of the large-scale structure around void halo groups, and compare this to observations of the VGS-31 galaxy group, which consists of three interacting galaxies inside a large void. The structure around such haloes shows a great deal of tenuous structure, with most of such systems being embedded in intra-void filaments and walls. We use the Nexus+} algorithm to detect walls and filaments in CosmoGrid, and find them to be present and detectable at every scale. The void regions embed tenuous walls, which in turn embed tenuous filaments. We hypothesize that the void galaxy group of VGS-31 formed in such an environment.

Disk space and load time requirements for eye movement biometric databases

NASA Astrophysics Data System (ADS)

Kasprowski, Pawel; Harezlak, Katarzyna

2016-06-01

Biometric identification is a very popular area of interest nowadays. Problems with the so-called physiological methods like fingerprints or iris recognition resulted in increased attention paid to methods measuring behavioral patterns. Eye movement based biometric (EMB) identification is one of the interesting behavioral methods and due to the intensive development of eye tracking devices it has become possible to define new methods for the eye movement signal processing. Such method should be supported by an efficient storage used to collect eye movement data and provide it for further analysis. The aim of the research was to check various setups enabling such a storage choice. There were various aspects taken into consideration, like disk space usage, time required for loading and saving whole data set or its chosen parts.

Property company's sustainability goals.

PubMed

Ormsby, Kim

2014-11-01

In a keynote presentation on the second morning of this year's Healthcare Estates conference, Kim Ormsby (pictured), national corporate social responsibility (CSR) and sustainability manager at NHS Property Services, discussed how, as part of its broader goals of 'supporting the NHS in delivering clinical services', and 'helping to enhance the experience' of patients visiting its buildings, the organization would continue to pursue and embed in its activities sustainable policies wherever and whenever possible, encouraging both its staff and tenants to take a similar approach. In an informative address, she highlighted some of the key steps the property company had already taken to encourage a proactive approach. Echoing the sentiments of Day One keynote speaker, Julian Hartley (see pages 55-60), she argued that one of the fundamentals to success was wide-ranging staff engagement.

Military Medical Decision Support for Homeland Defense During Emergency

DTIC Science & Technology

2004-12-01

abstraction hierarchy, three levels of information requirement for designing emergency training interface are recognized. These are epistemological ...support human decision making process is considered to be decision-centric. A typical decision-centric interface is supported by at least four design ... Designing Emergency Training Interface ......................................................................................... 5 Epistemological

Semantic Clinical Guideline Documents

PubMed Central

Eriksson, Henrik; Tu, Samson W.; Musen, Mark

2005-01-01

Decision-support systems based on clinical practice guidelines can support physicians and other health-care personnel in the process of following best practice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal manner, perform consistency checks, and use the guidelines directly in decision-support systems. Decision-support authors and guideline users require guidelines in human-readable formats in addition to computer-interpretable ones (e.g., for guideline review and quality assurance). We propose a new document-oriented information architecture that combines knowledge-representation models with electronic and paper documents. The approach integrates decision-support modes with standard document formats to create a combined clinical-guideline model that supports on-line viewing, printing, and decision support. PMID:16779037

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems.

PubMed

DesAutels, Spencer J; Fox, Zachary E; Giuse, Dario A; Williams, Annette M; Kou, Qing-Hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems.

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Research on web-based decision support system for sports competitions

NASA Astrophysics Data System (ADS)

Huo, Hanqiang

2010-07-01

This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

Fuzzy Logic Engine

NASA Technical Reports Server (NTRS)

Howard, Ayanna

2005-01-01

The Fuzzy Logic Engine is a software package that enables users to embed fuzzy-logic modules into their application programs. Fuzzy logic is useful as a means of formulating human expert knowledge and translating it into software to solve problems. Fuzzy logic provides flexibility for modeling relationships between input and output information and is distinguished by its robustness with respect to noise and variations in system parameters. In addition, linguistic fuzzy sets and conditional statements allow systems to make decisions based on imprecise and incomplete information. The user of the Fuzzy Logic Engine need not be an expert in fuzzy logic: it suffices to have a basic understanding of how linguistic rules can be applied to the user's problem. The Fuzzy Logic Engine is divided into two modules: (1) a graphical-interface software tool for creating linguistic fuzzy sets and conditional statements and (2) a fuzzy-logic software library for embedding fuzzy processing capability into current application programs. The graphical- interface tool was developed using the Tcl/Tk programming language. The fuzzy-logic software library was written in the C programming language.

A pathway to a more sustainable water sector: sustainability-based asset management.

PubMed

Marlow, D R; Beale, D J; Burn, S

2010-01-01

The water sectors of many countries are faced with the need to address simultaneously two overarching challenges; the need to undertake effective asset management coupled with the broader need to evolve business processes so as to embrace sustainability principles. Research has thus been undertaken into the role sustainability principles play in asset management. As part of this research, a series of 25 in-depth interviews were undertaken with water sector professionals from around Australia. Drawing on the results of these interviews, this paper outlines the conceptual relationship between asset management and sustainability along with a synthesis of the relevant opinions voiced in the interviews. The interviews indicated that the participating water authorities have made a strong commitment to sustainability, but there is a need to facilitate change processes to embed sustainability principles into business as usual practices. Interviewees also noted that asset management and sustainability are interlinked from a number of perspectives, especially in the way decision making is undertaken with respect to assets and service provision. The interviews also provided insights into the research needed to develop a holistic sustainability-based asset management framework.

Mitigating amphibian chytridiomycosis in nature

USGS Publications Warehouse

Garner, Trenton W. J.; Schmidt, Benedikt R.; Martel, An; Pasmans, Frank; Muths, Erin L.; Cunningham, Andrew A.; Weldon, Che; Fisher, Matthew C.; Bosch, Jaime

2016-01-01

Amphibians across the planet face the threat of population decline and extirpation caused by the disease chytridiomycosis. Despite consensus that the fungal pathogens responsible for the disease are conservation issues, strategies to mitigate their impacts in the natural world are, at best, nascent. Reducing risk associated with the movement of amphibians, non-amphibian vectors and other sources of infection remains the first line of defence and a primary objective when mitigating the threat of disease in wildlife. Amphibian-associated chytridiomycete fungi and chytridiomycosis are already widespread, though, and we therefore focus on discussing options for mitigating the threats once disease emergence has occurred in wild amphibian populations. All strategies have shortcomings that need to be overcome before implementation, including stronger efforts towards understanding and addressing ethical and legal considerations. Even if these issues can be dealt with, all currently available approaches, or those under discussion, are unlikely to yield the desired conservation outcome of disease mitigation. The decision process for establishing mitigation strategies requires integrated thinking that assesses disease mitigation options critically and embeds them within more comprehensive strategies for the conservation of amphibian populations, communities and ecosystems.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

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.

Photoinactivation effect of eosin methylene blue and chlorophyllin sodium-copper against Staphylococcus aureus and Escherichia coli.

PubMed

Caires, Cynthia S A; Leal, Cassia R B; Ramos, Carlos A N; Bogo, Danielle; Lima, Alessandra R; Arruda, Eduardo J; Oliveira, Samuel L; Caires, Anderson R L; Nascimento, Valter A

2017-07-01

The use of eosin methylene blue according to Giemsa as photosensitizer is presented for the first time in this paper. The present study evaluated the potential application of chlorophyllin sodium copper salt (CuChlNa) and eosin methylene blue according to Giemsa (EMB) as antimicrobial photosensitizers (aPS) for photodynamic inactivation (PDI) of Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacteria. The experiments were performed using S. aureus stain ATCC 25923 and E. coli ATCC 25922 in which five aPS concentrations (0.0, 1.0, 2.5, 5.0, 10.0, and 20.0 μM for S. aureus and 0.0, 5.0, 10.0, 20.0, 40.0, and 50.0 μM for E. coli) were prepared and added in 2 mL of a saline solution containing the bacterial inoculum. After aPS incubation, the samples were divided into two groups, one kept in the dark and another submitted to the illumination. Then, the bacterial inactivation was determined 18 h after the incubation at 37 °C by counting the colony-forming units (CFU). The results revealed that both EMB and CuChlNa can be used as aPS for the photoinactivation of S. aureus, while only EMB was able to photoinactivate E. coli. Nevertheless, a more complex experimental setup was needed for photoinactivation of E. coli. The data showed that EMB and CuChlNa presented similar photoinactivation effects on S. aureus, in which bacterial growth was completely inhibited at photosensitizer (PS) concentrations over 5 μM, when samples were previously incubated for 30 min and irradiated by a light dose of 30 J cm -2 as a result of an illumination of 1 h at 8.3 mW cm -2 by using a red light at 625 nm with a 1 cm beam diameter and output power of 6.5 mW. In the case of E. coli, bacterial growth was completely inhibited only when combining a PS incubation period of 120 min with concentrations over 20 μM.

A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services.

PubMed

MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E

2017-04-01

Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.

The Conformational Landscape of L-Threonine Matrix Isolation Infrared and {AB-INITIO Studies

NASA Astrophysics Data System (ADS)

Dubey, Pankaj; Mukhopadhyay, Anamika; Viswanathan, K. S.

2017-06-01

Amino acids, containing hydroxy side chains such as L-threonine and tyrosine play an important role in molecular recognition, such as in the docking of propofol, which is a commonly used anaesthetic. A rich conformational landscape of these amino acids makes them interesting candidates in the study of intra and intermolecular interactions. In this work, the conformational landscape of L-threonine was studied, as it can be expected to serve as a basis for understanding structure and functions of polypeptides and other biomolecules. The matrix isolation technique (MI) coupled with a high temperature effusive molecular beam (EMB) nozzle was used to trap conformers of amino acid, which were then characterized using FTIR spectroscopy. The usefulness of MI-EMB-FTIR spectroscopy is that it can trap structures corresponding to the local minima along with the global minimum and hence allows for a better exploration of the potential energy surface. A major challenge in conformational analysis of amino acids using matrix isolation FTIR arises from its non-volatile nature. A home built heating system which was mounted close to the cryotip, was used to evaporate the non-volatile amino acids. Our infrared spectra show that three conformations were trapped in the matrix. Experimental results were supported by {ab-initio calculations performed using the CCSD(T), MP2 and M06-2X methods together with 6-311++G(d,p) and aug/cc-pVDZ basis sets. The side chains of the amino acids appeared to have an influence on the preferential stabilisation of a particular backbone structure of amino acids. Factors such as entropy, anomeric effect and intramolecular H-bonding were also found to play an important role in determining conformal preferences, which will be discussed.

Visualization of historical data for the ATLAS detector controls - DDV

NASA Astrophysics Data System (ADS)

Maciejewski, J.; Schlenker, S.

2017-10-01

The ATLAS experiment is one of four detectors located on the Large Hardon Collider (LHC) based at CERN. Its detector control system (DCS) stores the slow control data acquired within the back-end of distributed WinCC OA applications, which enables the data to be retrieved for future analysis, debugging and detector development in an Oracle relational database. The ATLAS DCS Data Viewer (DDV) is a client-server application providing access to the historical data outside of the experiment network. The server builds optimized SQL queries, retrieves the data from the database and serves it to the clients via HTTP connections. The server also implements protection methods to prevent malicious use of the database. The client is an AJAX-type web application based on the Vaadin (framework build around the Google Web Toolkit (GWT)) which gives users the possibility to access the data with ease. The DCS metadata can be selected using a column-tree navigation or a search engine supporting regular expressions. The data is visualized by a selection of output modules such as a java script value-over time plots or a lazy loading table widget. Additional plugins give the users the possibility to retrieve the data in ROOT format or as an ASCII file. Control system alarms can also be visualized in a dedicated table if necessary. Python mock-up scripts can be generated by the client, allowing the user to query the pythonic DDV server directly, such that the users can embed the scripts into more complex analysis programs. Users are also able to store searches and output configurations as XML on the server to share with others via URL or to embed in HTML.

Overview of EPA tools for supporting local-, state- and regional-level decision makers addressing energy and environmental issues: NYC MARKAL Energy Systems Model and Municipal Solid Waste Decision Support Tool

EPA Science Inventory

A workshop will be conducted to demonstrate and focus on two decision support tools developed at EPA/ORD: 1. Community-scale MARKAL model: an energy-water technology evaluation tool and 2. Municipal Solid Waste Decision Support Tool (MSW DST). The Workshop will be part of Southea...

Entropic One-Class Classifiers.

PubMed

Livi, Lorenzo; Sadeghian, Alireza; Pedrycz, Witold

2015-12-01

The one-class classification problem is a well-known research endeavor in pattern recognition. The problem is also known under different names, such as outlier and novelty/anomaly detection. The core of the problem consists in modeling and recognizing patterns belonging only to a so-called target class. All other patterns are termed nontarget, and therefore, they should be recognized as such. In this paper, we propose a novel one-class classification system that is based on an interplay of different techniques. Primarily, we follow a dissimilarity representation-based approach; we embed the input data into the dissimilarity space (DS) by means of an appropriate parametric dissimilarity measure. This step allows us to process virtually any type of data. The dissimilarity vectors are then represented by weighted Euclidean graphs, which we use to determine the entropy of the data distribution in the DS and at the same time to derive effective decision regions that are modeled as clusters of vertices. Since the dissimilarity measure for the input data is parametric, we optimize its parameters by means of a global optimization scheme, which considers both mesoscopic and structural characteristics of the data represented through the graphs. The proposed one-class classifier is designed to provide both hard (Boolean) and soft decisions about the recognition of test patterns, allowing an accurate description of the classification process. We evaluate the performance of the system on different benchmarking data sets, containing either feature-based or structured patterns. Experimental results demonstrate the effectiveness of the proposed technique.

Surface transportation weather decision support requirements : operational concept description : advanced-integrated decision support using weather information for surface transportation decisions makers : draft version 2.0

DOT National Transportation Integrated Search

2000-07-14

This is a draft document for the Surface Transportation Weather Decision Support Requirements (STWDSR) project. The STWDSR project is being conducted for the FHWAs Office of Transportation Operations (HOTO) Road Weather Management Program by Mitre...

Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to Defence Transformation

DTIC Science & Technology

2005-04-01

RTO-MP-SAS-055 4 - 1 UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Analytical Support Capabilities of Turkish General Staff Scientific...the end failed to achieve anything commensurate with the effort. The analytical support capabilities of Turkish Scientific Decision Support Center to...percent of the İpekkan, Z.; Özkil, A. (2005) Analytical Support Capabilities of Turkish General Staff Scientific Decision Support Centre (SDSC) to

Bi-Level Decision Making for Supporting Energy and Water Nexus

NASA Astrophysics Data System (ADS)

Zhang, X.; Vesselinov, V. V.

2016-12-01

The inseparable relationship between energy production and water resources has led to the emerging energy-water nexus concept, which provides a means for integrated management and decision making of these two critical resources. However, the energy-water nexus frequently involves decision makers with different and competing management objectives. Furthermore, there is a challenge that decision makers and stakeholders might be making decisions sequentially from a higher level to a lower level, instead of at the same decision level, whereby the objective of a decision maker at a higher level should be satisfied first. In this study, a bi-level decision model is advanced to handle such decision-making situations for managing the energy-water nexus. The work represents a unique contribution to developing an integrated decision-support framework/tool to quantify and analyze the tradeoffs between the two-level energy-water nexus decision makers. Here, plans for electricity generation, fuel supply, water supply, capacity expansion of the power plants and environmental impacts are optimized to provide effective decision support. The developed decision-support framework is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is a part of the MADS (Model Analyses & Decision Support) framework (http://mads.lanl.gov). To demonstrate the capabilities of the developed methodology, a series of analyses are performed for synthetic problems consistent with actual real-world energy-water nexus management problems.

Climate Risk Informed Decision Analysis (CRIDA): A novel practical guidance for Climate Resilient Investments and Planning

NASA Astrophysics Data System (ADS)

Jeuken, Ad; Mendoza, Guillermo; Matthews, John; Ray, Patrick; Haasnoot, Marjolijn; Gilroy, Kristin; Olsen, Rolf; Kucharski, John; Stakhiv, Gene; Cushing, Janet; Brown, Casey

2016-04-01

Engineers and water managers have always incorporated uncertainty in water resources operations, design and planning. In recent years, concern has been growing concern that many of the fundamental principles to address uncertainty in planning and design are insufficient for coping with unprecedented shifts in climate, especially given the long lifetimes of water investments - spanning decades, even centuries. Can we design and operate new flood risk management, energy, water supply and sanitation, and agricultural projects that are robust to shifts over 20, 50, or more years? Since about 2009, better approaches to planning and designing under climate uncertainty have been gaining ground worldwide. The main challenge is to operationalize these approaches and bring them from science to practice, embed them within the existing decision-making processes of particular institutions, and shift from highly specialized "boutique" applications to methods that result in consistent, replicable outcomes accessible to water managers worldwide. With CRIDA a serious step is taken to achieve these goals. CRIDA is built on two innovative but complementary approaches that have developed in isolation across the Atlantic over the past seven years: diagnosing and assessing risk (decision scaling), and developing sequential decision steps to compensate for uncertainty within regulatory / performance standards (adaptation pathways). First, the decision scaling or "bottom up" framework to climate change adaptation was first conceptualized during the US/Canada Great Lakes regulation study and has recently been placed in a decision-making context for water-related investments published by the World Bank Second, the adaptation pathways approach was developed in the Netherlands to cope with the level of climate uncertainty we now face. Adaptation pathways is a tool for maintaining options and flexibility while meeting operational goals by envisioning how sequences of decisions can be navigated over time. They are part of the Dutch adaptive planning approach Adaptive Delta Management, executed and develop by the Dutch Delta program. Both decision scaling and adaptation pathways have been piloted in studies worldwide. The objective of CRIDA is to mainstream effective climate adaptation for professional water managers. The CRIDA publication, due in april 2016, follows the generic water design planning design cycle. At each step, CRIDA describes stepwise guidance for incorporating climate robustness: problem definition, stress test, alternatives formulation and recommendation, evaluation and selection. In the presentation the origin, goal, steps and practical tools available at each step of CRIDA will be explained. In two other abstracts ("Climate Risk Informed Decision Analysis: A Hypothetical Application to the Waas Region" by Gilroy et al., "The Application of Climate Risk Informed Decision Analysis to the Ioland Water Treatment Plant in Lusaka, Zambia, by Kucharski et al.), the application of CRIDA to cases is explained

Development of transportation asset management decision support tools : final report.

DOT National Transportation Integrated Search

2017-08-09

This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...

Modifications and integration of the electronic tracking board in a pediatric emergency department.

PubMed

Dexheimer, Judith W; Kennebeck, Stephanie

2013-07-01

Electronic health records (EHRs) are used for data storage; provider, laboratory, and patient communication; clinical decision support; procedure and medication orders; and decision support alerts. Clinical decision support is part of any EHR and is designed to help providers make better decisions. The emergency department (ED) poses a unique environment to the use of EHRs and clinical decision support. Used effectively, computerized tracking boards can help improve flow, communication, and the dissemination of pertinent visit information between providers and other departments in a busy ED. We discuss the unique modifications and decisions made in the implementation of an EHR and computerized tracking board in a pediatric ED. We discuss the changing views based on provider roles, customization to the user interface including the layout and colors, decision support, tracking board best practices collected from other institutions and colleagues, and a case study of using reminders on the electronic tracking board to drive pain reassessments.

Decision support systems for ecosystem management: An evaluation of existing systems

Treesearch

H. Todd Mowrer; Klaus Barber; Joe Campbell; Nick Crookston; Cathy Dahms; John Day; Jim Laacke; Jim Merzenich; Steve Mighton; Mike Rauscher; Rick Sojda; Joyce Thompson; Peter Trenchi; Mark Twery

1997-01-01

This report evaluated 24 computer-aided decision support systems (DSS) that can support management decision-making in forest ecosystems. It compares the scope of each system, spatial capabilities, computational methods, development status, input and output requirements, user support availability, and system performance. Questionnaire responses from the DSS developers (...

The design of patient decision support interventions: addressing the theory-practice gap.

PubMed

Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

2011-08-01

Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards Collaboration influence standards for the design of decision support interventions. However, this analysis points to the need to undertake more work in providing theoretical foundations for these interventions. © 2010 Blackwell Publishing Ltd.

Human action recognition with group lasso regularized-support vector machine

NASA Astrophysics Data System (ADS)

Luo, Huiwu; Lu, Huanzhang; Wu, Yabei; Zhao, Fei

2016-05-01

The bag-of-visual-words (BOVW) and Fisher kernel are two popular models in human action recognition, and support vector machine (SVM) is the most commonly used classifier for the two models. We show two kinds of group structures in the feature representation constructed by BOVW and Fisher kernel, respectively, since the structural information of feature representation can be seen as a prior for the classifier and can improve the performance of the classifier, which has been verified in several areas. However, the standard SVM employs L2-norm regularization in its learning procedure, which penalizes each variable individually and cannot express the structural information of feature representation. We replace the L2-norm regularization with group lasso regularization in standard SVM, and a group lasso regularized-support vector machine (GLRSVM) is proposed. Then, we embed the group structural information of feature representation into GLRSVM. Finally, we introduce an algorithm to solve the optimization problem of GLRSVM by alternating directions method of multipliers. The experiments evaluated on KTH, YouTube, and Hollywood2 datasets show that our method achieves promising results and improves the state-of-the-art methods on KTH and YouTube datasets.

Organizational Strategies to Implement Hospital Pressure Ulcer Prevention Programs: Findings from a National Survey

PubMed Central

SOBAN, LYNN M.; KIM, LINDA; YUAN, ANITA H.; MILTNER, REBECCA S.

2017-01-01

Aim To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system. Background Comprehensive pressure ulcer programs include nursing interventions such as use of a risk assessment tool and organizational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programs. Methods Data were collected by an email survey to all Chief Nursing Officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarize survey responses and evaluate relationships between some variables. Results Organizational strategies that support pressure ulcer prevention program implementation (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalized within individual hospitals. Conclusion Organizational strategies to support implementation of pressure ulcer preventive programs are often not optimally operationalized to achieve consistent, sustainable performance. Implications for Nursing Management The results of this study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. PMID:27487972

The excluded philosophy of evo-devo? Revisiting C.H. Waddington's failed attempt to embed Alfred North Whitehead's "organicism" in evolutionary biology.

PubMed

Peterson, Erik L

2011-01-01

Though a prominent British developmental biologist in his day, a close friend of Theodosius Dobzhansky, and a frequent correspondent with Ernst Mayr, C.H. Waddington did not enter the ranks of "architect" of the Modern Synthesis. By the end of his career, in fact, he recognized that other biologists reacted to his work "as though they feel obscurely uneasy"; and that the best that some philosophers of biology could say of his work was that he was not "wholly orthodox" (Waddington 1975c, 11). In this essay, I take Waddington's self-assessments at face value and explore three potential reasons why his work did not have more of a direct impact: Waddington's explicit support for the philosophy of Alfred North Whitehead; a lack of institutional support; and Waddington's occasional marginalization from the core network of American neo-Darwinians. Though excluded from the Modern Synthesis in the mid-20th century, it now appears that Waddington's work does undergird the emerging evo-devo synthesis. Whether this indicates concomitant, if implicit, support for Whiteheadian philosophy is an interesting question not explored here.

Advanced decision support for winter road maintenance

DOT National Transportation Integrated Search

2008-01-01

This document provides an overview of the Federal Highway Administration's winter Maintenance Decision Support System (MDSS). The MDSS is a decision support tool that has the ability to provide weather predictions focused toward the road surface. The...

Detroit deicing decision support tool : description, operation, and simulation results

DOT National Transportation Integrated Search

2006-01-01

The John A. Volpe National Transportation Systems Center, sponsored by the National Aeronautics and Space Administration, : developed a deicing decision support tool, for Detroit Metropolitan Wayne County Airport (DTW).1 The deicing decision support ...

Scotland's Knowledge Network: translating knowledge into action to improve quality of care.

PubMed

Wales, A; Graham, S; Rooney, K; Crawford, A

2012-11-01

The Knowledge Network (www.knowledge.scot.nhs.uk) is Scotland's online knowledge service for health and social care. It is designed to support practitioners to apply knowledge in frontline delivery of care, helping to translate knowledge into better health-care outcomes through safe, effective, person-centred care. The Knowledge Network helps to combine the worlds of evidence-based practice and quality improvement by providing access to knowledge about the effectiveness of clinical interventions ('know-what') and knowledge about how to implement this knowledge to support individual patients in working health-care environments ('know-how'). An 'evidence and guidance' search enables clinicians to quickly access quality-assured evidence and best practice, while point of care and mobile solutions provide knowledge in actionable formats to embed in clinical workflow. This research-based knowledge is complemented by social networking services and improvement tools which support the capture and exchange of knowledge from experience, facilitating practice change and systems improvement. In these cases, the Knowledge Network supports key components of the knowledge-to-action cycle--acquiring, creating, sharing and disseminating knowledge to improve performance and innovate. It provides a vehicle for implementing the recommendations of the national Knowledge into Action review, which outlines a new national approach to embedding knowledge in frontline practice and systems improvement.

The Customer Service Experience.

ERIC Educational Resources Information Center

Bell, Chip R.

2001-01-01

Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

Fabricating optical phantoms to simulate skin tissue properties and microvasculatures

NASA Astrophysics Data System (ADS)

Sheng, Shuwei; Wu, Qiang; Han, Yilin; Dong, Erbao; Xu, Ronald

2015-03-01

This paper introduces novel methods to fabricate optical phantoms that simulate the morphologic, optical, and microvascular characteristics of skin tissue. The multi-layer skin-simulating phantom was fabricated by a light-cured 3D printer that mixed and printed the colorless light-curable ink with the absorption and the scattering ingredients for the designated optical properties. The simulated microvascular network was fabricated by a soft lithography process to embed microchannels in polydimethylsiloxane (PDMS) phantoms. The phantoms also simulated vascular anomalies and hypoxia commonly observed in cancer. A dual-modal multispectral and laser speckle imaging system was used for oxygen and perfusion imaging of the tissue-simulating phantoms. The light-cured 3D printing technique and the soft lithography process may enable freeform fabrication of skin-simulating phantoms that embed microvessels for image and drug delivery applications.

Next-generation endomyocardial biopsy: the potential of confocal and super-resolution microscopy.

PubMed

Crossman, David J; Ruygrok, Peter N; Hou, Yu Feng; Soeller, Christian

2015-03-01

Confocal laser scanning microscopy and super-resolution microscopy provide high-contrast and high-resolution fluorescent imaging, which has great potential to increase the diagnostic yield of endomyocardial biopsy (EMB). EMB is currently the gold standard for identification of cardiac allograft rejection, myocarditis, and infiltrative and storage diseases. However, standard analysis is dominated by low-contrast bright-field light and electron microscopy (EM); this lack of contrast makes quantification of pathological features difficult. For example, assessment of cardiac allograft rejection relies on subjective grading of H&E histology, which may lead to diagnostic variability between pathologists. This issue could be solved by utilising the high contrast provided by fluorescence methods such as confocal to quantitatively assess the degree of lymphocytic infiltrate. For infiltrative diseases such as amyloidosis, the nanometre resolution provided by EM can be diagnostic in identifying disease-causing fibrils. The recent advent of super-resolution imaging, particularly direct stochastic optical reconstruction microscopy (dSTORM), provides high-contrast imaging at resolution approaching that of EM. Moreover, dSTORM utilises conventional fluorescence dyes allowing for the same structures to be routinely imaged at the cellular scale and then at the nanoscale. The key benefit of these technologies is that the high contrast facilitates quantitative digital analysis and thereby provides a means to robustly assess critical pathological features. Ultimately, this technology has the ability to provide greater accuracy and precision to EMB assessment, which could result in better outcomes for patients.

Time course of myosin heavy chain transitions in neonatal rats: importance of innervation and thyroid state

NASA Technical Reports Server (NTRS)

Adams, G. R.; McCue, S. A.; Zeng, M.; Baldwin, K. M.

1999-01-01

During the postnatal period, rat limb muscles adapt to weight bearing via the replacement of embryonic (Emb) and neonatal (Neo) myosin heavy chains (MHCs) by the adult isoforms. Our aim was to characterize this transition in terms of the six MHC isoforms expressed in skeletal muscle and to determine the importance of innervation and thyroid hormone status on the attainment of the adult MHC phenotype. Neonatal rats were made hypothyroid via propylthiouracil (PTU) injection. In normal and PTU subgroups, leg muscles were unilaterally denervated at 15 days of age. The MHC profiles of plantaris (PLN) and soleus (Sol) muscles were determined at 7, 14, 23, and 30 days postpartum. At day 7, the Sol MHC profile was 55% type I, 30% Emb, and 10% Neo; in the PLN, the pattern was 60% Neo and 25% Emb. By day 30 the Sol and PLN had essentially attained an adult MHC profile in the controls. PTU augmented slow MHC expression in the Sol, whereas in the PLN it markedly repressed IIb MHC by retaining neonatal MHC expression. Denervation blunted the upregulation of IIb in the PLN and of Type I in the Sol and shifted the pattern to greater expression of IIa and IIx MHCs in both muscles. In contrast to previous observations, these findings collectively suggest that both an intact thyroid and innervation state are obligatory for the attainment of the adult MHC phenotype, particularly in fast-twitch muscles.

Screening mutations in drug-resistant Mycobacterium tuberculosis strains in Yunnan, China.

PubMed

Li, Daoqun; Song, Yuzhu; Zhang, Cheng-Lin; Li, Xiaofei; Xia, Xueshan; Zhang, A-Mei

Drug-resistant tuberculosis (DR-TB), especially multidrug-resistant tuberculosis (MDR-TB), is a serious medical and societal problem in China. The purpose of this study was to evaluate the mutation characteristics of drug-resistant Mycobacterium tuberculosis (M. tuberculosis) isolates in Yunnan, China. Drug susceptibility testing (DST) was performed in 523 clinical M. tuberculosis isolates. Six drug resistance genes (katG, inhA, rpoB, rpsL, embB, and pncA) were selected to screen for mutations. In total, 54 clinical M. tuberculosis strains were identified as drug-resistant by DST, including 18 single drug-resistant (SDR) strains and 36 multidrug-resistant (MDR) strains. Twenty-four types of mutations in five genes (excluding the inhA gene) were screened in forty-one strains. Six novel mutations were identified in this study, including three missense mutations (p.S302R in katG, p.D78G in embB, and p.M1I in pncA), two frameshift mutations (408 ins A and 538-580 del in pncA), and one mutation in a control region (-6 C>T located upstream of rpsL). The mutation frequencies in the hotspot mutation regions in the katG, rpoB, rpsL, embB, and pncA genes were 92.5%, 44.4%, 54.2%, 52.6%, and 37.5%, respectively. The mutation spectra and frequencies seemed somewhat unique in the Yunnan DR-TB strains. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Developing a Software for Fuzzy Group Decision Support System: A Case Study

ERIC Educational Resources Information Center

Baba, A. Fevzi; Kuscu, Dincer; Han, Kerem

2009-01-01

The complex nature and uncertain information in social problems required the emergence of fuzzy decision support systems in social areas. In this paper, we developed user-friendly Fuzzy Group Decision Support Systems (FGDSS) software. The software can be used for multi-purpose decision making processes. It helps the users determine the main and…

Supported Decision Making: A Synthesis of the Literature across Intellectual Disability, Mental Health, and Aging

ERIC Educational Resources Information Center

Shogren, Karrie A.; Wehmeyer, Michael L.; Lassmann, Heather; Forber-Pratt, Anjali J.

2017-01-01

Supported decision making (SDM) has begun to receive significant attention as means to enable people to exercise autonomy and self-determination over decisions about their life. Practice frameworks that can be used to promote the provision of supports for decision making are needed. This paper integrates the literature across intellectual and…

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems

PubMed Central

DesAutels, Spencer J.; Fox, Zachary E.; Giuse, Dario A.; Williams, Annette M.; Kou, Qing-hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems. PMID:28269846

A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

PubMed

Fowler, G E; Baker, D M; Lee, M J; Brown, S R

2017-11-01

The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

PubMed

Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

2011-06-01

Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence

PubMed Central

2014-01-01

Background Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. Methods We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Results Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association between formulary decision support usage and adherence. Conclusion Interruptive formulary decision support shifted prescribing toward preferred tiers, but these medications were only minimally less expensive in the studied patient population. In this context, formulary decision support did not significantly increase adherence. To impact cost-related non-adherence, formulary decision support will likely need to be paired with complementary drug benefit design. Formulary decision support should be studied further, with particular attention to its effect on adherence in the setting of different benefit designs. PMID:25167807

Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence.

PubMed

Pevnick, Joshua M; Li, Ning; Asch, Steven M; Jackevicius, Cynthia A; Bell, Douglas S

2014-08-28

Medication non-adherence is prevalent. We assessed the effect of electronic prescribing (e-prescribing) with formulary decision support on preferred formulary tier usage, copayment, and concomitant adherence. We retrospectively analyzed 14,682 initial pharmaceutical claims for angiotensin receptor blocker and inhaled steroid medications among 14,410 patients of 2189 primary care physicians (PCPs) who were offered e-prescribing with formulary decision support, including 297 PCPs who adopted it. Formulary decision support was initially non-interruptive, such that formulary tier symbols were displayed adjacent to medication names. Subsequently, interruptive formulary decision support alerts also interrupted e-prescribing when preferred-tier alternatives were available. A difference in differences design was used to compare the pre-post differences in medication tier for each new prescription attributed to non-adopters, low user (<30% usage rate), and high user PCPs (>30% usage rate). Second, we modeled the effect of formulary tier on prescription copayment. Last, we modeled the effect of copayment on adherence (proportion of days covered) to each new medication. Compared with non-adopters, high users of e-prescribing were more likely to prescribe preferred-tier medications (vs. non-preferred tier) when both non-interruptive and interruptive formulary decision support were in place (OR 1.9 [95% CI 1.0-3.4], p = 0.04), but no more likely to prescribe preferred-tier when only non-interruptive formulary decision support was in place (p = 0.90). Preferred-tier claims had only slightly lower mean monthly copayments than non-preferred tier claims (angiotensin receptor blocker: $10.60 versus $11.81, inhaled steroid: $14.86 versus $16.42, p < 0.0001). Medication possession ratio was 8% lower for each $1.00 increase in monthly copayment to the one quarter power (p < 0.0001). However, we detected no significant direct association between formulary decision support usage and adherence. Interruptive formulary decision support shifted prescribing toward preferred tiers, but these medications were only minimally less expensive in the studied patient population. In this context, formulary decision support did not significantly increase adherence. To impact cost-related non-adherence, formulary decision support will likely need to be paired with complementary drug benefit design. Formulary decision support should be studied further, with particular attention to its effect on adherence in the setting of different benefit designs.

Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

PubMed

Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

2017-12-28

Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision-making with the patient. These factors fostered an in-depth knowledge of the patients and acted as a foundation for the nurses' reasoning process. Nurses' reasoning frequently advanced beyond the computerised decision support system recommendations. Future studies are warranted to develop more accurate algorithms, increase system maturity, and improve the integration of the digital clinical information with clinical experiences, to support telemedicine nurses' reasoning process.

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

PubMed

Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

2008-05-01

Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

ERIC Educational Resources Information Center

Ballantine, R. Malcolm

Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

Ensuring standards for the extended role of optometry.

PubMed

Jarvis, Ian; Ker, Jean

2014-06-01

In optometry, as in other health professions, such as pharmacy and nursing, there has been an expansion in the role of the optometrist in primary eye care, taking on aspects of care such as prescribing, which was traditionally undertaken by general practitioners. In optometry, this extended role involves monitoring eye conditions that do not require treatment or monitoring in secondary care, roles that were traditionally referred on. However, any extended role requires educational support. The development of a national educational programme can prevent any duplication of effort and provide a system of disseminating support to practitioners, who often work in isolation. The National Education Programme was developed and supported by the National Health Service (NHS) Education for Scotland (NES). This a national body responsible for supporting NHS services in Scotland, by developing and delivering education and training for those who work in NHS Scotland. Optometrists were given educational support in three main stages: simulation of component skills; safe learning in a simulated health care context; and support for the transfer of those skills to practice, including the use of mentoring via e-mail. The evaluation of this three-stage process has been positive. To further develop any expanded role in health care practice, safe guidelines for practice are required. Simulation can provide support at the start of this process in setting standards. However, mentorship in the practice area, as reported in this study, was required to embed newly acquired skills. © 2014 John Wiley & Sons Ltd.

Collaborative Response and Recovery from a Foot-and-Mouth Disease Animal Health Emergency: Supporting Decision Making in a Complex Environment with Multiple Stakeholders

DTIC Science & Technology

2013-12-01

RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING IN A COMPLEX ENVIRONMENT WITH MULTIPLE...Thesis 4. TITLE AND SUBTITLE COLLABORATIVE RESPONSE AND RECOVERY FROM A FOOT-AND- MOUTH DISEASE ANIMAL HEALTH EMERGENCY: SUPPORTING DECISION MAKING...200 words ) This thesis recommends ways to support decision makers who must operate within the multi-stakeholder complex situation of response and

SANDS: A Service-Oriented Architecture for Clinical Decision Support in a National Health Information Network

PubMed Central

Wright, Adam; Sittig, Dean F.

2008-01-01

In this paper we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. PMID:18434256

AppBuilder for DSSTools; an application development environment for developing decision support systems in Prolog

Treesearch

Geneho Kim; Donald Nute; H. Michael Rauscher; David L. Loftis

2000-01-01

A programming environment for developing complex decision support systems (DSSs) should support rapid prototyping and modular design, feature a flexible knowledge representation scheme and sound inference mechanisms, provide project management, and be domain independent. We have previously developed DSSTools (Decision Support System Tools), a reusable, domain-...

Changing hospitals, choosing chemotherapy and deciding you've made the right choice: Understanding the role of online support groups in different health decision-making activities.

PubMed

Sillence, Elizabeth; Bussey, Lauren

2017-05-01

To investigate the ways in which people use online support groups (OSGs) in relation to their health decision-making and to identify the key features of the resource that support those activities. Eighteen participants who used OSGs for a range of health conditions participated in qualitative study in which they were interviewed about their experiences of using OSGs in relation to decision-making. Exploration of their experiences was supported by discussion of illustrative quotes. Across the health conditions OSGs supported two main decision-making activities: (i) prompting decision making and (ii) evaluating and confirming decisions already made. Depending on the activity, participants valued information about the process, the experience and the outcome of patient narratives. The importance of forum interactivity was highlighted in relation to advice-seeking and the selection of relevant personal experiences. People use OSGs in different ways to support their health related decision-making valuing the different content types of the narratives and the interactivity provided by the resource. Engaging with OSGs helps people in a number of different ways in relation to decision-making. However, it only forms one part of people's decision-making strategies and appropriate resources should be signposted where possible. Copyright © 2017 Elsevier B.V. All rights reserved.

The Design and Use of Decision Support Systems by Academic Departments. AIR 1987 Annual Forum Paper.

ERIC Educational Resources Information Center

Johnson, F. Craig

The design and use of a departmental decision support system at Florida State University are described from the perspective of a department head. The decisions selected for study are ones of adequacy, equitability, quality, efficiency, and consistency. The complexity of the decision is related to the complexity of the support system. The major…

Decision Performance Using Spatial Decision Support Systems: A Geospatial Reasoning Ability Perspective

ERIC Educational Resources Information Center

Erskine, Michael A.

2013-01-01

As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…

Alternative Fuels Data Center: Maps and Data

Science.gov Websites

reduced AFV acquisition requirements. However, overall AFV acquisitions have since rebounded to pre-Great acquisitions have since rebounded to pre-Great Recession levels. Share Embed Share Copy and share this link

From guideline modeling to guideline execution: defining guideline-based decision-support services.

PubMed Central

Tu, S. W.; Musen, M. A.

2000-01-01

We describe our task-based approach to defining the guideline-based decision-support services that the EON system provides. We categorize uses of guidelines in patient-specific decision support into a set of generic tasks--making of decisions, specification of work to be performed, interpretation of data, setting of goals, and issuance of alert and reminders--that can be solved using various techniques. Our model includes constructs required for representing the knowledge used by these techniques. These constructs form a toolkit from which developers can select modeling solutions for guideline task. Based on the tasks and the guideline model, we define a guideline-execution architecture and a model of interactions between a decision-support server and clients that invoke services provided by the server. These services use generic interfaces derived from guideline tasks and their associated modeling constructs. We describe two implementations of these decision-support services and discuss how this work can be generalized. We argue that a well-defined specification of guideline-based decision-support services will facilitate sharing of tools that implement computable clinical guidelines. PMID:11080007

A Software Architecture for Adaptive Modular Sensing Systems

PubMed Central

Lyle, Andrew C.; Naish, Michael D.

2010-01-01

By combining a number of simple transducer modules, an arbitrarily complex sensing system may be produced to accommodate a wide range of applications. This work outlines a novel software architecture and knowledge representation scheme that has been developed to support this type of flexible and reconfigurable modular sensing system. Template algorithms are used to embed intelligence within each module. As modules are added or removed, the composite sensor is able to automatically determine its overall geometry and assume an appropriate collective identity. A virtual machine-based middleware layer runs on top of a real-time operating system with a pre-emptive kernel, enabling platform-independent template algorithms to be written once and run on any module, irrespective of its underlying hardware architecture. Applications that may benefit from easily reconfigurable modular sensing systems include flexible inspection, mobile robotics, surveillance, and space exploration. PMID:22163614

A software architecture for adaptive modular sensing systems.

PubMed

Lyle, Andrew C; Naish, Michael D

2010-01-01

By combining a number of simple transducer modules, an arbitrarily complex sensing system may be produced to accommodate a wide range of applications. This work outlines a novel software architecture and knowledge representation scheme that has been developed to support this type of flexible and reconfigurable modular sensing system. Template algorithms are used to embed intelligence within each module. As modules are added or removed, the composite sensor is able to automatically determine its overall geometry and assume an appropriate collective identity. A virtual machine-based middleware layer runs on top of a real-time operating system with a pre-emptive kernel, enabling platform-independent template algorithms to be written once and run on any module, irrespective of its underlying hardware architecture. Applications that may benefit from easily reconfigurable modular sensing systems include flexible inspection, mobile robotics, surveillance, and space exploration.

Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting.

PubMed

Sibthorpe, Beverly; Gardner, Karen; McAullay, Daniel

2016-01-01

A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.

Information systems in healthcare - state and steps towards sustainability.

PubMed

Lenz, R

2009-01-01

To identify core challenges and first steps on the way to sustainable information systems in healthcare. Recent articles on healthcare information technology and related articles from Medical Informatics and Computer Science were reviewed and analyzed. Core challenges that couldn't be solved over the years are identified. The two core problem areas are process integration, meaning to effectively embed IT-systems into routine workflows, and systems integration, meaning to reduce the effort for interconnecting independently developed IT-components. Standards for systems integration have improved a lot, but their usefulness is limited where system evolution is needed. Sustainable Healthcare Information Systems should be based on system architectures that support system evolution and avoid costly system replacements every five to ten years. Some basic principles for the design of such systems are separation of concerns, loose coupling, deferred systems design, and service oriented architectures.

A New Quantum Watermarking Based on Quantum Wavelet Transforms

NASA Astrophysics Data System (ADS)

Heidari, Shahrokh; Naseri, Mosayeb; Gheibi, Reza; Baghfalaki, Masoud; Rasoul Pourarian, Mohammad; Farouk, Ahmed

2017-06-01

Quantum watermarking is a technique to embed specific information, usually the owner’s identification, into quantum cover data such for copyright protection purposes. In this paper, a new scheme for quantum watermarking based on quantum wavelet transforms is proposed which includes scrambling, embedding and extracting procedures. The invisibility and robustness performances of the proposed watermarking method is confirmed by simulation technique. The invisibility of the scheme is examined by the peak-signal-to-noise ratio (PSNR) and the histogram calculation. Furthermore the robustness of the scheme is analyzed by the Bit Error Rate (BER) and the Correlation Two-Dimensional (Corr 2-D) calculation. The simulation results indicate that the proposed watermarking scheme indicate not only acceptable visual quality but also a good resistance against different types of attack. Supported by Kermanshah Branch, Islamic Azad University, Kermanshah, Iran

Ethical challenges in the use of social service robots for elderly people.

PubMed

Körtner, T

2016-06-01

Socially assistive robots are increasingly discussed as solutions in care and domestic use for the support of senior adults; however, this raises ethical questions which hitherto have not been considered or were not predictable. The most important questions are those of privacy and data protection, safety and responsibility as well as involvement of vulnerable persons and deception. Consequently, the ethical principles of nonmaleficence, beneficence, autonomy and fairness should be transposed to robotics. Clear answers and solutions are not yet available for every ethical challenge in robotics; however, the development of ethical guidelines for deployment of robots and research in the field of social service robots (SSR) are essential steps in order to embed ethics into dealing with socially assistive robots. This article provides some practical suggestions on this issue from a robotics project.

Deadlock-free genetic scheduling algorithm for automated manufacturing systems based on deadlock control policy.

PubMed

Xing, KeYi; Han, LiBin; Zhou, MengChu; Wang, Feng

2012-06-01

Deadlock-free control and scheduling are vital for optimizing the performance of automated manufacturing systems (AMSs) with shared resources and route flexibility. Based on the Petri net models of AMSs, this paper embeds the optimal deadlock avoidance policy into the genetic algorithm and develops a novel deadlock-free genetic scheduling algorithm for AMSs. A possible solution of the scheduling problem is coded as a chromosome representation that is a permutation with repetition of parts. By using the one-step look-ahead method in the optimal deadlock control policy, the feasibility of a chromosome is checked, and infeasible chromosomes are amended into feasible ones, which can be easily decoded into a feasible deadlock-free schedule. The chromosome representation and polynomial complexity of checking and amending procedures together support the cooperative aspect of genetic search for scheduling problems strongly.

Tools to support GHG emissions reduction : a regional effort, part 1 - carbon footprint estimation and decision support.

DOT National Transportation Integrated Search

2010-09-01

Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...

Decision Support Framework (DSF) (Formerly Decision Support Platform)

EPA Science Inventory

The Science Advisory Board (SAB) provided several comments on the draft Ecosystem Services Research Program's (ESRP's) Multi-Year Plan (MYP). This presentation provides a response to comments related to the decision support framework (DSF) part of Long-Term Goal 1. The comments...

The Feasibility of a Decision Support System for the Determination of Source Selection Evaluation Criteria

DTIC Science & Technology

1984-09-01

is not only difficult and time consuming , but also crucial to the success of the project, the question is whether a decision support system designed...KtI I - uAujvhIMtf IENE In THE FEASIBILITY OF A DECISION SUPPORT SYSTEM FOR THE DETERMINATION OF SOURCE SELECTION EVALUATION ’CRITERIA THESIS .2...INSTITUTE OF TECHNOLOGY Wright-Patterson Air Force Base, Ohio DZM=0N STATEMENT A ,’r !’ILMILSHIM S /8 4 THE FEASIBILITY OF A DECISION SUPPORT SYSTEM FOR

Adaptation of a Knowledge-Based Decision-Support System in the Tactical Environment.

DTIC Science & Technology

1981-12-01

002-04-6411S1CURITY CL All PICATION OF 1,416 PAGE (00HIR Onto ea0aOW .L10 *GU9WVC 4bGSI.CAYON S. Voss 10466lVka t... OftesoE ’ making decisons . The...noe..aaw Ad tdlalttt’ IV 680011 MMib) Artificial Intelligence; Decision-Support Systems; Tactical Decision- making ; Knowledge-based Decision-support...tactical information to assist tactical commanders in making decisions. The system, TAC*, for "Tactical Adaptable Consultant," incorporates a database

Web-services-based spatial decision support system to facilitate nuclear waste siting

NASA Astrophysics Data System (ADS)

Huang, L. Xinglai; Sheng, Grant

2006-10-01

The availability of spatial web services enables data sharing among managers, decision and policy makers and other stakeholders in much simpler ways than before and subsequently has created completely new opportunities in the process of spatial decision making. Though generally designed for a certain problem domain, web-services-based spatial decision support systems (WSDSS) can provide a flexible problem-solving environment to explore the decision problem, understand and refine problem definition, and generate and evaluate multiple alternatives for decision. This paper presents a new framework for the development of a web-services-based spatial decision support system. The WSDSS is comprised of distributed web services that either have their own functions or provide different geospatial data and may reside in different computers and locations. WSDSS includes six key components, namely: database management system, catalog, analysis functions and models, GIS viewers and editors, report generators, and graphical user interfaces. In this study, the architecture of a web-services-based spatial decision support system to facilitate nuclear waste siting is described as an example. The theoretical, conceptual and methodological challenges and issues associated with developing web services-based spatial decision support system are described.

Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

PubMed

Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

2016-01-01

Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

The Contribution of a Decision Support System to Educational Decision-Making Processes

ERIC Educational Resources Information Center

Klein, Joseph; Ronen, Herman

2003-01-01

In the light of reports of bias, the present study investigated the hypothesis that administrative educational decisions assisted by Decision Support Systems (DSS) are characterized by different pedagogical and organizational orientation than decisions made without computer assistance. One hundred and ten high school teachers were asked to suggest…

Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

PubMed

Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

2018-07-01

We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

EPA Science Inventory

A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

Decision support systems in water and wastewater treatment process selection and design: a review.

PubMed

Hamouda, M A; Anderson, W B; Huck, P M

2009-01-01

The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

A decision-supported outpatient practice system.

PubMed Central

Barrows, R. C.; Allen, B. A.; Smith, K. C.; Arni, V. V.; Sherman, E.

1996-01-01

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed. PMID:8947774

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

PubMed Central

Miller, Randolph A.; Waitman, Lemuel R.; Chen, Sutin; Rosenbloom, S. Trent

2006-01-01

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt’s inpatient “WizOrder” care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model’s utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user’s workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users’ workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise. PMID:16290243

Home care decision support using an Arden engine--merging smart home and vital signs data.

PubMed

Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold

2009-01-01

The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Systematic review of the empirical investigation of resources to support decision-making regarding BRCA1 and BRCA2 genetic testing in women with breast cancer.

PubMed

Grimmett, Chloe; Pickett, Karen; Shepherd, Jonathan; Welch, Karen; Recio-Saucedo, Alejandra; Streit, Elke; Seers, Helen; Armstrong, Anne; Cutress, Ramsey I; Evans, D Gareth; Copson, Ellen; Meiser, Bettina; Eccles, Diana; Foster, Claire

2018-05-01

Identify existing resources developed and/or evaluated empirically in the published literature designed to support women with breast cancer making decisions regarding genetic testing for BRCA1/2 mutations. Systematic review of seven electronic databases. Studies were included if they described or evaluated resources that were designed to support women with breast cancer in making a decision to have genetic counselling or testing for familial breast cancer. Outcome and process evaluations, using any type of study design, as well as articles reporting the development of decision aids, were eligible for inclusion. Total of 9 publications, describing 6 resources were identified. Resources were effective at increasing knowledge or understanding of hereditary breast cancer. Satisfaction with resources was high. There was no evidence that any resource increased distress, worry or decisional conflict. Few resources included active functionalities for example, values-based exercises, to support decision-making. Tailored resources supporting decision-making may be helpful and valued by patients and increase knowledge of hereditary breast cancer, without causing additional distress. Clinicians should provide supportive written information to patients where it is available. However, there is a need for robustly developed decision tools to support decision-making around genetic testing in women with breast cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

Decision support models for solid waste management: Review and game-theoretic approaches

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

Karmperis, Athanasios C., E-mail: athkarmp@mail.ntua.gr; Army Corps of Engineers, Hellenic Army General Staff, Ministry of Defence; Aravossis, Konstantinos

Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decisionmore » support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed.« less

Improving the discoverability, accessibility, and citability of omics datasets: a case report.

PubMed

Darlington, Yolanda F; Naumov, Alexey; McOwiti, Apollo; Kankanamge, Wasula H; Becnel, Lauren B; McKenna, Neil J

2017-03-01

Although omics datasets represent valuable assets for hypothesis generation, model testing, and data validation, the infrastructure supporting their reuse lacks organization and consistency. Using nuclear receptor signaling transcriptomic datasets as proof of principle, we developed a model to improve the discoverability, accessibility, and citability of published omics datasets. Primary datasets were retrieved from archives, processed to extract data points, then subjected to metadata enrichment and gap filling. The resulting secondary datasets were exposed on responsive web pages to support mining of gene lists, discovery of related datasets, and single-click citation integration with popular reference managers. Automated processes were established to embed digital object identifier-driven links to the secondary datasets in associated journal articles, small molecule and gene-centric databases, and a dataset search engine. Our model creates multiple points of access to reprocessed and reannotated derivative datasets across the digital biomedical research ecosystem, promoting their visibility and usability across disparate research communities. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Validation of a German Version of the Ethical Leadership at Work Questionnaire by Kalshoven et al. (2011)

PubMed Central

Steinmann, Barbara; Nübold, Annika; Maier, Günter W.

2016-01-01

The present study evaluates the psychometric properties of a German version of the Ethical Leadership at Work questionnaire (ELW-D), and further embeds the construct of ethical leadership within its nomological network. Confirmatory factor analyses (CFAs) based on the total sample of N = 363 employees support the assumed seven-factor structure of the German translation. Within a sub-sample of N = 133, the ELW-D shows positive correlations with related leadership behaviors (transformational leadership, contingent reward, and servant leadership), and negative correlations with destructive ones (passive leadership, autocratic leadership, and abusive supervision), approving convergent validity of the scale. Comparisons of correlated correlation coefficients reveal restrictions of its discriminant validity. In support of the criterion-related validity (N = 100), the ELW-D relates to work-related attitudes (e.g., job satisfaction, satisfaction with the leader, trust in the leader) and follower behaviors (e.g., extra effort, organizational citizenship behavior) in the way expected. Besides, ELW-D-dimensions show incremental validity over and above the Ethical Leadership Scale, emphasizing the added value of this questionnaire. PMID:27065916

Validation of a German Version of the Ethical Leadership at Work Questionnaire by Kalshoven et al. (2011).

PubMed

Steinmann, Barbara; Nübold, Annika; Maier, Günter W

2016-01-01

The present study evaluates the psychometric properties of a German version of the Ethical Leadership at Work questionnaire (ELW-D), and further embeds the construct of ethical leadership within its nomological network. Confirmatory factor analyses (CFAs) based on the total sample of N = 363 employees support the assumed seven-factor structure of the German translation. Within a sub-sample of N = 133, the ELW-D shows positive correlations with related leadership behaviors (transformational leadership, contingent reward, and servant leadership), and negative correlations with destructive ones (passive leadership, autocratic leadership, and abusive supervision), approving convergent validity of the scale. Comparisons of correlated correlation coefficients reveal restrictions of its discriminant validity. In support of the criterion-related validity (N = 100), the ELW-D relates to work-related attitudes (e.g., job satisfaction, satisfaction with the leader, trust in the leader) and follower behaviors (e.g., extra effort, organizational citizenship behavior) in the way expected. Besides, ELW-D-dimensions show incremental validity over and above the Ethical Leadership Scale, emphasizing the added value of this questionnaire.

78 FR 63902 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Flight Envelope Protection: Normal...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... displacement maneuvers because of the following: Knowledge that the limit system will protect the structure, Low stick force/displacement gradients, Smooth transition from pilot elevator control to limit control...

Burn Prevention for Families with Children with Special Needs

MedlinePlus

... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are ... needs. Read our burn prevention tips | Visit our YouTube channel To embed this Safety Tip in your ...

Opioid Overdose Reversal with Naloxone (Narcan, Evzio)

MedlinePlus

... Teens Search Connect with NIDA : Facebook LinkedIn Twitter YouTube Flickr RSS Menu Home Drugs of Abuse Commonly ... and no insurance. Where can I get naloxone? YouTube embedded video: https://www.youtube-nocookie.com/embed/ ...

78 FR 19981 - Special Conditions: Embraer S.A., Model EMB-550 Airplanes; Flight Envelope Protection: High Speed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

...; Flight Envelope Protection: High Speed Limiting AGENCY: Federal Aviation Administration (FAA), DOT... protection: high speed limiting. As published, the document contained an error in that the Special Conditions...

Surface transportation weather decision support requirements : advanced-integrated decision support using weather information for surface transportation decisions makers : draft (truncated*) version 1.0

DOT National Transportation Integrated Search

1997-09-19

This report gives an overview of the National Intelligent Transportation Infrastructure Initiative (NITI). NITI refers to the integrated electronics, communications, and hardware and software elements that are available to support Intelligent Transpo...

E-Estuary: Developing a Decision-support System for Coastal Management in the Conterminous United States

EPA Science Inventory

Ready access to geographic information is needed to support management decisions for estuaries at local, state, regional, and national scales. The United States Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for coastal management. E...

High-fidelity data embedding for image annotation.

PubMed

He, Shan; Kirovski, Darko; Wu, Min

2009-02-01

High fidelity is a demanding requirement for data hiding, especially for images with artistic or medical value. This correspondence proposes a high-fidelity image watermarking for annotation with robustness to moderate distortion. To achieve the high fidelity of the embedded image, we introduce a visual perception model that aims at quantifying the local tolerance to noise for arbitrary imagery. Based on this model, we embed two kinds of watermarks: a pilot watermark that indicates the existence of the watermark and an information watermark that conveys a payload of several dozen bits. The objective is to embed 32 bits of metadata into a single image in such a way that it is robust to JPEG compression and cropping. We demonstrate the effectiveness of the visual model and the application of the proposed annotation technology using a database of challenging photographic and medical images that contain a large amount of smooth regions.

Grain growth in Class I protostar Per-emb-50: a dust continuum analysis with NOEMA & SMA .

NASA Astrophysics Data System (ADS)

Agurto-Gangas, C.; Pineda, J. E.; Testi, L.; Caselli, P.; Szucs, L.; Tazzari, M.; Dunham, M.; Stephens, I. W.; Miotello, A.

A good understanding of when dust grains grow from sub-micrometer to millimeter sizes occurs is crucial for models of planet formation. This provides the first step towards the production of pebbles and planetesimals in protoplanetary disks. Thanks to detailed studies of the spectral index in Class II disks, it is well established that Class II objects have already dust grains of millimetres sizes, however, it is not clear when in the star formation process this grain growth occurs. Here, we present interferometric data from NOEMA at 3 mm and SMA at 1.3 mm of the Class I protostar, Per-emb-50, to determine the flux density spectral index at mm-wavelengths of the unresolved disk and the surrounding envelope. We find a spectral index in the unresolved disk 30% smaller than the envelope, alpha env=2.18, comparable to values obtained toward Class 0 sources.

Reynolds averaged turbulence modelling using deep neural networks with embedded invariance

DOE PAGES

Ling, Julia; Kurzawski, Andrew; Templeton, Jeremy

2016-10-18

There exists significant demand for improved Reynolds-averaged Navier–Stokes (RANS) turbulence models that are informed by and can represent a richer set of turbulence physics. This paper presents a method of using deep neural networks to learn a model for the Reynolds stress anisotropy tensor from high-fidelity simulation data. A novel neural network architecture is proposed which uses a multiplicative layer with an invariant tensor basis to embed Galilean invariance into the predicted anisotropy tensor. It is demonstrated that this neural network architecture provides improved prediction accuracy compared with a generic neural network architecture that does not embed this invariance property.more » Furthermore, the Reynolds stress anisotropy predictions of this invariant neural network are propagated through to the velocity field for two test cases. For both test cases, significant improvement versus baseline RANS linear eddy viscosity and nonlinear eddy viscosity models is demonstrated.« less

A novel data hiding scheme for block truncation coding compressed images using dynamic programming strategy

NASA Astrophysics Data System (ADS)

Chang, Ching-Chun; Liu, Yanjun; Nguyen, Son T.

2015-03-01

Data hiding is a technique that embeds information into digital cover data. This technique has been concentrated on the spatial uncompressed domain, and it is considered more challenging to perform in the compressed domain, i.e., vector quantization, JPEG, and block truncation coding (BTC). In this paper, we propose a new data hiding scheme for BTC-compressed images. In the proposed scheme, a dynamic programming strategy was used to search for the optimal solution of the bijective mapping function for LSB substitution. Then, according to the optimal solution, each mean value embeds three secret bits to obtain high hiding capacity with low distortion. The experimental results indicated that the proposed scheme obtained both higher hiding capacity and hiding efficiency than the other four existing schemes, while ensuring good visual quality of the stego-image. In addition, the proposed scheme achieved a low bit rate as original BTC algorithm.

Final Technical Report for "High-resolution global modeling of the effects of subgrid-scale clouds and turbulence on precipitating cloud systems"

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

Larson, Vincent

2016-11-25

The Multiscale Modeling Framework (MMF) embeds a cloud-resolving model in each grid column of a General Circulation Model (GCM). A MMF model does not need to use a deep convective parameterization, and thereby dispenses with the uncertainties in such parameterizations. However, MMF models grossly under-resolve shallow boundary-layer clouds, and hence those clouds may still benefit from parameterization. In this grant, we successfully created a climate model that embeds a cloud parameterization (“CLUBB”) within a MMF model. This involved interfacing CLUBB’s clouds with microphysics and reducing computational cost. We have evaluated the resulting simulated clouds and precipitation with satellite observations. Themore » chief benefit of the project is to provide a MMF model that has an improved representation of clouds and that provides improved simulations of precipitation.« less

A Mouse Model of the Cornea Pocket Assay for Angiogenesis Study

PubMed Central

Tang, Zhongshu; Zhang, Fan; Li, Yang; Arjunan, Pachiappan; Kumar, Anil; Lee, Chunsik; Li, Xuri

2011-01-01

A normal cornea is clear of vascular tissues. However, blood vessels can be induced to grow and survive in the cornea when potent angiogenic factors are administered 1. This uniqueness has made the cornea pocket assay one of the most used models for angiogenesis studies. The cornea composes multiple layers of cells. It is therefore possible to embed a pellet containing the angiogenic factor of interest in the cornea to investigate its angiogenic effect 2,3. Here, we provide a step by step demonstration of how to (I) produce the angiogenic factor-containing pellet (II) embed the pellet into the cornea (III) analyze the angiogenesis induced by the angiogenic factor of interest. Since the basic fibroblast growth factor (bFGF) is known as one of the most potent angiogenic factors 4, it is used here to induce angiogenesis in the cornea. PMID:21876523

Multiparty Quantum Key Agreement Based on Quantum Search Algorithm

PubMed Central

Cao, Hao; Ma, Wenping

2017-01-01

Quantum key agreement is an important topic that the shared key must be negotiated equally by all participants, and any nontrivial subset of participants cannot fully determine the shared key. To date, the embed modes of subkey in all the previously proposed quantum key agreement protocols are based on either BB84 or entangled states. The research of the quantum key agreement protocol based on quantum search algorithms is still blank. In this paper, on the basis of investigating the properties of quantum search algorithms, we propose the first quantum key agreement protocol whose embed mode of subkey is based on a quantum search algorithm known as Grover’s algorithm. A novel example of protocols with 5 – party is presented. The efficiency analysis shows that our protocol is prior to existing MQKA protocols. Furthermore it is secure against both external attack and internal attacks. PMID:28332610

Reynolds averaged turbulence modelling using deep neural networks with embedded invariance

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

Ling, Julia; Kurzawski, Andrew; Templeton, Jeremy

There exists significant demand for improved Reynolds-averaged Navier–Stokes (RANS) turbulence models that are informed by and can represent a richer set of turbulence physics. This paper presents a method of using deep neural networks to learn a model for the Reynolds stress anisotropy tensor from high-fidelity simulation data. A novel neural network architecture is proposed which uses a multiplicative layer with an invariant tensor basis to embed Galilean invariance into the predicted anisotropy tensor. It is demonstrated that this neural network architecture provides improved prediction accuracy compared with a generic neural network architecture that does not embed this invariance property.more » Furthermore, the Reynolds stress anisotropy predictions of this invariant neural network are propagated through to the velocity field for two test cases. For both test cases, significant improvement versus baseline RANS linear eddy viscosity and nonlinear eddy viscosity models is demonstrated.« less

New approaches for real time decision support systems

NASA Technical Reports Server (NTRS)

Hair, D. Charles; Pickslay, Kent

1994-01-01

NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

Lessons learned from implementing service-oriented clinical decision support at four sites: A qualitative study.

PubMed

Wright, Adam; Sittig, Dean F; Ash, Joan S; Erickson, Jessica L; Hickman, Trang T; Paterno, Marilyn; Gebhardt, Eric; McMullen, Carmit; Tsurikova, Ruslana; Dixon, Brian E; Fraser, Greg; Simonaitis, Linas; Sonnenberg, Frank A; Middleton, Blackford

2015-11-01

To identify challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Ethnographic investigation using the rapid assessment process, a procedure for agile qualitative data collection and analysis, including clinical observation, system demonstrations and analysis and 91 interviews. We identified challenges and lessons learned in eight dimensions: (1) hardware and software computing infrastructure, (2) clinical content, (3) human-computer interface, (4) people, (5) workflow and communication, (6) internal organizational policies, procedures, environment and culture, (7) external rules, regulations, and pressures and (8) system measurement and monitoring. Key challenges included performance issues (particularly related to data retrieval), differences in terminologies used across sites, workflow variability and the need for a legal framework. Based on the challenges and lessons learned, we identified eight best practices for developers and implementers of service-oriented clinical decision support: (1) optimize performance, or make asynchronous calls, (2) be liberal in what you accept (particularly for terminology), (3) foster clinical transparency, (4) develop a legal framework, (5) support a flexible front-end, (6) dedicate human resources, (7) support peer-to-peer communication, (8) improve standards. The Clinical Decision Support Consortium successfully developed a clinical decision support service and implemented it in four different electronic health records and four diverse clinical sites; however, the process was arduous. The lessons identified by the Consortium may be useful for other developers and implementers of clinical decision support services. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Audio-video decision support for patients: the documentary genré as a basis for decision aids.

PubMed

Volandes, Angelo E; Barry, Michael J; Wood, Fiona; Elwyn, Glyn

2013-09-01

Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased. This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio-visual materials. Three concerns arising from documentary film studies as they apply to the use of audio-visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio-visual materials (selection bias) and how to ensure objectivity (editorial bias). Decision science needs to start a debate about how audio-visual materials are to be used in decision support tools. Simply because audio-visual materials may be subjective and open to bias does not mean that we should not use them. Methods need to be found to ensure consensus around balance and editorial control, such that audio-visual materials can be used. © 2011 John Wiley & Sons Ltd.

Audio‐video decision support for patients: the documentary genré as a basis for decision aids

PubMed Central

Volandes, Angelo E.; Barry, Michael J.; Wood, Fiona; Elwyn, Glyn

2011-01-01

Abstract Objective  Decision support tools are increasingly using audio‐visual materials. However, disagreement exists about the use of audio‐visual materials as they may be subjective and biased. Methods  This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. Results  The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio‐visual materials. Three concerns arising from documentary film studies as they apply to the use of audio‐visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio‐visual materials (selection bias) and how to ensure objectivity (editorial bias). Discussion  Decision science needs to start a debate about how audio‐visual materials are to be used in decision support tools. Simply because audio‐visual materials may be subjective and open to bias does not mean that we should not use them. Conclusion  Methods need to be found to ensure consensus around balance and editorial control, such that audio‐visual materials can be used. PMID:22032516

Health professionals' opinions on supporting a cancer biobank: identification of barriers to combat biobanking pitfalls.

PubMed

Caixeiro, Nicole J; Byun, Hei Lan; Descallar, Joseph; Levesque, Janelle V; de Souza, Paul; Soon Lee, Cheok

2016-05-01

Although rarely acknowledged, a successful biobank is highly dependent on the support of the health professionals who assist the biobank in all aspects of its activities. In many cases, the lack of health professional support can be a limiting factor in the biobanking process of collecting and processing high-quality biospecimens. The aim of this study was to determine the attitudes of health professionals towards cancer biobanking. Using a 5-point Likert scale questionnaire, important aspects of biobanking, including accrual, quality, knowledge, responsiveness, impact, access, trust, governance and accreditation, were investigated. In total, 95 of 124 health and medical practitioners who were approached participated in this study (77% response rate). Health professionals in general supported the aims of biobanking with 56% of participants showing willingness to create a biobank and recruit donors (accrual), 85% understanding the importance in the storage and distribution of biospecimens (quality), 88% having an appreciation for the role of a biobank in furthering cancer research (knowledge), 70% showing awareness of the use of biospecimens in future research initiatives (responsiveness) and 73% demonstrating support for a biobank with proper control, authority and credibility measures in place (governance and accreditation). Overall, provided that proper information about the activities of the biobank and researcher access was transparent, health professionals were very willing to support cancer biobanking. These findings may assist in developing strategies for the establishment and maintenance of biobanks and aid the implementation of more effective policies and procedures to embed biobanking into routine hospital practices.

Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

ERIC Educational Resources Information Center

Campbell, Merle Wayne

2013-01-01

Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

The design of aircraft using the decision support problem technique

NASA Technical Reports Server (NTRS)

Mistree, Farrokh; Marinopoulos, Stergios; Jackson, David M.; Shupe, Jon A.

1988-01-01

The Decision Support Problem Technique for unified design, manufacturing and maintenance is being developed at the Systems Design Laboratory at the University of Houston. This involves the development of a domain-independent method (and the associated software) that can be used to process domain-dependent information and thereby provide support for human judgment. In a computer assisted environment, this support is provided in the form of optimal solutions to Decision Support Problems.

E-Estuary: Developing a Decision Support System for Coastal Management in the Conterminous United States (IAHR)

EPA Science Inventory

Ready access to geographic information is needed to support management decisions for estuaries at local, state, regional, and national scales. The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for coastal management. E-Estuary ...

E-Estuary: Developing a Decision-support System for Coastal Management in the Counterminous Untied States (Coastal Geotools 09)

EPA Science Inventory

Ready access to geographic information is needed to support management decisions for estuaries at local, state, regional, and national scales. The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for coastal management. E-Estuary ...

E-estuary: A Decision Support System for Coastal Water and Ecosystem Management in the US (CZ09)

EPA Science Inventory

Ready access to geographic information is needed to support management decisions for estuaries at local, state, regional, and national scales. The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for coastal management. E-Estuary ...

Becoming a Mother: Supported Decision-Making in Context

ERIC Educational Resources Information Center

Jamieson, Rhiann; Theodore, Kate; Raczka, Roman

2016-01-01

Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended…

Moving toward climate-informed agricultural decision support - can we use PRISM data for more than just monthly averages?

USDA-ARS?s Scientific Manuscript database

Decision support systems/models for agriculture are varied in target application and complexity, ranging from simple worksheets to near real-time forecast systems requiring significant computational and manpower resources. Until recently, most such decision support systems have been constructed with...

Design and realization of tourism spatial decision support system based on GIS

NASA Astrophysics Data System (ADS)

Ma, Zhangbao; Qi, Qingwen; Xu, Li

2008-10-01

In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.

Using mobile health technology to deliver decision support for self-monitoring after lung transplantation.

PubMed

Jiang, Yun; Sereika, Susan M; DeVito Dabbs, Annette; Handler, Steven M; Schlenk, Elizabeth A

2016-10-01

Lung transplant recipients (LTR) experience problems recognizing and reporting critical condition changes during their daily health self-monitoring. Pocket PATH(®), a mobile health application, was designed to provide automatic feedback messages to LTR to guide decisions for detecting and reporting critical values of health indicators. To examine the degree to which LTR followed decision support messages to report recorded critical values, and to explore predictors of appropriately following technology decision support by reporting critical values during the first year after transplantation. A cross-sectional correlational study was conducted to analyze existing data from 96 LTR who used the Pocket PATH for daily health self-monitoring. When a critical value is entered, the device automatically generated a feedback message to guide LTR about when and what to report to their transplant coordinators. Their socio-demographics and clinical characteristics were obtained before discharge. Their use of Pocket PATH for health self-monitoring during 12 months was categorized as low (≤25% of days), moderate (>25% to ≤75% of days), and high (>75% of days) use. Following technology decision support was defined by the total number of critical feedback messages appropriately handled divided by the total number of critical feedback messages generated. This variable was dichotomized by whether or not all (100%) feedback messages were appropriately followed. Binary logistic regression was used to explore predictors of appropriately following decision support. Of the 96 participants, 53 had at least 1 critical feedback message generated during 12 months. Of these 53 participants, the average message response rate was 90% and 33 (62%) followed 100% decision support. LTR who moderately used Pocket PATH (n=23) were less likely to follow technology decision support than the high (odds ratio [OR]=0.11, p=0.02) and low (OR=0.04, p=0.02) use groups. The odds of following decision support were reduced in LTR whose income met basic needs (OR=0.01, p=0.01) or who had longer hospital stays (OR=0.94, p=0.004). A significant interaction was found between gender and past technology experience (OR=0.21, p=0.03), suggesting that with increased past technology experience, the odds of following decision support to report all critical values decreased in men but increased in women. The majority of LTR responded appropriately to mobile technology-based decision support for reporting recorded critical values. Appropriately following technology decision support was associated with gender, income, experience with technology, length of hospital stay, and frequency of use of technology for self-monitoring. Clinicians should monitor LTR, who are at risk for poor reporting of recorded critical values, more vigilantly even when LTR are provided with mobile technology decision support. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

PubMed

Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

2013-06-01

The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

Social support plays a role in the attitude that people have towards taking an active role in medical decision-making.

PubMed

Brabers, Anne E M; de Jong, Judith D; Groenewegen, Peter P; van Dijk, Liset

2016-09-21

There is a growing emphasis towards including patients in medical decision-making. However, not all patients are actively involved in such decisions. Research has so far focused mainly on the influence of patient characteristics on preferences for active involvement. However, it can be argued that a patient's social context has to be taken into account as well, because social norms and resources affect behaviour. This study aims to examine the role of social resources, in the form of the availability of informational and emotional support, on the attitude towards taking an active role in medical decision-making. A questionnaire was sent to members of the Dutch Health Care Consumer Panel (response 70 %; n = 1300) in June 2013. A regression model was then used to estimate the relation between medical and lay informational support and emotional support and the attitude towards taking an active role in medical decision-making. Availability of emotional support is positively related to the attitude towards taking an active role in medical decision-making only in people with a low level of education, not in persons with a middle and high level of education. The latter have a more positive attitude towards taking an active role in medical decision-making, irrespective of the level of emotional support available. People with better access to medical informational support have a more positive attitude towards taking an active role in medical decision-making; but no significant association was found for lay informational support. This study shows that social resources are associated with the attitude towards taking an active role in medical decision-making. Strategies aimed at increasing patient involvement have to address this.

Nurses' Clinical Decision Making on Adopting a Wound Clinical Decision Support System.

PubMed

Khong, Peck Chui Betty; Hoi, Shu Yin; Holroyd, Eleanor; Wang, Wenru

2015-07-01

Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.

An Integrated Web-based Decision Support System in Disaster Risk Management

NASA Astrophysics Data System (ADS)

Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

2012-04-01

Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

Identifying the decision to be supported: a review of papers from environmental modelling and software

USGS Publications Warehouse

Sojda, Richard S.; Chen, Serena H.; El Sawah, Sondoss; Guillaume, Joseph H.A.; Jakeman, A.J.; Lautenbach, Sven; McIntosh, Brian S.; Rizzoli, A.E.; Seppelt, Ralf; Struss, Peter; Voinov, Alexey; Volk, Martin

2012-01-01

Two of the basic tenets of decision support system efforts are to help identify and structure the decisions to be supported, and to then provide analysis in how those decisions might be best made. One example from wetland management would be that wildlife biologists must decide when to draw down water levels to optimise aquatic invertebrates as food for breeding ducks. Once such a decision is identified, a system or tool to help them make that decision in the face of current and projected climate conditions could be developed. We examined a random sample of 100 papers published from 2001-2011 in Environmental Modelling and Software that used the phrase “decision support system” or “decision support tool”, and which are characteristic of different sectors. In our review, 41% of the systems and tools related to the water resources sector, 34% were related to agriculture, and 22% to the conservation of fish, wildlife, and protected area management. Only 60% of the papers were deemed to be reporting on DSS. This was based on the papers reviewed not having directly identified a specific decision to be supported. We also report on the techniques that were used to identify the decisions, such as formal survey, focus group, expert opinion, or sole judgment of the author(s). The primary underlying modelling system, e.g., expert system, agent based model, Bayesian belief network, geographical information system (GIS), and the like was categorised next. Finally, since decision support typically should target some aspect of unstructured decisions, we subjectively determined to what degree this was the case. In only 23% of the papers reviewed, did the system appear to tackle unstructured decisions. This knowledge should be useful in helping workers in the field develop more effective systems and tools, especially by being exposed to the approaches in different, but related, disciplines. We propose that a standard blueprint for reporting on DSS be developed for consideration by journal editors to aid them in filtering papers that use the term, “decision support”.

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise.

PubMed

Militello, Laura G; Saleem, Jason J; Borders, Morgan R; Sushereba, Christen E; Haverkamp, Donald; Wolf, Steven P; Doebbeling, Bradley N

2016-03-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

PubMed Central

Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

2016-01-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

Do emotional support and classroom organization earlier in the year set the stage for higher quality instruction?

PubMed

Curby, Timothy W; Rimm-Kaufman, Sara E; Abry, Tashia

2013-10-01

Many teachers believe that providing greater emotional and organizational supports in the beginning of the year strengthens their ability to teach effectively as the year progresses. Some interventions, such as the Responsive Classroom (RC) approach, explicitly embed this sequence into professional development efforts. We tested the hypothesis that earlier emotional and organizational supports set the stage for improved instruction later in the year in a sample of third- and fourth-grade teachers enrolled in a randomized controlled trial of the RC approach. Further, we examined the extent to which the model generalized for teachers using varying levels of RC practices as well as whether or not teachers were in the intervention or control groups. Teachers' emotional, organizational, and instructional interactions were observed using the Classroom Assessment Scoring System (Pianta, La Paro, & Hamre, 2008) on five occasions throughout the year. Results indicated a reciprocal relation between emotional and instructional supports. Specifically, higher levels of emotional support earlier in the year predicted higher instructional support later in the year. Also, higher levels of instructional support earlier in the year predicted higher emotional support later in the year. Classroom organization was not found to have longitudinal associations with the other domains across a year. This pattern was robust when controlling for the use of RC practices as well as across intervention and control groups. Further, teachers' use of RC practices predicted higher emotional support and classroom organization throughout the year, suggesting the malleability of this teacher characteristic. Discussion highlights the connection between teachers' emotional and instructional supports and how the use of RC practices improves teachers' emotionally supportive interactions with students. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

A luciferase-based assay for rapid assessment of drug activity against Mycobacterium tuberculosis including monitoring of macrophage viability.

PubMed

Larsson, Marie C; Lerm, Maria; Ängeby, Kristian; Nordvall, Michaela; Juréen, Pontus; Schön, Thomas

2014-11-01

The intracellular (IC) effect of drugs against Mycobacterium tuberculosis (Mtb) is not well established but increasingly important to consider when combining current and future multidrug regimens into the best possible treatment strategies. For this purpose, we developed an IC model based on a genetically modified Mtb H37Rv strain, expressing the Vibrio harvei luciferase (H37Rv-lux) infecting the human macrophage like cell line THP-1. Cells were infected at a low multiplicity of infection (1:1) and subsequently exposed to isoniazid (INH), ethambutol (EMB), amikacin (AMI) or levofloxacin (LEV) for 5days in a 96-well format. Cell viability was evaluated by Calcein AM and was maintained throughout the experiment. The number of viable H37Rv-lux was determined by luminescence and verified by a colony forming unit analysis. The results were compared to the effects of the same drugs in broth cultures. AMI, EMB and LEV were significantly less effective intracellularly (MIC90: >4mg/L, 8mg/L and 2mg/L, respectively) compared to extracellularly (MIC90: 0.5mg/L for AMI and EMB; 0.25mg/L for LEV). The reverse was the case for INH (IC: 0.064mg/L vs EC: 0.25mg/L). In conclusion, this luciferase based method, in which monitoring of cell viability is included, has the potential to become a useful tool while evaluating the intracellular effects of anti-mycobacterial drugs. Copyright © 2014 Elsevier B.V. All rights reserved.

Prevalence and molecular characteristics of drug-resistant Mycobacterium tuberculosis in Hunan, China.

PubMed

Zhao, Li-li; Chen, Yan; Chen, Zhong-nan; Liu, Hai-can; Hu, Pei-lei; Sun, Qing; Zhao, Xiu-qin; Jiang, Yi; Li, Gui-lian; Tan, Yun-hong; Wan, Kang-lin

2014-06-01

To determine the prevalence and molecular characteristics of drug-resistant tuberculosis in Hunan province, drug susceptibility testing and spoligotyping methods were performed among 171 M. tuberculosis isolates. In addition, the mutated characteristics of 12 loci, including katG, inhA, rpoB, rpsL, nucleotides 388 to 1084 of the rrs gene [rrs(388-1084)], embB, pncA, tlyA, eis, nucleotides 1158 to 1674 of the rrs gene [rrs(1158-1674)], gyrA, and gyrB, among drug-resistant isolates were also analyzed by DNA sequencing. Our results indicated that the prevalences of isoniazid (INH), rifampin (RIF), streptomycin (SM), ethambutol (EMB), pyrazinamide (PZA), capreomycin (CAP), kanamycin (KAN), amikacin (AKM), and ofloxacin (OFX) resistance in Hunan province were 35.7%, 26.9%, 20.5%, 9.9% 15.2%, 2.3%, 1.8%, 1.2%, and 10.5%, respectively. The previously treated patients presented significantly increased risks for developing drug resistance. The majority of M. tuberculosis isolates belonged to the Beijing family. Almost all the drug resistance results demonstrated no association with genotype. The most frequent mutations of drug-resistant isolates were katG codon 315 (katG315), inhA15, rpoB531, rpoB526, rpoB516, rpsL43, rrs514, embB306, pncA96, rrs1401, gyrA94, and gyrA90. These results contribute to the knowledge of the prevalence of drug resistance in Hunan province and also expand the molecular characteristics of drug resistance in China. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

A conceptual evolutionary aseismic decision support framework for hospitals

NASA Astrophysics Data System (ADS)

Hu, Yufeng; Dargush, Gary F.; Shao, Xiaoyun

2012-12-01

In this paper, aconceptual evolutionary framework for aseismic decision support for hospitalsthat attempts to integrate a range of engineering and sociotechnical models is presented. Genetic algorithms are applied to find the optimal decision sets. A case study is completed to demonstrate how the frameworkmay applytoa specific hospital.The simulations show that the proposed evolutionary decision support framework is able to discover robust policy sets in either uncertain or fixed environments. The framework also qualitatively identifies some of the characteristicbehavior of the critical care organization. Thus, by utilizing the proposedframework, the decision makers are able to make more informed decisions, especially toenhance the seismic safety of the hospitals.

Preparing for a decision support system.

PubMed

Callan, K

2000-08-01

The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS

EPA Science Inventory

Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...

Analysis and Design of a Decision Support System for Silas B. Hays Army Community Hospital

DTIC Science & Technology

1988-09-01

develop the DSS. This collaboration allows the user to learn about the power decision support can give to the decision maker and... projects under their control. A DSS is developed to provide decision support for a specific manager or group , and con- sequently falls under the ... It is possible the first iteration could be developed in more than one programming language and results compared . Once the first

Encountering aged care: a mixed methods investigation of medical students' clinical placement experiences.

PubMed

Annear, Michael J; Lea, Emma; Lo, Amanda; Tierney, Laura; Robinson, Andrew

2016-02-04

Residential aged care is an increasingly important health setting due to population ageing and the increase in age-related conditions, such as dementia. However, medical education has limited engagement with this fast-growing sector and undergraduate training remains primarily focussed on acute presentations in hospital settings. Additionally, concerns have been raised about the adequacy of dementia-related content in undergraduate medical curricula, while research has found mixed attitudes among students towards the care of older people. This study explores how medical students engage with the learning experiences accessible in clinical placements in residential aged care facilities (RACFs), particularly exposure to multiple comorbidity, cognitive impairment, and palliative care. Fifth-year medical students (N = 61) completed five-day clinical placements at two Australian aged care facilities in 2013 and 2014. The placements were supported by an iterative yet structured program and academic teaching staff to ensure appropriate educational experiences and oversight. Mixed methods data were collected before and after the clinical placement. Quantitative data included surveys of dementia knowledge and questions about attitudes to the aged care sector and working with older adults. Qualitative data were collected from focus group discussions concerning medical student expectations, learning opportunities, and challenges to engagement. Pre-placement surveys identified good dementia knowledge, but poor attitudes towards aged care and older adults. Negative placement experiences were associated with a struggle to discern case complexity and a perception of an aged care placement as an opportunity cost associated with reduced hospital training time. Irrespective of negative sentiment, post-placement survey data showed significant improvements in attitudes to working with older people and dementia knowledge. Positive student experiences were explained by in-depth engagement with clinically challenging cases and opportunities to practice independent clinical decision making and contribute to resident care. Aged care placements can improve medical student attitudes to working with older people and dementia knowledge. Clinical placements in RACFs challenge students to become more resourceful and independent in their clinical assessment and decision-making with vulnerable older adults. This suggests that aged care facilities offer considerable opportunity to enhance undergraduate medical education. However, more work is required to engender cultural change across medical curricula to embed issues around ageing, multiple comorbidity, and dementia.

Ensemble modelling and structured decision-making to support Emergency Disease Management.

PubMed

Webb, Colleen T; Ferrari, Matthew; Lindström, Tom; Carpenter, Tim; Dürr, Salome; Garner, Graeme; Jewell, Chris; Stevenson, Mark; Ward, Michael P; Werkman, Marleen; Backer, Jantien; Tildesley, Michael

2017-03-01

Epidemiological models in animal health are commonly used as decision-support tools to understand the impact of various control actions on infection spread in susceptible populations. Different models contain different assumptions and parameterizations, and policy decisions might be improved by considering outputs from multiple models. However, a transparent decision-support framework to integrate outputs from multiple models is nascent in epidemiology. Ensemble modelling and structured decision-making integrate the outputs of multiple models, compare policy actions and support policy decision-making. We briefly review the epidemiological application of ensemble modelling and structured decision-making and illustrate the potential of these methods using foot and mouth disease (FMD) models. In case study one, we apply structured decision-making to compare five possible control actions across three FMD models and show which control actions and outbreak costs are robustly supported and which are impacted by model uncertainty. In case study two, we develop a methodology for weighting the outputs of different models and show how different weighting schemes may impact the choice of control action. Using these case studies, we broadly illustrate the potential of ensemble modelling and structured decision-making in epidemiology to provide better information for decision-making and outline necessary development of these methods for their further application. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Project Spectrum: An Innovative Assessment Alternative.

ERIC Educational Resources Information Center

Krechevsky, Mara

1991-01-01

Project Spectrum attempts to reconceptualize the traditional linguistic and logical/mathematical bases of intelligence. Spectrum blurs the line between curriculum and assessment, embeds assessment in meaningful, real-world activities, uses "intelligence-fair" measures, emphasizes children's strengths, and recognizes the stylistic…

47 CFR 76.1903 - Interfaces.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Encoding Rules § 76.1903 Interfaces. A covered entity shall not attach or embed data or information with commercial audiovisual content, or otherwise apply to, associate with, or...

Determination of potential role of antioxidative status and circulating biochemical markers in the pathogenesis of ethambutol induced toxic optic neuropathy among diabetic and non-diabetic patients.

PubMed

Rasool, Mahmood; Malik, Arif; Manan, Abdul; Aziz, Khuram; Mahmood, Amna; Zaheer, Saima; Shuja, Naveed; Qazi, Mahmood Husain; Kamal, Mohammad Amjad; Karim, Sajjad

2015-11-01

The present study was designed to explore the antioxidative status and circulating biochemical markers having a potential role in the pathogenesis of ethambutol (EMB) induced toxic optic neuropathy (TON) among diabetic and non-diabetic patients. Fifty patients under complete therapy of EMB for tuberculosis were included in the present study. Inclusion criteria for patients were to receive EMB everyday during treatment, a dose of 25 mg/kg for initial 2 months and 15 mg/kg during the rest of therapy period. We conducted color vision and visual acuity test for all patients. Fifteen out of fifty EMB induced TON patients, were found to be diabetic. Color vision and visual acuity test results were evaluated for diabetic and non-diabetic as well as twenty age matched controls. The results demonstrated a significant pattern of circulating biochemical markers between the studied groups. Data regarding hematological (RBC, p value = 0.02; Hemoglobin, p value = 0.02), hepatic (total bilirubin, p value = 0.01), renal (urea, p value = 0.03; creatinine, p value = 0.007), lipid (total cholesterol, p value = 0.01; total triglycerides, p value = 0.03) and antioxidative (superoxide dismutase, p value = 0.005; glutathione, p value = 0.02; catalase, p value = 0.02) profile showed a highly significant difference among the studied groups specially patients with diabetes. Malondialdehyde (MDA) level had gone significantly up in diabetic TON patients (p value = 0.02), in comparison to other antioxidants and vitamins (Vit). Vit-A, E, B1, B12 and Zinc seem to be playing a major role in the pathogenesis of TON, specially Vit-E and B1 surpassed all the antioxidants as having highly significant inverse relationships with MDA (MDA vs Vit-E, r = -0.676(**) and MDA vs Vit-B1, r = -0.724(**) respectively). We conclude that during the ethambutol therapy the decreased levels of Vit-E and Vit-B1 possibly play a role in the development of TON and may be used as therapeutic agents to lessen the deleterious effects of ethambutol.

The value of endomyocardial biopsy in diagnosis and guiding therapy.

PubMed

Khan, Tayyaba; Selvakumar, Dinesh; Trivedi, Siddharth; Rao, Karan; Harapoz, Mehmet; Thiagalingam, Aravinda; Denniss, A Robert; Varikatt, Winny

2017-12-01

Endomyocardial biopsy (EMB) is a highly-specialised procedure that is associated with some controversy as to its diagnostic role due to its inconsistency in diagnosing a wide variety of cardiac diseases. Given the advances and sophistication in echocardiography and cardiac magnetic resonance imaging (MRI), the vast majority of cardiac diseases can be diagnosed by these non-invasive procedures. Under-sampling and the fact that biopsy site is limited to the right side of the interventricular septum further limits its value. In spite of all these limitations, there still remains a group of pathological conditions that require biopsy for a conclusive diagnosis such as myocarditis, amyloidosis, sarcoidosis and giant cell myocarditis. Correct patient selection and the quantity of tissue samples impart a significant influence on the accuracy of the diagnosis, and thus the value of EMB is variable for each patient. The purpose of this study was to evaluate the role of EMB in patient care, through its ability to either change clinical diagnosis or alter patient management. Our study was based in a single teaching centre. An audit of cardiac biopsies performed over a 10 year period identified 250 patients. We assessed indications, histology, electron microscopic findings, final clinical diagnosis and how they influenced patient management. A definite diagnosis on histology was given in 44 of 250 patients (17.6%). Non-specific findings were observed in the remaining 206 patients (82.4%). Histology influenced patient management in 73 (29.2%) patients. Histological examination in the remaining 177 biopsies (70.8%) did not provide a definite diagnosis or influence patient management. It was additionally found that the number of tissue fragments sampled has significant impact on diagnostic accuracy. A more accurate diagnosis of 45% was obtained when ≥5 fragments were sampled, as compared to 1-3 fragments where accuracy dropped to 20%. Our study indicated that sampling for electron microscopy has very limited value. We found that of 245 biopsies sampled for electron microscopy, only three biopsies (1.2%) had diagnostically useful findings. In our institution procedure related complications were observed in 7 of 250 patients (2.8%). The diagnostic value of EMB is important but limited. Strict triaging of patients according to clinical suspicion and adequate sampling of tissue may increase useful diagnostic information. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Using basic geographic information systems functionality to support sustainable forest management decision making and post-decision assessments

Treesearch

Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.

2006-01-01

Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...

Digital technology and clinical decision making in depression treatment: Current findings and future opportunities.

PubMed

Hallgren, Kevin A; Bauer, Amy M; Atkins, David C

2017-06-01

Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined. Discussions of these opportunities are organized around three established movements designed to enhance clinical decision making for depression treatment, including measurement-based care, integrated care, and personalized medicine. Research, design, and implementation efforts may support clinical decision making for depression by (1) improving tools to incorporate depression symptom data into existing electronic health record systems, (2) enhancing measurement of treatment fidelity and treatment processes, (3) harnessing smartphone and biosensor data to inform clinical decision making, (4) enhancing tools that support communication and care coordination between patients and providers and within provider teams, and (5) leveraging treatment and outcome data from electronic health record systems to support personalized depression treatment. The current climate of rapid changes in both healthcare and digital technologies facilitates an urgent need for research, design, and implementation of digital technologies that explicitly support clinical decision making. Ensuring that such tools are efficient, effective, and usable in frontline treatment settings will be essential for their success and will require engagement of stakeholders from multiple domains. © 2017 Wiley Periodicals, Inc.

Academic Support Services and Career Decision-Making Self-Efficacy in Student Athletes

ERIC Educational Resources Information Center

Burns, Gary N.; Jasinski, Dale; Dunn, Steve; Fletcher, Duncan

2013-01-01

This study examined the relationship between evaluations of academic support services and student athletes' career decision-making self-efficacy. One hundred and fifty-eight NCAA athletes (68% male) from 11 Division I teams completed measures of satisfaction with their academic support services, career decision-making self-efficacy, general…

EMDS users guide (version 2.0): knowledge-based decision support for ecological assessment.

Treesearch

Keith M. Reynolds

1999-01-01

The USDA Forest Service Pacific Northwest Research Station in Corvallis, Oregon, has developed the ecosystem management decision support (EMDS) system. The system integrates the logical formalism of knowledge-based reasoning into a geographic information system (GIS) environment to provide decision support for ecological landscape assessment and evaluation. The...

Developing an Interactive Data Visualization Tool to Assess the Impact of Decision Support on Clinical Operations.

PubMed

Huber, Timothy C; Krishnaraj, Arun; Monaghan, Dayna; Gaskin, Cree M

2018-05-18

Due to mandates from recent legislation, clinical decision support (CDS) software is being adopted by radiology practices across the country. This software provides imaging study decision support for referring providers at the point of order entry. CDS systems produce a large volume of data, providing opportunities for research and quality improvement. In order to better visualize and analyze trends in this data, an interactive data visualization dashboard was created using a commercially available data visualization platform. Following the integration of a commercially available clinical decision support product into the electronic health record, a dashboard was created using a commercially available data visualization platform (Tableau, Seattle, WA). Data generated by the CDS were exported from the data warehouse, where they were stored, into the platform. This allowed for real-time visualization of the data generated by the decision support software. The creation of the dashboard allowed the output from the CDS platform to be more easily analyzed and facilitated hypothesis generation. Integrating data visualization tools into clinical decision support tools allows for easier data analysis and can streamline research and quality improvement efforts.

Design, implementation, use, and preliminary evaluation of SEBASTIAN, a standards-based Web service for clinical decision support.

PubMed

Kawamoto, Kensaku; Lobach, David F

2005-01-01

Despite their demonstrated ability to improve care quality, clinical decision support systems are not widely used. In part, this limited use is due to the difficulty of sharing medical knowledge in a machine-executable format. To address this problem, we developed a decision support Web service known as SEBASTIAN. In SEBASTIAN, individual knowledge modules define the data requirements for assessing a patient, the conclusions that can be drawn using that data, and instructions on how to generate those conclusions. Using standards-based XML messages transmitted over HTTP, client decision support applications provide patient data to SEBASTIAN and receive patient-specific assessments and recommendations. SEBASTIAN has been used to implement four distinct decision support systems; an architectural overview is provided for one of these systems. Preliminary assessments indicate that SEBASTIAN fulfills all original design objectives, including the re-use of executable medical knowledge across diverse applications and care settings, the straightforward authoring of knowledge modules, and use of the framework to implement decision support applications with significant clinical utility.

User-centered design to improve clinical decision support in primary care.

PubMed

Brunner, Julian; Chuang, Emmeline; Goldzweig, Caroline; Cain, Cindy L; Sugar, Catherine; Yano, Elizabeth M

2017-08-01

A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations." (1) Identify the prevalence of four user-centered design practices at United States Veterans Affairs (VA) primary care clinics and assess the perceived utility of clinical decision support at those clinics; (2) Evaluate the association between those user-centered design practices and the perceived utility of clinical decision support. We analyzed clinic-level survey data collected in 2006-2007 from 170 VA primary care clinics. We examined four user-centered design practices: 1) pilot testing, 2) provider satisfaction assessment, 3) formal usability assessment, and 4) analysis of impact on performance improvement. We used a regression model to evaluate the association between user-centered design practices and the perceived utility of clinical decision support, while accounting for other important factors at those clinics, including implementation climate, available resources, and structural characteristics. We also examined associations separately at community-based clinics and at hospital-based clinics. User-centered design practices for clinical decision support varied across clinics: 74% conducted pilot testing, 62% conducted provider satisfaction assessment, 36% conducted a formal usability assessment, and 79% conducted an analysis of impact on performance improvement. Overall perceived utility of clinical decision support was high, with a mean rating of 4.17 (±.67) out of 5 on a composite measure. "Analysis of impact on performance improvement" was the only user-centered design practice significantly associated with perceived utility of clinical decision support, b=.47 (p<.001). This association was present in hospital-based clinics, b=.34 (p<.05), but was stronger at community-based clinics, b=.61 (p<.001). Our findings are highly supportive of the practice of analyzing the impact of clinical decision support on performance metrics. This was the most common user-centered design practice in our study, and was the practice associated with higher perceived utility of clinical decision support. This practice may be particularly helpful at community-based clinics, which are typically less connected to VA medical center resources. Published by Elsevier B.V.

Geospatial Data Fusion and Multigroup Decision Support for Surface Water Quality Management

NASA Astrophysics Data System (ADS)

Sun, A. Y.; Osidele, O.; Green, R. T.; Xie, H.

2010-12-01

Social networking and social media have gained significant popularity and brought fundamental changes to many facets of our everyday life. With the ever-increasing adoption of GPS-enabled gadgets and technology, location-based content is likely to play a central role in social networking sites. While location-based content is not new to the geoscience community, where geographic information systems (GIS) are extensively used, the delivery of useful geospatial data to targeted user groups for decision support is new. Decision makers and modelers ought to make more effective use of the new web-based tools to expand the scope of environmental awareness education, public outreach, and stakeholder interaction. Environmental decision processes are often rife with uncertainty and controversy, requiring integration of multiple sources of information and compromises between diverse interests. Fusing of multisource, multiscale environmental data for multigroup decision support is a challenging task. Toward this goal, a multigroup decision support platform should strive to achieve transparency, impartiality, and timely synthesis of information. The latter criterion often constitutes a major technical bottleneck to traditional GIS-based media, featuring large file or image sizes and requiring special processing before web deployment. Many tools and design patterns have appeared in recent years to ease the situation somewhat. In this project, we explore the use of Web 2.0 technologies for “pushing” location-based content to multigroups involved in surface water quality management and decision making. In particular, our granular bottom-up approach facilitates effective delivery of information to most relevant user groups. Our location-based content includes in-situ and remotely sensed data disseminated by NASA and other national and local agencies. Our project is demonstrated for managing the total maximum daily load (TMDL) program in the Arroyo Colorado coastal river basin in Texas. The overall design focuses on assigning spatial information to decision support elements and on efficiently using Web 2.0 technologies to relay scientific information to the nonscientific community. We conclude that (i) social networking, if appropriately used, has great potential for mitigating difficulty associated with multigroup decision making; (ii) all potential stakeholder groups should be involved in creating a useful decision support system; and (iii) environmental decision support systems should be considered a must-have, instead of an optional component of TMDL decision support projects. Acknowledgment: This project was supported by NASA grant NNX09AR63G.

Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

PubMed

Dhukaram, Anandhi Vivekanandan; Baber, Chris

2015-06-01

Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Decision Support System for Evaluating Systems of Undersea Sensors and Weapons

DTIC Science & Technology

2015-12-01

distribution is unlimited A DECISION SUPPORT SYSTEM FOR EVALUATING SYSTEMS OF UNDERSEA SENSORS AND WEAPONS by Team Mental Focus Cohort 142O...A DECISION SUPPORT SYSTEM FOR EVALUATING SYSTEMS OF UNDERSEA SENSORS AND WEAPONS 5. FUNDING NUMBERS 6. AUTHOR(S) Systems Engineering Cohort...undersea weapons, it requires the supporting tools to evaluate and predict the effectiveness of these system concepts. While current naval minefield

Combat Service Support (CSS) Enabler Functional Assessment (CEFA)

DTIC Science & Technology

1998-07-01

CDR), Combined Arms Support Command (CASCOM) with a tool to aid decision making related to mitigating E/I peacetime (programmatic) and wartime risks...not be fielded by Fiscal Year (FY) 10. Based on their estimates, any decisions , especially reductions in manpower, which rely on the existence of the E...Support (CSS) enablers/initiatives (E/I), thereby providing the Commander (CDR), Combined Arms Support Command (CASCOM) with a tool to aid decision

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.

NIH-IEEE 2015 Strategic Conference on Healthcare Innovations and Point-of-Care Technologies for Prec

Cancer.gov

NIH and the Institute for Electrical and Electronics Engineering, Engineering in Medicine and Biology Society (IEEE/EMBS) hosted the third iteration of the Healthcare Innovations and Point-of-Care Technologies Conference last week.

Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions?

PubMed Central

Abbasgholizadeh Rahimi, Samira; Menear, Matthew; Robitaille, Hubert; Légaré, France

2017-01-01

ABSTRACT Mobile health (mHealth) applications intended to support shared decision making in diagnostic and treatment decisions are increasingly available. In this paper, we discuss some recent studies on mHealth applications with relevance to shared decision making. We discuss the potential advantages and disadvantages of using mHealth in shared decision making in various contexts, and suggest some directions for future research in this quickly expanding field. PMID:28838306

Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

PubMed Central

2010-01-01

Background Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. Methods We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Results Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational linkages were critical to success. The Greenhalgh framework provided a useful starting point for investigation, but we believe it is more a descriptive than explanatory model. As such, it has limitations in the extent to which it could assist us in understanding the interactions of the practices and processes that we observed at different levels of the system. Summary Taking up CQI involved engaging multiple stakeholders in new relationships that could support services to construct shared meaning and purpose, operationalise key concepts and tools, and develop and embed new practices into services systems and routines. Promoting quality improvement requires a system approach and organization-wide commitment. At the organization level, a formal high-level mandate, leadership at all levels, and resources to support implementation are needed. At the broader system level, governance arrangements that can fulfil a number of policy objectives related to articulating the linkages between CQI and other aspects of the regulatory, financing, and performance frameworks within the health system would help define a role and vision for quality improvement. PMID:20226066

Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project.

PubMed

Gardner, Karen L; Dowden, Michelle; Togni, Samantha; Bailie, Ross

2010-03-13

Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational linkages were critical to success. The Greenhalgh framework provided a useful starting point for investigation, but we believe it is more a descriptive than explanatory model. As such, it has limitations in the extent to which it could assist us in understanding the interactions of the practices and processes that we observed at different levels of the system. Taking up CQI involved engaging multiple stakeholders in new relationships that could support services to construct shared meaning and purpose, operationalise key concepts and tools, and develop and embed new practices into services systems and routines. Promoting quality improvement requires a system approach and organization-wide commitment. At the organization level, a formal high-level mandate, leadership at all levels, and resources to support implementation are needed. At the broader system level, governance arrangements that can fulfil a number of policy objectives related to articulating the linkages between CQI and other aspects of the regulatory, financing, and performance frameworks within the health system would help define a role and vision for quality improvement.

Human-computer interface for the study of information fusion concepts in situation analysis and command decision support systems

NASA Astrophysics Data System (ADS)

Roy, Jean; Breton, Richard; Paradis, Stephane

2001-08-01

Situation Awareness (SAW) is essential for commanders to conduct decision-making (DM) activities. Situation Analysis (SA) is defined as a process, the examination of a situation, its elements, and their relations, to provide and maintain a product, i.e., a state of SAW for the decision maker. Operational trends in warfare put the situation analysis process under pressure. This emphasizes the need for a real-time computer-based Situation analysis Support System (SASS) to aid commanders in achieving the appropriate situation awareness, thereby supporting their response to actual or anticipated threats. Data fusion is clearly a key enabler for SA and a SASS. Since data fusion is used for SA in support of dynamic human decision-making, the exploration of the SA concepts and the design of data fusion techniques must take into account human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight integration of the human element with the SA technology is essential. Regarding these issues, this paper provides a description of CODSI (Command Decision Support Interface), and operational- like human machine interface prototype for investigations in computer-based SA and command decision support. With CODSI, one objective was to apply recent developments in SA theory and information display technology to the problem of enhancing SAW quality. It thus provides a capability to adequately convey tactical information to command decision makers. It also supports the study of human-computer interactions for SA, and methodologies for SAW measurement.

The use of the Dutch Self-Sufficiency Matrix (SSM-D) to inform allocation decisions to public mental health care for homeless people.

PubMed

Lauriks, Steve; de Wit, Matty A S; Buster, Marcel C A; Fassaert, Thijs J L; van Wifferen, Ron; Klazinga, Niek S

2014-10-01

The current study set out to develop a decision support tool based on the Self-Sufficiency Matrix (Dutch version; SSM-D) for the clinical decision to allocate homeless people to the public mental health care system at the central access point of public mental health care in Amsterdam, The Netherlands. Logistic regression and receiver operating characteristic-curve analyses were used to model professional decisions and establish four decision categories based on SSM-D scores from half of the research population (Total n = 612). The model and decision categories were found to be accurate and reliable in predicting professional decisions in the second half of the population. Results indicate that the decision support tool based on the SSM-D is useful and feasible. The method to develop the SSM-D as a decision support tool could be applied to decision-making processes in other systems and services where the SSM-D has been implemented, to further increase the utility of the instrument.

Parallel implementation of all-digital timing recovery for high-speed and real-time optical coherent receivers.

PubMed

Zhou, Xian; Chen, Xue

2011-05-09

The digital coherent receivers combine coherent detection with digital signal processing (DSP) to compensate for transmission impairments, and therefore are a promising candidate for future high-speed optical transmission system. However, the maximum symbol rate supported by such real-time receivers is limited by the processing rate of hardware. In order to cope with this difficulty, the parallel processing algorithms is imperative. In this paper, we propose a novel parallel digital timing recovery loop (PDTRL) based on our previous work. Furthermore, for increasing the dynamic dispersion tolerance range of receivers, we embed a parallel adaptive equalizer in the PDTRL. This parallel joint scheme (PJS) can be used to complete synchronization, equalization and polarization de-multiplexing simultaneously. Finally, we demonstrate that PDTRL and PJS allow the hardware to process 112 Gbit/s POLMUX-DQPSK signal at the hundreds MHz range. © 2011 Optical Society of America

Social Computing as Next-Gen Learning Paradigm: A Platform and Applications

NASA Astrophysics Data System (ADS)

Margherita, Alessandro; Taurino, Cesare; Del Vecchio, Pasquale

As a field at the intersection between computer science and people behavior, social computing can contribute significantly in the endeavor of innovating how individuals and groups interact for learning and working purposes. In particular, the generation of Internet applications tagged as web 2.0 provides an opportunity to create new “environments” where people can exchange knowledge and experience, create new knowledge and learn together. This chapter illustrates the design and application of a prototypal platform which embeds tools such as blog, wiki, folksonomy and RSS in a unique web-based system. This platform has been developed to support a case-based and project-driven learning strategy for the development of business and technology management competencies in undergraduate and graduate education programs. A set of illustrative scenarios are described to show how a learning community can be promoted, created, and sustained through the technological platform.

Mission and Safety Critical (MASC): An EVACS simulation with nested transactions

NASA Technical Reports Server (NTRS)

Auty, David; Atkinson, Colin; Randall, Charlie

1992-01-01

The Extra-Vehicular Activity Control System (EVACS) Simulation with Nested Transactions, a recent effort of the MISSION Kernel Team, is documented. The EVACS simulation is a simulation of some aspects of the Extra-Vehicular Activity Control System, in particular, just the selection of communication frequencies. The simulation is a tool to explore mission and safety critical (MASC) applications. For the purpose of this effort, its current definition is quite narrow serving only as a starting point for prototyping purposes. (Note that EVACS itself has been supplanted in a larger scenario of a lunar outpost with astronauts and a lunar rover). The frequency selection scenario was modified to embed its processing in nested transactions. Again as a first step, only two aspects of transaction support were implemented in this prototype: architecture and state recovery. Issues of concurrency and distribution are yet to be addressed.

Australian engineering educators' attitudes towards Aboriginal cultures and perspectives

NASA Astrophysics Data System (ADS)

Goldfinch, Thomas; Prpic, Juliana Kaya; Jolly, Lesley; Leigh, Elyssebeth; Kennedy, Jade

2017-07-01

In Australia, representation of Aboriginal populations within the engineering profession is very low despite participation targets set by Government departments, professional bodies and Universities. Progressing the Aboriginal inclusion agenda within Australian Engineering Education requires a clearer understanding of engineering educators' preparedness for increased numbers of students from this non-traditional cohort. This research stems from a recently completed project that explored Aboriginal perspectives in engineering education and proposed a model for embedding perspectives in curricula. Nine engineering academics were interviewed to explore attitudes towards Aboriginal perspectives in engineering and the viability of the proposed model. Results of the interviews indicate efforts to embed Aboriginal perspectives are starting from a small base of knowledge and experience. Individuals' motivations and values indicate that there is significant support for improving this, but that efforts can be hampered by conceptions of Aboriginal perspectives that do not consider how Aboriginal knowledges may change engineering itself.

Privacy by Design at Population Data BC: a case study describing the technical, administrative, and physical controls for privacy-sensitive secondary use of personal information for research in the public interest.

PubMed

Pencarrick Hertzman, Caitlin; Meagher, Nancy; McGrail, Kimberlyn M

2013-01-01

Population Data BC (PopData) is an innovative leader in facilitating access to linked data for population health research. Researchers from academic institutions across Canada work with PopData to submit data access requests for projects involving linked administrative data, with or without their own researcher-collected data. PopData and its predecessor-the British Columbia Linked Health Database-have facilitated over 350 research projects analyzing a broad spectrum of population health issues. PopData embeds privacy in every aspect of its operations. This case study focuses on how implementing the Privacy by Design model protects privacy while supporting access to individual-level data for research in the public interest. It explores challenges presented by legislation, stewardship, and public perception and demonstrates how PopData achieves both operational efficiencies and due diligence.

Family Life Goes On: Disability in Contemporary Families

PubMed Central

Farrell, Anne F.; Krahn, Gloria L.

2015-01-01

Disability is part of life for most contemporary families, but to date the literature on disability in families is fragmented and narrow. This editorial commentary introduces the content and findings of peer-reviewed articles appearing in a special issue of Family Relations. The editors outline unanswered but core research questions and preview the themes present in the issue: families with disabilities are diverse; economic hardship disproportionately characterizes their lives; family life with disabilities is a journey that includes stress and resilience, with support contributing significantly to the latter; and that work benefits and taxes family life. Articles extrapolate beyond findings to explore implications for family policy and practice. The editors assert that developing understanding of how disability influences families requires a more diverse and rigorous research portfolio. They further cite the need to embed disability as a variable in a range of family studies and advocate more outlets for publication. PMID:26185356

Linking research, education and public engagement in geoscience: Leadership and strategic partnerships (invited)

NASA Astrophysics Data System (ADS)

Harcourt, P.

2017-12-01

Addressing the urgent issue of climate change requires mitigation and adaptation actions on individual to global scales, and appropriate action must be based upon geoscience literacy across population sectors. The NSF-funded MADE CLEAR (Maryland and Delaware Climate Change Education, Assessment, and Research) project provides a coordinated approach to embed climate change into education programs at the university level, in formal K12 classrooms, and among informal educators. We have worked with state agencies, university systems, non-profit organizations, and community groups to establish and support research-based education about climate change. In this panel I will describe how MADE CLEAR approached the task of infusing climate change education across sectors in the highly diverse states of Delaware and Maryland. I will share the characteristics of our strongest alliances, an analysis of significant barriers to climate change education, and our perspective on the outlook for the future of climate change education.

Honoring children, making relatives: the cultural translation of parent-child interaction therapy for American Indian and Alaska Native families.

PubMed

Bigfoot, Dolores Subia; Funderburk, Beverly W

2011-01-01

The Indian Country Child Trauma Center, as part of the National Child Traumatic Stress Network, designed a series of American Indian and Alaska Native transformations of evidence-based treatment models. Parent-Child Interaction Therapy (PCIT) was culturally adapted/translated to provide an effective treatment model for parents who have difficulty with appropriate parenting skills or for their children who have problematic behavior. The model, Honoring Children-Making Relatives, embeds the basic tenets and procedures of PCIT in a framework that supports American Indian and Alaska Native traditional beliefs and parenting practices that regard children as being the center of the Circle. This article provides an overview of the Honoring Children-Making Relatives model, reviews cultural considerations incorporated into ICCTC's model transformation process, and discusses specific applications for Parent-Child Interaction Therapy within the model.

Extending LMS to Support IRT-Based Assessment Test Calibration

NASA Astrophysics Data System (ADS)

Fotaris, Panagiotis; Mastoras, Theodoros; Mavridis, Ioannis; Manitsaris, Athanasios

Developing unambiguous and challenging assessment material for measuring educational attainment is a time-consuming, labor-intensive process. As a result Computer Aided Assessment (CAA) tools are becoming widely adopted in academic environments in an effort to improve the assessment quality and deliver reliable results of examinee performance. This paper introduces a methodological and architectural framework which embeds a CAA tool in a Learning Management System (LMS) so as to assist test developers in refining items to constitute assessment tests. An Item Response Theory (IRT) based analysis is applied to a dynamic assessment profile provided by the LMS. Test developers define a set of validity rules for the statistical indices given by the IRT analysis. By applying those rules, the LMS can detect items with various discrepancies which are then flagged for review of their content. Repeatedly executing the aforementioned procedure can improve the overall efficiency of the testing process.

British Columbia Ministry of Health Patients as Partners: A transformational approach.

PubMed

Bar, Sherry; Grant, Kristen; Asuri, Sirisha; Holms, Shannon

2018-03-01

Patients as Partners is a quality improvement initiative of the British Columbia Ministry of Health (the Ministry) that aims to bring patient voice, choice, and representation to the forefront of healthcare through collaboration with patients, families, non-governmental organizations, funded partners, regional health authorities, and healthcare providers. A spectrum of patient engagement activities, including capacity building and self-management support, occur through partnerships at the individual patient and provider, community, and system levels. These activities ensure patient priorities are identified and embed a patient-centred care approach into provincial policies and projects. Multi-/interdisciplinary collaborations in the healthcare sector occur through participation in working groups, advisory committees, and engagement events. Ongoing improvements include enhancing measurement strategies and leveraging opportunities around gaps. The Ministry was honoured with the International Association of Public Participation Award as the 2016 Canadian Organization of the Year in recognition of improving healthcare through patient and public education.

Privacy by Design at Population Data BC: a case study describing the technical, administrative, and physical controls for privacy-sensitive secondary use of personal information for research in the public interest

PubMed Central

Pencarrick Hertzman, Caitlin; Meagher, Nancy; McGrail, Kimberlyn M

2013-01-01

Population Data BC (PopData) is an innovative leader in facilitating access to linked data for population health research. Researchers from academic institutions across Canada work with PopData to submit data access requests for projects involving linked administrative data, with or without their own researcher-collected data. PopData and its predecessor—the British Columbia Linked Health Database—have facilitated over 350 research projects analyzing a broad spectrum of population health issues. PopData embeds privacy in every aspect of its operations. This case study focuses on how implementing the Privacy by Design model protects privacy while supporting access to individual-level data for research in the public interest. It explores challenges presented by legislation, stewardship, and public perception and demonstrates how PopData achieves both operational efficiencies and due diligence. PMID:22935136

Multi-Scale Modeling of Liquid Phase Sintering Affected by Gravity: Preliminary Analysis

NASA Technical Reports Server (NTRS)

Olevsky, Eugene; German, Randall M.

2012-01-01

A multi-scale simulation concept taking into account impact of gravity on liquid phase sintering is described. The gravity influence can be included at both the micro- and macro-scales. At the micro-scale, the diffusion mass-transport is directionally modified in the framework of kinetic Monte-Carlo simulations to include the impact of gravity. The micro-scale simulations can provide the values of the constitutive parameters for macroscopic sintering simulations. At the macro-scale, we are attempting to embed a continuum model of sintering into a finite-element framework that includes the gravity forces and substrate friction. If successful, the finite elements analysis will enable predictions relevant to space-based processing, including size and shape and property predictions. Model experiments are underway to support the models via extraction of viscosity moduli versus composition, particle size, heating rate, temperature and time.

Time to rethink the role of the library in educating doctors: driving information literacy in the clinical environment.

PubMed

Simons, Mary R; Morgan, Michael Kerin; Davidson, Andrew Stewart

2012-10-01

Can information literacy (IL) be embedded into the curriculum and clinical environment to facilitate patient care and lifelong learning? The Australian School of Advanced Medicine (ASAM) provides competence-based programs incorporating patient-centred care and lifelong learning. ASAM librarians use outcomes-based educational theory to embed and assess IL into ASAM's educational and clinical environments. A competence-based IL program was developed where learning outcomes were linked to current patients and assessed with checklists. Weekly case presentations included clinicians' literature search strategies, results, and conclusions. Librarians provided support to clinicians' literature searches and assessed their presentations using a checklist. Outcome data showed clinicians' searching skills improved over time; however, advanced MEDLINE searching remained challenging for some. Recommendations are provided. IL learning that takes place in context using measurable outcomes is more meaningful, is enduring, and likely contributes to patient care. Competence-based assessment drives learning in this environment.

Integrating CLIPS applications into heterogeneous distributed systems

NASA Technical Reports Server (NTRS)

Adler, Richard M.

1991-01-01

SOCIAL is an advanced, object-oriented development tool for integrating intelligent and conventional applications across heterogeneous hardware and software platforms. SOCIAL defines a family of 'wrapper' objects called agents, which incorporate predefined capabilities for distributed communication and control. Developers embed applications within agents and establish interactions between distributed agents via non-intrusive message-based interfaces. This paper describes a predefined SOCIAL agent that is specialized for integrating C Language Integrated Production System (CLIPS)-based applications. The agent's high-level Application Programming Interface supports bidirectional flow of data, knowledge, and commands to other agents, enabling CLIPS applications to initiate interactions autonomously, and respond to requests and results from heterogeneous remote systems. The design and operation of CLIPS agents are illustrated with two distributed applications that integrate CLIPS-based expert systems with other intelligent systems for isolating and mapping problems in the Space Shuttle Launch Processing System at the NASA Kennedy Space Center.

Knowledge-Based Information Management in Decision Support for Ecosystem Management

Treesearch

Keith Reynolds; Micahel Saunders; Richard Olson; Daniel Schmoldt; Michael Foster; Donald Latham; Bruce Miller; John Steffenson; Lawrence Bednar; Patrick Cunningham

1995-01-01

The Pacific Northwest Research Station (USDA Forest Service) is developing a knowledge-based information management system to provide decision support for watershed analysis in the Pacific Northwest region of the U.S. The decision support system includes: (1) a GIS interface that allows users to graphically navigate to specific provinces and watersheds and display a...

Decision Support Systems Project. Design Review Conference, October 14-15, 1984. Summary Report of Findings.

ERIC Educational Resources Information Center

Tetlow, William L.

Findings of a conference that reviewed and evaluated design decisions concerning the Decision Support System (DSS) Demonstrator are summarized. The DSS Demonstrator was designed by the National Center for Higher Education Management Systems as an example of the way in which microcomputer technology can support and make more effective planning and…

Development of Asset Management Decision Support Tools for Power Equipment

NASA Astrophysics Data System (ADS)

Okamoto, Tatsuki; Takahashi, Tsuguhiro

Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

Learning Activity Predictors from Sensor Data: Algorithms, Evaluation, and Applications.

PubMed

Minor, Bryan; Doppa, Janardhan Rao; Cook, Diane J

2017-12-01

Recent progress in Internet of Things (IoT) platforms has allowed us to collect large amounts of sensing data. However, there are significant challenges in converting this large-scale sensing data into decisions for real-world applications. Motivated by applications like health monitoring and intervention and home automation we consider a novel problem called Activity Prediction , where the goal is to predict future activity occurrence times from sensor data. In this paper, we make three main contributions. First, we formulate and solve the activity prediction problem in the framework of imitation learning and reduce it to a simple regression learning problem. This approach allows us to leverage powerful regression learners that can reason about the relational structure of the problem with negligible computational overhead. Second, we present several metrics to evaluate activity predictors in the context of real-world applications. Third, we evaluate our approach using real sensor data collected from 24 smart home testbeds. We also embed the learned predictor into a mobile-device-based activity prompter and evaluate the app for 9 participants living in smart homes. Our results indicate that our activity predictor performs better than the baseline methods, and offers a simple approach for predicting activities from sensor data.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Applied Empiricism: Ensuring the Validity of Causal Response to Intervention Decisions

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Collier-Meek, Melissa A.; Johnson, Austin H.; Jaffery, Rose

2014-01-01

School personnel make a variety of decisions within multitiered problem-solving frameworks, including the decision to assign a student to group-based support, to design an individualized support plan, or classify a student as eligible for special education. Each decision is founded upon a judgment regarding whether the student has responded to…

Surface transportation weather decision support requirements : user needs and appendices : advanced-integrated decision support using weather information for surface transportation decision makers

DOT National Transportation Integrated Search

2000-01-24

The Federal Highway Administration (FHWA) of the U.S. Department of Transportation (USDOT) : has a responsibility to coordinate and promote projects that will bring the best information on weather to decision makers, in order to improve performance o...

Designing a Decision Support System (DSS) for Academic Library Managers Using Preprogrammed Application Software on a Microcomputer.

ERIC Educational Resources Information Center

McDonald, Joseph

1986-01-01

Focusing on management decisions in academic libraries, this article compares management information systems (MIS) with decision support systems (DSS) and discusses the decision-making process, information needs of library managers, sources of data, reasons for choosing microcomputer, preprogrammed application software, prototyping a system, and…

User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

ERIC Educational Resources Information Center

Hartley, Roger; Almuhaidib, Saud M. Y.

2007-01-01

Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

The Wildland Fire Decision Support System: Integrating science, technology, and fire management

Treesearch

Morgan Pence; Tom Zimmerman

2011-01-01

Federal agency policy requires documentation and analysis of all wildland fire response decisions. In the past, planning and decision documentation for fires were completed using multiple unconnected processes, yielding many limitations. In response, interagency fire management executives chartered the development of the Wildland Fire Decision Support System (WFDSS)....

Integrated Energy Solutions Research | Integrated Energy Solutions | NREL

Science.gov Websites

that spans the height and width of the wall they are facing. Decision Science and Informatics Enabling decision makers with rigorous, technology-neutral, data-backed decision support to maximize the impact of security in energy systems through analysis, decision support, advanced energy technology development, and

A Multi-criterial Decision Support System for Forest Management

Treesearch

Donald Nute; Geneho Kim; Walter D. Potter; Mark J. Twery; H. Michael Rauscher; Scott Thomasma; Deborah Bennett; Peter Kollasch

1999-01-01

We describe a research project that has as its goal development of a full-featured decision support system for managing forested land to satisfy multiple criteria represented as timber, wildlife, water, ecological, and wildlife objectives. The decision process proposed for what was originally conceived of as a Northeast Decision Model (NED) includes data acquisition,...

A knowledge-based decision support system for payload scheduling

NASA Technical Reports Server (NTRS)

Floyd, Stephen; Ford, Donnie

1988-01-01

The role that artificial intelligence/expert systems technologies play in the development and implementation of effective decision support systems is illustrated. A recently developed prototype system for supporting the scheduling of subsystems and payloads/experiments for NASA's Space Station program is presented and serves to highlight various concepts. The potential integration of knowledge based systems and decision support systems which has been proposed in several recent articles and presentations is illustrated.

Ergonomics action research II: a framework for integrating HF into work system design.

PubMed

Neumann, W P; Village, J

2012-01-01

This paper presents a conceptual framework that can support efforts to integrate human factors (HF) into the work system design process, where improved and cost-effective application of HF is possible. The framework advocates strategies of broad stakeholder participation, linking of performance and health goals, and process focussed change tools that can help practitioners engage in improvements to embed HF into a firm's work system design process. Recommended tools include business process mapping of the design process, implementing design criteria, using cognitive mapping to connect to managers' strategic goals, tactical use of training and adopting virtual HF (VHF) tools to support the integration effort. Consistent with organisational change research, the framework provides guidance but does not suggest a strict set of steps. This allows more adaptability for the practitioner who must navigate within a particular organisational context to secure support for embedding HF into the design process for improved operator wellbeing and system performance. There has been little scientific literature about how a practitioner might integrate HF into a company's work system design process. This paper proposes a framework for this effort by presenting a coherent conceptual framework, process tools, design tools and procedural advice that can be adapted for a target organisation.

Personal care workers in Australian aged care: retention and turnover intentions.

PubMed

Radford, Katrina; Shacklock, Kate; Bradley, Graham

2015-07-01

This study examined factors influencing personal care workers' intentions to stay or leave Australian aged care employment - especially for older workers. Retention of personal care workers is particularly important in aged care as they provide the majority of the direct care via community aged care or long-term aged care environments. However, there is limited research on what drives their turnover and retention. A survey was conducted during 2012 collecting 206 responses from workers within community and long-term aged care in four organisations in Australia. Perceived supervisor support, on-the-job embeddedness and area of employment were identified as predictors of both intention to stay and to leave, although the relationship strength differed. Community care workers were more likely to stay and reported more supervisor support than long-term care workers. Unexpectedly, age and health status were not predictors of staying or leaving. While there are similarities between retention and turnover motivators, there are also differences. Within a global context of health worker shortages, such new knowledge is keenly sought to enhance organisational effectiveness and sustain the provision of quality aged care. Retention strategies for older workers should involve increasing supervisor support, and seeking to embed workers more fully within their organisation. © 2013 John Wiley & Sons Ltd.

Leveraging Metadata to Create Interactive Images... Today!

NASA Astrophysics Data System (ADS)

Hurt, Robert L.; Squires, G. K.; Llamas, J.; Rosenthal, C.; Brinkworth, C.; Fay, J.

2011-01-01

The image gallery for NASA's Spitzer Space Telescope has been newly rebuilt to fully support the Astronomy Visualization Metadata (AVM) standard to create a new user experience both on the website and in other applications. We encapsulate all the key descriptive information for a public image, including color representations and astronomical and sky coordinates and make it accessible in a user-friendly form on the website, but also embed the same metadata within the image files themselves. Thus, images downloaded from the site will carry with them all their descriptive information. Real-world benefits include display of general metadata when such images are imported into image editing software (e.g. Photoshop) or image catalog software (e.g. iPhoto). More advanced support in Microsoft's WorldWide Telescope can open a tagged image after it has been downloaded and display it in its correct sky position, allowing comparison with observations from other observatories. An increasing number of software developers are implementing AVM support in applications and an online image archive for tagged images is under development at the Spitzer Science Center. Tagging images following the AVM offers ever-increasing benefits to public-friendly imagery in all its standard forms (JPEG, TIFF, PNG). The AVM standard is one part of the Virtual Astronomy Multimedia Project (VAMP); http://www.communicatingastronomy.org

Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

PubMed

Soban, Lynn M; Kim, Linda; Yuan, Anita H; Miltner, Rebecca S

2017-09-01

To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Dairy cow culling strategies: making economical culling decisions.

PubMed

Lehenbauer, T W; Oltjen, J W

1998-01-01

The purpose of this report was to examine important economic elements of culling decisions, to review progress in development of culling decision support systems, and to discern some of the potentially rewarding areas for future research on culling models. Culling decisions have an important influence on the economic performance of the dairy but are often made in a nonprogrammed fashion and based partly on the intuition of the decision maker. The computer technology that is available for dairy herd management has made feasible the use of economic models to support culling decisions. Financial components--including profit, cash flow, and risk--are major economic factors affecting culling decisions. Culling strategies are further influenced by short-term fluctuations in cow numbers as well as by planned herd expansion. Changes in herd size affect the opportunity cost for postponed replacement and may alter the relevance of optimization strategies that assume a fixed herd size. Improvements in model components related to biological factors affecting future cow performance, including milk production, reproductive status, and mastitis, appear to offer the greatest economic potential for enhancing culling decision support systems. The ultimate value of any culling decision support system for developing economic culling strategies will be determined by its results under field conditions.

Impact of vendor computerized physician order entry on patients with renal impairment in community hospitals.

PubMed

Leung, Alexander A; Schiff, Gordon; Keohane, Carol; Amato, Mary; Simon, Steven R; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan; Zimlichman, Eyal; Seger, Diane L; Yoon, Catherine; Bates, David W

2013-10-01

Adverse drug events (ADEs) are common among hospitalized patients with renal impairment. To determine whether computerized physician order entry (CPOE) systems with clinical decision support capabilities reduce the frequency of renally related ADEs in hospitals. Quasi-experimental study of 1590 adult patients with renal impairment who were admitted to 5 community hospitals in Massachusetts from January 2005 to September 2010, preimplementation and postimplementation of CPOE. Varying levels of clinical decision support, ranging from basic CPOE only (sites 4 and 5), rudimentary clinical decision support (sites 1 and 2), and advanced clinical decision support (site 3). Primary outcome was the rate of preventable ADEs from nephrotoxic and/or renally cleared medications. Similarly, secondary outcomes were the rates of overall ADEs and potential ADEs. There was a 45% decrease in the rate of preventable ADEs following implementation (8.0/100 vs 4.4/100 admissions; P < 0.01), and the impact was related to the level of decision support. Basic CPOE was not associated with any significant benefit (4.6/100 vs 4.3/100 admissions; P = 0.87). There was a nonsignificant decrease in preventable ADEs with rudimentary clinical decision support (9.1/100 vs 6.4/100 admissions; P = 0.22). However, substantial reduction was seen with advanced clinical decision support (12.4/100 vs 0/100 admissions; P = 0.01). Despite these benefits, a significant increase in potential ADEs was found for all systems (55.5/100 vs 136.8/100 admissions; P < 0.01). Vendor-developed CPOE with advanced clinical decision support can reduce the occurrence of preventable ADEs but may be associated with an increase in potential ADEs. © 2013 Society of Hospital Medicine.

Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support.

PubMed

Xia, Eryu; Liu, Haifeng; Li, Jing; Mei, Jing; Li, Xuejun; Xu, Enliang; Li, Xiang; Hu, Gang; Xie, Guotong; Xu, Meilin

2017-01-01

Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.

Decision support systems for robotic surgery and acute care

NASA Astrophysics Data System (ADS)

Kazanzides, Peter

2012-06-01

Doctors must frequently make decisions during medical treatment, whether in an acute care facility, such as an Intensive Care Unit (ICU), or in an operating room. These decisions rely on a various information sources, such as the patient's medical history, preoperative images, and general medical knowledge. Decision support systems can assist by facilitating access to this information when and where it is needed. This paper presents some research eorts that address the integration of information with clinical practice. The example systems include a clinical decision support system (CDSS) for pediatric traumatic brain injury, an augmented reality head- mounted display for neurosurgery, and an augmented reality telerobotic system for minimally-invasive surgery. While these are dierent systems and applications, they share the common theme of providing information to support clinical decisions and actions, whether the actions are performed with the surgeon's own hands or with robotic assistance.

Patient factors that influence clinicians' decision making in self-management support: A clinical vignette study.

PubMed

Bos-Touwen, Irene D; Trappenburg, Jaap C A; van der Wulp, Ineke; Schuurmans, Marieke J; de Wit, Niek J

2017-01-01

Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current decision making of health professionals can support future tailoring of self-management interventions. The aim of this study is to identify the relative importance of patient factors in health professionals' decision making regarding self-management support. A factorial survey was presented to primary care physicians and nurses. The survey consisted of clinical vignettes (case descriptions), in which 11 patient factors were systematically varied. Each care provider received a set of 12 vignettes. For each vignette, they decided whether they would give this patient self-management support and whether they expected this support to be successful. The associations between respondent decisions and patient factors were explored using ordered logit regression. The survey was completed by 60 general practitioners and 80 nurses. Self-management support was unlikely to be provided in a third of the vignettes. The most important patient factor in the decision to provide self-management support as well as in the expectation that self-management support would be successful was motivation, followed by patient-provider relationship and illness perception. Other factors, such as depression or anxiety, education level, self-efficacy and social support, had a small impact on decisions. Disease, disease severity, knowledge of disease, and age were relatively unimportant factors. This is the first study to explore the relative importance of patient factors in decision making and the expectations regarding the provision of self-management support to chronic disease patients. By far, the most important factor considered was patient's motivation; unmotivated patients were less likely to receive self-management support. Future tailored interventions should incorporate strategies to enhance motivation in unmotivated patients. Furthermore, care providers should be better equipped to promote motivational change in their patients.

Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.

PubMed

Dehlendorf, Christine; Fitzpatrick, Judith; Steinauer, Jody; Swiader, Lawrence; Grumbach, Kevin; Hall, Cara; Kuppermann, Miriam

2017-07-01

We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection. Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process. Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement. Our decision support tool appears acceptable to women in the family planning setting. Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

PubMed Central

Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

2018-01-01

ABSTRACT Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures. PMID:29405889

Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study.

PubMed

Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

2018-12-01

Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

Behavioral Economics: A New Lens for Understanding Genomic Decision Making.

PubMed

Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H

2018-05-01

This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.

Extending BPM Environments of Your Choice with Performance Related Decision Support

NASA Astrophysics Data System (ADS)

Fritzsche, Mathias; Picht, Michael; Gilani, Wasif; Spence, Ivor; Brown, John; Kilpatrick, Peter

What-if Simulations have been identified as one solution for business performance related decision support. Such support is especially useful in cases where it can be automatically generated out of Business Process Management (BPM) Environments from the existing business process models and performance parameters monitored from the executed business process instances. Currently, some of the available BPM Environments offer basic-level performance prediction capabilities. However, these functionalities are normally too limited to be generally useful for performance related decision support at business process level. In this paper, an approach is presented which allows the non-intrusive integration of sophisticated tooling for what-if simulations, analytic performance prediction tools, process optimizations or a combination of such solutions into already existing BPM environments. The approach abstracts from process modelling techniques which enable automatic decision support spanning processes across numerous BPM Environments. For instance, this enables end-to-end decision support for composite processes modelled with the Business Process Modelling Notation (BPMN) on top of existing Enterprise Resource Planning (ERP) processes modelled with proprietary languages.

Interprofessional education about patient decision support in specialty care.

PubMed

Politi, Mary C; Pieterse, Arwen H; Truant, Tracy; Borkhoff, Cornelia; Jha, Vikram; Kuhl, Laura; Nicolai, Jennifer; Goss, Claudia

2011-11-01

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care - aimed at providing continuous, comprehensive care - specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients' care. Interprofessional care involves multiple professionals from different disciplines collaborating to provide an integrated approach to patient care. For patients to experience continuity of care across interprofessional providers, providers need to communicate and maintain a shared sense of responsibility to their patients. In this article, we describe challenges inherent in providing interprofessional patient decision support in specialty care. We propose ways for providers to engage in interprofessional decision support and discuss promising approaches to teaching an interprofessional decision support to specialty care providers. Additional evaluation and empirical research are required before further recommendations can be made about education for interprofessional decision support in specialty care.

Research of Simple Multi-Attribute Rating Technique for Decision Support

NASA Astrophysics Data System (ADS)

Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi

2017-12-01

One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).

Shared decision-making and decision support: their role in obstetrics and gynecology.

PubMed

Tucker Edmonds, Brownsyne

2014-12-01

To discuss the role for shared decision-making in obstetrics/gynecology and to review evidence on the impact of decision aids on reproductive health decision-making. Among the 155 studies included in a 2014 Cochrane review of decision aids, 31 (29%) addressed reproductive health decisions. Although the majority did not show evidence of an effect on treatment choice, there was a greater uptake of mammography in selected groups of women exposed to decision aids compared with usual care; and a statistically significant reduction in the uptake of hormone replacement therapy among detailed decision aid users compared with simple decision aid users. Studies also found an effect on patient-centered outcomes of care, such as medication adherence, quality-of-life measures, and anxiety scores. In maternity care, only decision analysis tools affected final treatment choice, and patient-directed aids yielded no difference in planned mode of birth after cesarean. There is untapped potential for obstetricians/gynecologists to optimize decision support for reproductive health decisions. Given the limited evidence-base guiding practice, the preference-sensitive nature of reproductive health decisions, and the increase in policy efforts and financial incentives to optimize patients' satisfaction, it is increasingly important for obstetricians/gynecologists to appreciate the role of shared decision-making and decision support in providing patient-centered reproductive healthcare.

"Many miles to go …": a systematic review of the implementation of patient decision support interventions into routine clinical practice.

PubMed

Elwyn, Glyn; Scholl, Isabelle; Tietbohl, Caroline; Mann, Mala; Edwards, Adrian G K; Clay, Catharine; Légaré, France; van der Weijden, Trudy; Lewis, Carmen L; Wexler, Richard M; Frosch, Dominick L

2013-01-01

Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings. An electronic search strategy was devised and adapted for the following databases: ASSIA, CINAHL, Embase, HMIC, Medline, Medline-in-process, OpenSIGLE, PsycINFO, Scopus, Social Services Abstracts, and the Web of Science. In addition, we used snowballing techniques. Studies were included after dual independent assessment. After assessment, 5322 abstracts yielded 51 articles for consideration. After examining full-texts, 17 studies were included and subjected to data extraction. The approach used in all studies was one where clinicians and their staff used a referral model, asking eligible patients to use decision support. The results point to significant challenges to the implementation of patient decision support using this model, including indifference on the part of health care professionals. This indifference stemmed from a reported lack of confidence in the content of decision support interventions and concern about disruption to established workflows, ultimately contributing to organizational inertia regarding their adoption. It seems too early to make firm recommendations about how best to implement patient decision support into routine practice because approaches that use a 'referral model' consistently report difficulties. We sense that the underlying issues that militate against the use of patient decision support and, more generally, limit the adoption of shared decision making, are under-investigated and under-specified. Future reports from implementation studies could be improved by following guidelines, for example the SQUIRE proposals, and by adopting methods that would be able to go beyond the 'barriers' and 'facilitators' approach to understand more about the nature of professional and organizational resistance to these tools. The lack of incentives that reward the use of these interventions needs to be considered as a significant impediment.

“Many miles to go …”: a systematic review of the implementation of patient decision support interventions into routine clinical practice

PubMed Central

2013-01-01

Background Two decades of research has established the positive effect of using patient-targeted decision support interventions: patients gain knowledge, greater understanding of probabilities and increased confidence in decisions. Yet, despite their efficacy, the effectiveness of these decision support interventions in routine practice has yet to be established; widespread adoption has not occurred. The aim of this review was to search for and analyze the findings of published peer-reviewed studies that investigated the success levels of strategies or methods where attempts were made to implement patient-targeted decision support interventions into routine clinical settings. Methods An electronic search strategy was devised and adapted for the following databases: ASSIA, CINAHL, Embase, HMIC, Medline, Medline-in-process, OpenSIGLE, PsycINFO, Scopus, Social Services Abstracts, and the Web of Science. In addition, we used snowballing techniques. Studies were included after dual independent assessment. Results After assessment, 5322 abstracts yielded 51 articles for consideration. After examining full-texts, 17 studies were included and subjected to data extraction. The approach used in all studies was one where clinicians and their staff used a referral model, asking eligible patients to use decision support. The results point to significant challenges to the implementation of patient decision support using this model, including indifference on the part of health care professionals. This indifference stemmed from a reported lack of confidence in the content of decision support interventions and concern about disruption to established workflows, ultimately contributing to organizational inertia regarding their adoption. Conclusions It seems too early to make firm recommendations about how best to implement patient decision support into routine practice because approaches that use a ‘referral model’ consistently report difficulties. We sense that the underlying issues that militate against the use of patient decision support and, more generally, limit the adoption of shared decision making, are under-investigated and under-specified. Future reports from implementation studies could be improved by following guidelines, for example the SQUIRE proposals, and by adopting methods that would be able to go beyond the ‘barriers’ and ‘facilitators’ approach to understand more about the nature of professional and organizational resistance to these tools. The lack of incentives that reward the use of these interventions needs to be considered as a significant impediment. PMID:24625083

Inhibition of Glutathione Biosynthesis Alters Compartmental Redox Status and the Thiol Proteome in Organogenesis-Stage Rat Conceptuses

PubMed Central

Harris, Craig; Shuster, Daniel Z.; Gomez, Rosaicela Roman; Sant, Karilyn E.; Reed, Matthew S.; Pohl, Jan; Hansen, Jason M.

2013-01-01

Developmental signals that control growth and differentiation are regulated by environmental factors that generate reactive oxygen species (ROS) and alter steady state redox environments in tissues and fluids. Protein thiols are selectively oxidized and reduced in distinct spatial and temporal patterns in conjunction with changes in glutathione/glutathione disulfide (GSH/GSSG) and cysteine/cystine (Cys/CySS) redox potentials (E0) to regulate developmental signaling. The purpose of this study was to measure compartment specific thiol redox status in cultured organogenesis-stage rat conceptuses and to evaluate the impact of thiol oxidation on the redox proteome. The visceral yolk sac (VYS) has the highest initial (0 hr) total intracellular GSH (GSH + 2GSSG) concentrations (5.5 mM) and the lowest Eh (−223 mV) as determined by HPLC analysis. Total embryo (EMB) GSH concentrations ranged lower (3.2 mM) and were only slightly more oxidized than the VYS. Total GSH concentrations in yolk sac fluid (YSF) and amniotic fluid (AF) are >500-fold lower than in tissues and are highly oxidized (YSF Eh = −121 mV and AF Eh = −49 mV). Steady state total Cys concentrations (Cys + 2CySS) were significantly lower than GSH in tissues but were otherwise equal in VYS and EMB near 0.5 mM. On gestational day 11, total GSH and Cys concentrations in EMB and VYS increase significantly over the 6 hr time course while Eh remains relatively constant. The Eh (GSH/GSSG) in YSF and AF become more reduced over time while Eh (Cys/CySS) become more oxidized. Addition of L-buthionine-S,R-sulfoximine (BS0) to selectively inhibit GSH synthesis and mimic the effects of some GSH-depleting environmental chemicals, significantly decreased VYS and EMB GSH and cys concentrations and increased Eh over the 6 hr exposure period, showing a greater overall oxidation. In the YSF, BSO caused a significant increase in total Cys concentrations to 1.7 mM but did not significantly change the Eh for Cys/CySS. A significant net oxidation was seen in the BSO-treated AF compartment after 6 hr. Biotinylated iodoacetamide (BIAM) labeling of proteins revealed the significant thiol-oxidation of many EMB proteins following BSO treatment. Quantitative changes in the thiol proteome, associated with developmentally-relevant pathways, were detected using isotope coded affinity tag (ICAT) labeling and mass spectroscopy. Adaptive pathways were selectively enriched with increased concentrations of proteins involved in mRNA processing (splicesome) and mRNA stabilization (glycolysis, GAPDH), as well as, protein synthesis (aminoacyl-tRNA) and protein folding (antigen processing, Hsp70, protein disulfide isomerase). These results show the ability of chemical and environmental modulators to selectively alter compartmental intracellular and extracellular GSH and Cys concentrations and change their corresponding Eh within the intact viable conceptus. The altered Eh were also of sufficient magnitude to alter the redox proteome and change relative protein concentrations suggesting that the mechanistic links through which environmental factors inform and regulate developmental signaling pathways may be discovered using systems developmental biology techniques. PMID:23736079

Inhibition of glutathione biosynthesis alters compartmental redox status and the thiol proteome in organogenesis-stage rat conceptuses.

PubMed

Harris, Craig; Shuster, Daniel Z; Roman Gomez, Rosaicela; Sant, Karilyn E; Reed, Matthew S; Pohl, Jan; Hansen, Jason M

2013-10-01

Developmental signals that control growth and differentiation are regulated by environmental factors that generate reactive oxygen species (ROS) and alter steady-state redox environments in tissues and fluids. Protein thiols are selectively oxidized and reduced in distinct spatial and temporal patterns in conjunction with changes in glutathione/glutathione disulfide (GSH/GSSG) and cysteine/cystine (Cys/CySS) redox potentials (E(h)) to regulate developmental signaling. The purpose of this study was to measure compartment-specific thiol redox status in cultured organogenesis-stage rat conceptuses and to evaluate the impact of thiol oxidation on the redox proteome. The visceral yolk sac (VYS) has the highest initial (0 h) total intracellular GSH (GSH+2GSSG) concentration (5.5 mM) and the lowest Eh (-223 mV) as determined by HPLC analysis. Total embryo (EMB) GSH concentrations ranged lower (3.2 mM) and were only slightly more oxidized than the VYS. Total GSH concentrations in yolk sac fluid (YSF) and amniotic fluid (AF) are >500-fold lower than in tissues and are highly oxidized (YSF E(h)=-121 mV and AF E(h)=-49 mV). Steady-state total Cys concentrations (Cys+2CySS) were significantly lower than GSH in tissues but were otherwise equal in VYS and EMB near 0.5 mM. On gestational day 11, total GSH and Cys concentrations in EMB and VYS increase significantly over the 6h time course while E(h) remains relatively constant. The Eh (GSH/GSSG) in YSF and AF become more reduced over time while E(h) (Cys/CySS) become more oxidized. Addition of L-buthionine-S,R-sulfoximine (BS0) to selectively inhibit GSH synthesis and mimic the effects of some GSH-depleting environmental chemicals significantly decreased VYS and EMB GSH and Cys concentrations and increased Eh over the 6h exposure period, showing a greater overall oxidation. In the YSF, BSO caused a significant increase in total Cys concentrations to 1.7 mM but did not significantly change the E(h) for Cys/CySS. A significant net oxidation was seen in the BSO-treated AF compartment after 6 h. Biotinylated iodoacetamide (BIAM) labeling of proteins revealed the significant thiol oxidation of many EMB proteins following BSO treatment. Quantitative changes in the thiol proteome, associated with developmentally relevant pathways, were detected using isotope coded affinity tag (ICAT) labeling and mass spectroscopy. Adaptive pathways were selectively enriched with increased concentrations of proteins involved in mRNA processing (splicesome) and mRNA stabilization (glycolysis, GAPDH), as well as protein synthesis (aminoacyl-tRNA) and protein folding (antigen processing, Hsp70, protein disulfide isomerase). These results show the ability of chemical and environmental modulators to selectively alter compartmental intracellular and extracellular GSH and Cys concentrations and change their corresponding E(h) within the intact viable conceptus. The altered E(h) were also of sufficient magnitude to alter the redox proteome and change relative protein concentrations, suggesting that the mechanistic links through which environmental factors inform and regulate developmental signaling pathways may be discovered using systems developmental biology techniques. Copyright © 2013 Elsevier Inc. All rights reserved.

NASA E-DECIDER Rapid Disaster Decision Support Products

NASA Image and Video Library

2014-09-03

A NASA-funded disaster decision support system, provided a number of rapid response map data products to decision makers at the California Earthquake Clearinghouse following its activation for the Aug. 24, 2014 magnitude 6.0 earthquake in Napa, California

Decision support tools to support the operations of traffic management centers (TMC)

DOT National Transportation Integrated Search

2011-01-31

The goal of this project is to develop decision support tools to support traffic management operations based on collected intelligent transportation system (ITS) data. The project developments are in accordance with the needs of traffic management ce...

Decision support for the integrated restoration and protection strategy of the Forest Service, Northern Region

Treesearch

Keith Reynolds; Barry Bollenbacher; Chip Fisher; Melissa Hart; Mary Manning; Eric Henderson; Bruce Sims

2016-01-01

This report documents a decision-support process developed in the U.S. Department of Agriculture, Forest Service, Northern Region to assess management opportunities as part of an ecosystem-based approach to management that emphasizes ecological resilience. The decision-support system described in this work implements what is known as the Integrated Restoration and...

System for selecting relevant information for decision support.

PubMed

Kalina, Jan; Seidl, Libor; Zvára, Karel; Grünfeldová, Hana; Slovák, Dalibor; Zvárová, Jana

2013-01-01

We implemented a prototype of a decision support system called SIR which has a form of a web-based classification service for diagnostic decision support. The system has the ability to select the most relevant variables and to learn a classification rule, which is guaranteed to be suitable also for high-dimensional measurements. The classification system can be useful for clinicians in primary care to support their decision-making tasks with relevant information extracted from any available clinical study. The implemented prototype was tested on a sample of patients in a cardiological study and performs an information extraction from a high-dimensional set containing both clinical and gene expression data.

Grand Challenges in Clinical Decision Support v10

PubMed Central

Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

2008-01-01

There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232

A medical informatics perspective on clinical decision support systems. Findings from the yearbook 2013 section on decision support.

PubMed

Bouaud, J; Lamy, J-B

2013-01-01

To summarize excellent research and to select best papers published in 2012 in the field of computer-based decision support in healthcare. A bibliographic search focused on clinical decision support systems (CDSSs) and computer provider order entry was performed, followed by a double-blind literature review. The review process yielded six papers, illustrating various aspects of clinical decision support. The first paper is a systematic review of CDSS intervention trials in real settings, and considers different types of possible outcomes. It emphasizes the heterogeneity of studies and confirms that CDSSs can improve process measures but that evidence lacks for other types of outcomes, especially clinical or economic. Four other papers tackle the safety of drug prescribing and show that CDSSs can be efficient in reducing prescription errors. The sixth paper exemplifies the growing role of ontological resources which can be used for several applications including decision support. CDSS research has to be continuously developed and assessed. The wide variety of systems and of interventions limits the understanding of factors of success of CDSS implementations. A standardization in the characterization of CDSSs and of intervention trial reporting will help to overcome this obstacle.

Science Immersion

ERIC Educational Resources Information Center

Burgin, Stephen R.; Sadler, Troy D.

2013-01-01

This article describes summer programs that allow high school students to participate in an "authentic scientific research experience" (ASRE). These summer programs are specifically designed to embed students in working laboratories and research groups. Summer ASRE programs for secondary learners range in length from a couple of weeks to…

Alaska Department of Transportation and Public Facilities, Arizona Department of Transportation : research programs peer exchange, October 31 - November 2, 2011.

DOT National Transportation Integrated Search

2011-10-01

The objectives of the peer exchange were to explore and identify: : Effective research advisory council structures : Strategic research topic/focus areas : Effective research project selection practices : Effective strategies to embed...

Sustainability in Chemical Engineering Curriculum

ERIC Educational Resources Information Center

Glassey, Jarka; Haile, Sue

2012-01-01

Purpose: The purpose of this paper is to describe a concentrated strategy to embed sustainability teaching into a (chemical) engineering undergraduate curriculum throughout the whole programme. Innovative teaching approaches in subject-specific context are described and their efficiency investigated. Design/methodology/approach: The activities in…

Purpose, Mission, and Context: The Call for Educating Future Leaders

ERIC Educational Resources Information Center

Chunoo, Vivechkanand; Osteen, Laura

2016-01-01

This chapter calls on higher education to reclaim its role in leadership education. Specifically it examines higher education's purpose, context, and mission as clarion calls to embed leadership education throughout higher education institutions and focuses on why this is important.

The Art of Reviewing Science Journals

ERIC Educational Resources Information Center

Shepardson, Daniel P.; Britsch, Susan Jane

2004-01-01

Science journals are wonderful tools. They offer a glimpse into children's science understandings, and they are both diagnostic and pedagogically informative to teachers. Examining and reflecting on children's journal work lets teachers embed assessment in curriculum and instruction; however, effectively analyzing children's journal writing and…

HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: JOURNAL ARTICLE

EPA Science Inventory

NRMRL-CIN-1351 Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. Risk Analysis 600/R/01/104, Available: on internet, www.epa.gov/ORD/NRMRL/Pubs/600R01104, [NET]. 03/07/2001 D...

Decision Support Framework (DSF) For Evaluating Planned Land And Resource Use Decisions: Hypothetical Application Of The DSF To Address Nutrient Loads In The Florida Keys

EPA Science Inventory

The mission of ORD's Ecosystme Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

A Synthesis Of Knowledge About Caregiver Decision Making Finds Gaps In Support For Those Who Care For Aging Loved Ones.

PubMed

Garvelink, Mirjam M; Ngangue, Patrice A G; Adekpedjou, Rheda; Diouf, Ndeye T; Goh, Larissa; Blair, Louisa; Légaré, France

2016-04-01

We conducted a mixed-methods knowledge synthesis to assess the effectiveness of interventions to improve caregivers' involvement in decision making with seniors, and to describe caregivers' experiences of decision making in the absence of interventions. We analyzed forty-nine qualitative, fourteen quantitative, and three mixed-methods studies. The qualitative studies indicated that caregivers had unmet needs for information, discussions of values and needs, and decision support, which led to negative sentiments after decision making. Our results indicate that there have been insufficient quantitative evaluations of interventions to involve caregivers in decision making with seniors and that the evaluations that do exist found few clinically significant effects. Elements of usual care that received positive evaluations were the availability of a decision coach and a supportive decision-making environment. Additional rigorously evaluated interventions are needed to help caregivers be more involved in decision making with seniors. Project HOPE—The People-to-People Health Foundation, Inc.

Safety and efficacy of the switch to generic mycophenolate mofetil and tacrolimus in heart transplant patients.

PubMed

Söderlund, Carl; Rådegran, Göran

2015-07-01

Generic immunosuppressants may offer economic advantages, but their use is still controversial. At our center, 55 heart transplant patients were switched from CellCept(®) to Myfenax Teva(®) (MT) (n = 51, 18% female, 8.1 ± 6.6 yr post-transplantation) and/or Prograf(®) to Tacrolimus Sandoz(®) (TS) (n = 17, 41% female, 6.6 ± 5.8 yr post-transplantation). We conducted an acute monitoring and a retrospective follow-up with regard to safety and efficacy. Acute cellular rejections (ACRs) on endomyocardial biopsies (EMBs) four wk after the MT switch were specifically compared to a matched retrospective control group. Tacrolimus C0 levels (TS switch) as well as hemoglobin, leukocytes, and thrombocytes (MT switch) did not change (p = NS) during the three wk after each respective switch (8.7 ± 2.9 vs. 8.4 ± 1.9 μg/L, 129.1 ± 12.6 vs. 130.1 ± 12.8 g/L, 6.3 vs. 6.2 × 10(9) /L, and 217.4 ± 56.6 vs. 219.3 ± 61.8 × 10(9) /L, respectively). 0% of the EMBs in the MT switch vs. 3% of the EMBs in the control group showed ACR>grade 1R (p = NS). After six months, survival was 96% (MT switch) and 100% (TS switch), and the frequency of severe ACR was low. Safety parameters measured at the next annual follow-up were also stable following each switch. Switching to MT and/or TS several years after heart transplantation appeared safe in the short-term perspective, showing no detectable changes in tacrolimus C0 levels, safety or efficacy, during an average follow-up of six months. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence of sleep apnoea and capnographic detection of nocturnal hypoventilation in amyotrophic lateral sclerosis.

PubMed

Boentert, Matthias; Glatz, Christian; Helmle, Cornelia; Okegwo, Angelika; Young, Peter

2018-04-01

This retrospective study aimed to investigate whether overnight oxymetry and early morning blood gas analysis predict nocturnal hypoventilation (NH) as reflected by night-time hypercapnia in patients with amyotrophic lateral sclerosis (ALS). In addition, prevalence and clinical determinants of sleep apnoea in ALS were evaluated. In 250 patients with non-ventilated ALS, transcutaneous capnometry was performed along with polysomnography or polygraphy and early morning blood gases. 123 patients were female, and 84 patients had bulbar-onset ALS. 40.0% showed NH, and an apnoea-hypopnoea index (AHI) >5/hour was found in 45.6%. In 22.3%, sleep apnoea and NH coincided. The obstructive apnoea index was significantly higher than the central apnoea index (p<0.0001). Both NH and sleep apnoea were significantly more common in male than in female patients. Sleep apnoea and AHI were associated with better bulbar function. Desaturation time (t <90% ) and transcutaneous CO 2 were negatively correlated with upright vital capacity. Early morning base excess (EMBE), bicarbonate and t <90% were independent predictors of NH. However, among 100 patients with NH, 31 were missed by t <90% >5 min and 17 were not identified when EMBE >3 mmol/L and t <90% >5 min were combined. In ALS, sleep apnoea is common and often accompanies NH. It is mainly obstructive, and central apnoea appears to be clinically irrelevant. Polygraphy or oxymetry alone are not sufficient to uncover NH. Combination of EMBE and t <90% may increase sensitivity, but transcutaneous capnography is strongly recommended for reliable detection of NH in patients with ALS. © 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.