Sample records for fire email alerts

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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 Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database.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

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  3. Advantages and Disadvantages of Educational Email Alerts for Family Physicians: Viewpoint

    PubMed Central

    Badran, Hani; Grad, Roland

    2015-01-01

    Background Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. Objective The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians’ knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants’ suggestions to improve email alert services for CME. Methods We conducted a qualitative descriptive study using the “Knowledge, Attitude, Behavior” model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. Results All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. Conclusions The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts. PMID:25803184

  4. Advantages and disadvantages of educational email alerts for family physicians: viewpoint.

    PubMed

    Badran, Hani; Pluye, Pierre; Grad, Roland

    2015-02-27

    Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians' knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants' suggestions to improve email alert services for CME. We conducted a qualitative descriptive study using the "Knowledge, Attitude, Behavior" model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts.

  5. Monitoring Fires from Space and Getting Data in to the hands of Users: An Example from NASA's Fire Information for Resource Management System (FIRMS)

    NASA Astrophysics Data System (ADS)

    Davies, D.; Wong, M.; Ilavajhala, S.; Molinario, G.; Justice, C. O.

    2012-12-01

    This paper discusses the broad uptake of MODIS near-real-time (NRT) active fire data for applications. Prior to the launch of MODIS most real-time satellite-derived fire information was obtained from NOAA AVHRR via direct broadcast (DB) systems. Whilst there were efforts to make direct broadcast stations affordable in developing countries, such as through the Local Applications of Satellite Remote Technologies (LARST), these systems were relatively few and far between and required expertise to manage and operate. One such system was in Etosha National Park (ENP) in Namibia. Prior to the installation of the AVHRR DB system in ENP, fires were reported by rangers and the quality, accuracy and timing of reports was variable. With the introduction of the DB station, early warning of fires improved and fire maps could be produced for park managers within 2-3 hours by staff trained to process data, interpret images and produce maps. Up keep and maintenance of such systems was relatively costly for parks with limited resources therefore when global fire data from MODIS became available uptake was widespread. NRT data from MODIS became availalbe through a collaboration between the MODIS Fire Team and the US Forest Service (USFS) Remote Sensing Applications Center to provide rapid access to imagery to help fight the Montana wildfires of 2001. This prompted the development of a Rapid Response System for fire data that eventually led to the operational use of MODIS data by the USFS for fire monitoring. Building on this success, the Fire Information for Resource Management System (FIRMS) project was funded by NASA Applications, and developed under the umbrella of the GOFC-GOLD Fire program, to further improve products and services for the global fire information community. FIRMS was developed as a web-based geospatial tool, offering a range of geospatial data services, including a fire email alert service which is widely used around the world. FIRMS was initially developed to meet the needs of protected area managers, who like the managers in ENP had limited resources to cover large, remote areas. It was quickly realized that these data could be used for a wide range of applications beyond wildfire management including ecological studies, informing fire policy and public outreach. Today, FIRMS sends approximately 2000 email alerts daily to users in over 120 countries. In addition to the direct users of the MODIS fire data, there are a growing number of brokers who add value to the data, by combining them with targeted geospatial information and re-distribute the information. In addition to the English, French and Spanish fire notifications sent out by FIRMS, some brokers translate the alerts in to local languages and distribute them in Thailand, Indonesia, Russia and India.

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

    PubMed

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

    2017-11-01

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

  7. Hemochromatosis

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  8. Bronchiectasis

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  9. Tracheostomy

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  10. Palpitations

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  11. Thalassemias

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  12. Cardioversion

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  13. Lung Transplant

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  14. Carotid Endarterectomy

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  15. Pulmonary Embolism

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  16. Pernicious Anemia

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  17. Catheter Ablation

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  18. Immune Thrombocytopenia

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  19. Chest MRI

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  20. Cardiac Rehabilitation

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  1. Cardiac MRI

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  2. Oxygen Therapy

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  3. Automated External Defibrillator

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  4. Thrombocythemia and Thrombocytosis

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  5. von Willebrand Disease

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  6. Chest X-Ray

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  7. What Is Cardiomyopathy?

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  8. Long QT Syndrome

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  9. Percutaneous Coronary Intervention

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  10. What is Hemophilia?

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  11. Thrombotic Thrombocytopenic Purpura

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  12. What Is Anemia?

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  13. Cardiac CT Scan

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  14. Coronary Calcium Scan

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  15. Patent Ductus Arteriosus

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  16. What is Bronchoscopy?

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  17. Holter and Event Monitors

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  18. What Is Heart Failure?

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  19. What Is Bronchopulmonary Dysplasia?

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  20. What Is Cardiac Catheterization?

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  1. What Is a Ventilator?

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  2. What Are Sleep Studies?

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  3. What Are the Lungs?

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  4. What Is Sudden Cardiac Arrest?

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  5. Blood and Bone Marrow Transplant?

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  6. What Is Respiratory Distress Syndrome?

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  7. What Is a Heart Transplant?

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  8. What is Broken Heart Syndrome

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  9. ARDS (Acute Respiratory Distress Syndrome)

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  10. What Are Bone Marrow Tests?

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  11. Remote monitoring of a Fire Protection System

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  12. What Is a Total Artificial Heart?

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  13. What Is a Ventricular Assist Device?

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  14. Aspirin to Prevent a First Heart Attack or Stroke

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  15. Advanced Fire Information System - A real time fire information system for Africa

    NASA Astrophysics Data System (ADS)

    Frost, P. E.; Roy, D. P.

    2012-12-01

    The Council for Scientific and Industrial Research (CSIR) lead by the Meraka Institute and supported by the South African National Space Agency (SANSA) developed the Advanced Fire Information System (AFIS) to provide near real time fire information to a variety of operational and science fire users including disaster managers, fire fighters, farmers and forest managers located across Southern and Eastern Africa. The AFIS combines satellite data with ground based observations and statistics and distributes the information via mobile phone technology. The system was launched in 2004, and Eskom (South Africa' and Africa's largest power utility) quickly became the biggest user and today more than 300 Eskom line managers and support staff receive cell phone and email fire alert messages whenever a wildfire is within 2km of any of the 28 000km of Eskom electricity transmission lines. The AFIS uses Earth observation satellites from NASA and Europe to detect possible actively burning fires and their fire radiative power (FRP). The polar orbiting MODIS Terra and Aqua satellites provide data at around 10am, 15pm, 22am and 3am daily, while the European Geostationary MSG satellite provides 15 minute updates at lower spatial resolution. The AFIS processing system ingests the raw satellite data and within minutes of the satellite overpass generates fire location and FRP based fire intensity information. The AFIS and new functionality are presented including an incident report and permiting system that can be used to differentiate between prescribed burns and uncontrolled wild fires, and the provision of other information including 5-day fire danger forecasts, vegetation curing information and historical burned area maps. A new AFIS mobile application for IOS and Android devices as well as a fire reporting tool are showcased that enable both the dissemination and alerting of fire information and enable user upload of geo tagged photographs and on the fly creation of fire reports for user defined areas of interest.

  16. Do Family Physicians Retrieve Synopses of Clinical Research Previously Read as Email Alerts?

    PubMed Central

    Pluye, Pierre; Johnson-Lafleur, Janique; Granikov, Vera; Shulha, Michael; Bartlett, Gillian; Marlow, Bernard

    2011-01-01

    Background A synopsis of new clinical research highlights important aspects of one study in a brief structured format. When delivered as email alerts, synopses enable clinicians to become aware of new developments relevant for practice. Once read, a synopsis can become a known item of clinical information. In time-pressured situations, remembering a known item may facilitate information retrieval by the clinician. However, exactly how synopses first delivered as email alerts influence retrieval at some later time is not known. Objectives We examined searches for clinical information in which a synopsis previously read as an email alert was retrieved (defined as a dyad). Our study objectives were to (1) examine whether family physicians retrieved synopses they previously read as email alerts and then to (2) explore whether family physicians purposefully retrieved these synopses. Methods We conducted a mixed-methods study in which a qualitative multiple case study explored the retrieval of email alerts within a prospective longitudinal cohort of practicing family physicians. Reading of research-based synopses was tracked in two contexts: (1) push, meaning to read on email and (2) pull, meaning to read after retrieval from one electronic knowledge resource. Dyads, defined as synopses first read as email alerts and subsequently retrieved in a search of a knowledge resource, were prospectively identified. Participants were interviewed about all of their dyads. Outcomes were the total number of dyads and their type. Results Over a period of 341 days, 194 unique synopses delivered to 41 participants resulted in 4937 synopsis readings. In all, 1205 synopses were retrieved over an average of 320 days. Of the 1205 retrieved synopses, 21 (1.7%) were dyads made by 17 family physicians. Of the 1205 retrieved synopses, 6 (0.5%) were known item type dyads. However, dyads also occurred serendipitously. Conclusion In the single knowledge resource we studied, email alerts containing research-based synopses were rarely retrieved. Our findings help us to better understand the effect of push on pull and to improve the integration of research-based information within electronic resources for clinicians. PMID:22130465

  17. Do family physicians retrieve synopses of clinical research previously read as email alerts?

    PubMed

    Grad, Roland; Pluye, Pierre; Johnson-Lafleur, Janique; Granikov, Vera; Shulha, Michael; Bartlett, Gillian; Marlow, Bernard

    2011-11-30

    A synopsis of new clinical research highlights important aspects of one study in a brief structured format. When delivered as email alerts, synopses enable clinicians to become aware of new developments relevant for practice. Once read, a synopsis can become a known item of clinical information. In time-pressured situations, remembering a known item may facilitate information retrieval by the clinician. However, exactly how synopses first delivered as email alerts influence retrieval at some later time is not known. We examined searches for clinical information in which a synopsis previously read as an email alert was retrieved (defined as a dyad). Our study objectives were to (1) examine whether family physicians retrieved synopses they previously read as email alerts and then to (2) explore whether family physicians purposefully retrieved these synopses. We conducted a mixed-methods study in which a qualitative multiple case study explored the retrieval of email alerts within a prospective longitudinal cohort of practicing family physicians. Reading of research-based synopses was tracked in two contexts: (1) push, meaning to read on email and (2) pull, meaning to read after retrieval from one electronic knowledge resource. Dyads, defined as synopses first read as email alerts and subsequently retrieved in a search of a knowledge resource, were prospectively identified. Participants were interviewed about all of their dyads. Outcomes were the total number of dyads and their type. Over a period of 341 days, 194 unique synopses delivered to 41 participants resulted in 4937 synopsis readings. In all, 1205 synopses were retrieved over an average of 320 days. Of the 1205 retrieved synopses, 21 (1.7%) were dyads made by 17 family physicians. Of the 1205 retrieved synopses, 6 (0.5%) were known item type dyads. However, dyads also occurred serendipitously. In the single knowledge resource we studied, email alerts containing research-based synopses were rarely retrieved. Our findings help us to better understand the effect of push on pull and to improve the integration of research-based information within electronic resources for clinicians.

  18. PubMedAlertMe - Standalone Windows-based PubMed SDI Software Application

    PubMed Central

    Ma’ayan, Avi

    2008-01-01

    PubMedAlertMe is a Windows-based software system for automatically receiving e-mail alert messages about recent publications listed on PubMed. The e-mail messages contain links to newly available abstracts listed on PubMed describing publications that were selectively returned from a specified list of queries. Links are also provided to directly export citations to EndNote, and links are provided to directly forward articles to colleagues. The program is standalone. Thus, it does not require a remote mail server or user registration. PubMedAlertMe is free software, and can be downloaded from: http://amp.pharm.mssm.edu/PubMedAlertMe/PubMedAlertMe_setup.zip PMID:18402930

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

    NASA Technical Reports Server (NTRS)

    Burian, Barbara K.

    2015-01-01

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

  20. MODIS Near real-time (NRT) data for fire applications

    NASA Astrophysics Data System (ADS)

    Wong, M.; Davies, D.; Ilavajhala, S.; Molinario, G.; Justice, C.; Latham, J.; Martucci, A.; Murphy, K. J.

    2011-12-01

    This paper describes the lessons learned from the development of the Fire Information for Resource Management System (FIRMS) prototype and its transition to an operational system, the Global Fire Information Management System (GFIMS), at the United Nations Food and Agriculture Organization (FAO) in August 2010. These systems provide active fire data from the MODIS sensor, on board NASA's Terra and Aqua Earth Observing Satellites, to users at no cost, in near-real time and in easy-to-use formats. The FIRMS prototype evolved from simply providing daily active fire text files via FTP, to include services such as providing fire data in various data formats, an interactive WebGIS allowing users to view and query the data and an email alert service enabling users to receive emails of near real-time fire data of their chosen area of interest. FIRMS was designed to remove obstacles to the uptake and use of fire data by addressing issues often associated with satellite data: cost, timeliness of delivery, limited data formats and the need for technical expertise to process and analyze the data. We also illustrate how the MODIS active fire data are routinely used for firefighting and conservation monitoring. We present results from a user survey, completed by approximately 345 people from 65 countries, and provide case studies highlighting how the provision of MODIS active fire data have made an impact on conservation and firefighting, especially in remote areas where it is difficult to have on-the-ground surveillance. We highlight the gaps in current capabilities, both with users and the data. A major obstacle still for some users is having low or no internet connectivity and a possible solution is through the use of cell phone technologies such as SMS text messaging of fire locations and information. GFIMS, and its precursor, FIRMS, were developed by the University of Maryland with funding from NASA's Applied Sciences Program. With GFIMS established at FAO as an operational system, FIRMS will become part of NASA's Land Atmosphere Near-real-time Capability for EOS (LANCE), to continue to meet NASA data-user needs.

  1. E-Mail Alerts and RSS Feeds for Distance Learning Administrators

    ERIC Educational Resources Information Center

    Washburn, Allyson; Howell, Scott L.

    2008-01-01

    This article describes how E-Mail Alerts and RSS feeds can be helpful tools for busy distance education administrators by helping them to efficiently sort through the research and news information that is now available. These tools and their respective filters and aggregators make it possible for busy distance education administrators to stay…

  2. Do e-mail alerts of new research increase knowledge translation? A "Nephrology Now" randomized control trial.

    PubMed

    Tanna, Gemini V; Sood, Manish M; Schiff, Jeffrey; Schwartz, Daniel; Naimark, David M

    2011-01-01

    As the volume of medical literature increases exponentially, maintaining current clinical practice is becoming more difficult. Multiple, Internet-based journal clubs and alert services have recently emerged. The purpose of this study is to determine whether the use of the e-mail alert service, Nephrology Now, increases knowledge translation regarding current nephrology literature. Nephrology Now is a nonprofit, monthly e-mail alert service that highlights clinically relevant articles in nephrology. In 2007-2008, the authors randomized 1,683 subscribers into two different groups receiving select intervention articles, and then they used an online survey to assess both groups on their familiarity with the articles and their acquisition of knowledge. Of the randomized subscribers, 803 (47.7%) completed surveys, and the two groups had a similar number of responses (401 and 402, respectively). The authors noted no differences in baseline characteristics between the two groups. Familiarity increased as a result of the Nephrology Now alerts (0.23 ± 0.087 units on a familiarity scale; 95% confidence interval [CI]: 0.06-0.41; P = .007) especially in physicians (multivariate odds ratio 1.83; P = .0002). No detectable improvement in knowledge occurred (0.03 ± 0.083 units on a knowledge scale; 95% CI: -0.13 to 0.20; P = .687). An e-mail alert service of new literature improved a component of knowledge translation--familiarity--but not knowledge acquisition in a large, randomized, international population.

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

    NASA Astrophysics Data System (ADS)

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

    2017-10-01

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

  4. A Near Real-time Decision Support System Improving Forest Management in the Tropics

    NASA Astrophysics Data System (ADS)

    Tabor, K.; Musinsky, J.; Ledezma, J.; Rasolohery, A.; Mendoza, E.; Kistler, H.; Steininger, M.; Morton, D. C.; Melton, F. S.; Manwell, J.; Koenig, K.

    2013-12-01

    Conservation International (CI) has a decade of experience developing near real-time fire and deforestation monitoring and forecasting systems that channel monitoring information from satellite observations directly to national and sub-national government agencies, Non-Government Organizations (NGOs), and local communities. These systems are used to strengthen forest surveillance and monitoring, fire management and prevention, protected areas management and sustainable land use planning. With support from a NASA Wildland Fires grant, in September 2013 CI will launch a brand new near real-time alert system (FIRECAST) to better meet the outstanding needs and challenges users face in addressing ecosystem degradation from wildland fire and illegal forest activities. Outreach efforts and user feedback have indicated the need for seasonal fire forecasts for effective land use planning, faster alert delivery to enhance response to illegal forest activities, and expanded forest monitoring capabilities that enable proactive responses and that strengthen forest conservation and sustainable development actions. The new FIRECAST system addresses these challenges by integrating the current fire alert and deforestation systems and adding improved ecological forecasting of fire risk; expanding data exchange capabilities with mobile technologies; and delivering a deforestation alert product that can inform policies related to land use management and Reduced Emissions from Deforestation and forest Degradation (REDD+). In addition to demonstrating the capabilities of this new real-time alert system, we also highlight how coordination with host-country institutions enhances the system's capacity to address the implementation needs of REDD+ forest carbon projects, improve tropical forest management, strengthen environmental law enforcement, and facilitate the uptake of near real-time satellite monitoring data into business practices of these national/sub-national institutions.

  5. Applications of Near Real-Time Image and Fire Products from MODIS

    NASA Astrophysics Data System (ADS)

    Schmaltz, J. E.; Ilavajhala, S.; Teague, M.; Ye, G.; Masuoka, E.; Davies, D.; Murphy, K. J.; Michael, K.

    2010-12-01

    NASA’s MODIS Rapid Response Project (http://rapidfire.sci.gsfc.nasa.gov/) has been providing MODIS fire detections and imagery in near real-time since 2001. The Rapid Response system is part of the Land and Atmospheres Near-real time Capability for EOS (LANCE-MODIS) system. Current capabilities include providing MODIS imagery in true color and false color band combinations, a vegetation index, and temperature - in both uncorrected swath format and geographically corrected subset regions. The geographically-corrected subsets images cover the world's land areas and adjoining waters, as well as the entire Arctic and Antarctic. These data are available within a few hours of data acquisition. The images are accessed by large number of user communities to obtain a rapid, 250 meter-resolution overview of ground conditions for fire management, crop and famine monitoring and forecasting, disaster response (fires, oil spills, floods, storms), dust and aerosol monitoring, aviation (tracking volcanic ash), monitoring sea ice conditions, environmental monitoring, and more. In addition, the scientific community uses imagery to locate phenomena of interest prior to ordering and processing data and to support the day-to-day planning of field campaigns. The MODIS Rapid Response project has also been providing a near real-time data feed on fire locations and MODIS imagery subsets to the Fire Information for Resource Management System (FIRMS) project (http://maps.geog.umd.edu/firms). FIRMS provides timely availability of fire location information, which is essential in preventing and fighting large forest/wild fires. Products are available through a WebGIS for visualizing MODIS hotspots and MCD45 Burned Area images, an email alerting tool to deliver fire data on daily/weekly/near real-time basis, active data downloads in formats such as shape, KML, CSV, WMS, etc., along with MODIS imagery subsets. FIRMS’ user base covers more than 100 countries and territories. A recent user survey showed that a majority of people use FIRMS for the purposes of conservation, fire-fighting, natural hazard monitoring, land cover change monitoring, and climate change. FIRMS has also developed a cellphone-based text (SMS) alerting of MODIS and MSG-detected fires in near real-time in South Africa, in partnership with the South African power company ESKOM and Council of Scientific and Industrial Research, South Africa. FIRMS was transitioned to the United Nations Food and Agricultural Organization (UN-FAO) in Rome, Italy in Spring 2010 and is scheduled to become a part of the LANCE-MODIS data system (http://lance.nasa.gov/) in Spring 2011.

  6. MedlinePlus E-mail Updates | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. MedlinePlus E-mail Updates Past Issues / Spring - Summer 2010 Table ... in health and medicine? Sign up for MedlinePlus e-mail updates, and you'll receive alerts whenever ...

  7. The Earth Observation Monitor - Automated monitoring and alerting for spatial time-series data based on OGC web services

    NASA Astrophysics Data System (ADS)

    Eberle, J.; Hüttich, C.; Schmullius, C.

    2014-12-01

    Spatial time series data are freely available around the globe from earth observation satellites and meteorological stations for many years until now. They provide useful and important information to detect ongoing changes of the environment; but for end-users it is often too complex to extract this information out of the original time series datasets. This issue led to the development of the Earth Observation Monitor (EOM), an operational framework and research project to provide simple access, analysis and monitoring tools for global spatial time series data. A multi-source data processing middleware in the backend is linked to MODIS data from Land Processes Distributed Archive Center (LP DAAC) and Google Earth Engine as well as daily climate station data from NOAA National Climatic Data Center. OGC Web Processing Services are used to integrate datasets from linked data providers or external OGC-compliant interfaces to the EOM. Users can either use the web portal (webEOM) or the mobile application (mobileEOM) to execute these processing services and to retrieve the requested data for a given point or polygon in userfriendly file formats (CSV, GeoTiff). Beside providing just data access tools, users can also do further time series analyses like trend calculations, breakpoint detections or the derivation of phenological parameters from vegetation time series data. Furthermore data from climate stations can be aggregated over a given time interval. Calculated results can be visualized in the client and downloaded for offline usage. Automated monitoring and alerting of the time series data integrated by the user is provided by an OGC Sensor Observation Service with a coupled OGC Web Notification Service. Users can decide which datasets and parameters are monitored with a given filter expression (e.g., precipitation value higher than x millimeter per day, occurrence of a MODIS Fire point, detection of a time series anomaly). Datasets integrated in the SOS service are updated in near-realtime based on the linked data providers mentioned above. An alert is automatically pushed to the user if the new data meets the conditions of the registered filter expression. This monitoring service is available on the web portal with alerting by email and within the mobile app with alerting by email and push notification.

  8. 47 CFR 11.52 - EAS code and Attention Signal Monitoring requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... technologies, such as instant messaging and email) the distribution of Common Alert Protocol (CAP)-formatted... Integrated Public Alert and Warning System (IPAWS) to enable (whether through “pull” interface technologies...

  9. 47 CFR 11.52 - EAS code and Attention Signal Monitoring requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... technologies, such as instant messaging and email) the distribution of Common Alert Protocol (CAP)-formatted... Integrated Public Alert and Warning System (IPAWS) to enable (whether through “pull” interface technologies...

  10. 47 CFR 11.52 - EAS code and Attention Signal Monitoring requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... technologies, such as instant messaging and email) the distribution of Common Alert Protocol (CAP)-formatted... Integrated Public Alert and Warning System (IPAWS) to enable (whether through “pull” interface technologies...

  11. 34 CFR 668.49 - Institutional fire safety policies and fire statistics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... fire. Fire safety system: Any mechanism or system related to the detection of a fire, the warning resulting from a fire, or the control of a fire. This may include sprinkler systems or other fire extinguishing systems, fire detection devices, stand-alone smoke alarms, devices that alert one to the presence...

  12. 34 CFR 668.49 - Institutional fire safety policies and fire statistics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... fire. Fire safety system: Any mechanism or system related to the detection of a fire, the warning resulting from a fire, or the control of a fire. This may include sprinkler systems or other fire extinguishing systems, fire detection devices, stand-alone smoke alarms, devices that alert one to the presence...

  13. 34 CFR 668.49 - Institutional fire safety policies and fire statistics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... fire. Fire safety system: Any mechanism or system related to the detection of a fire, the warning resulting from a fire, or the control of a fire. This may include sprinkler systems or other fire extinguishing systems, fire detection devices, stand-alone smoke alarms, devices that alert one to the presence...

  14. 34 CFR 668.49 - Institutional fire safety policies and fire statistics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... fire. Fire safety system: Any mechanism or system related to the detection of a fire, the warning resulting from a fire, or the control of a fire. This may include sprinkler systems or other fire extinguishing systems, fire detection devices, stand-alone smoke alarms, devices that alert one to the presence...

  15. Engineering Software for Interoperability through Use of Enterprise Architecture Techniques

    DTIC Science & Technology

    2003-03-01

    Response Home/ Business Security . To detect flood conditions (i.e. excess water levels) within the monitored area and alert authorities, as necessary...Response; Fire Detection & Response; and Flood Detection & Response. Functional Area Description Intruder Detection & Response Home/ Business ... Security . To monitor and detect unauthorized entry into the secured area and sound alarms/alert authorities, as necessary. Fire Detection

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

    PubMed

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

    2009-09-01

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

  17. Purge-Alert | High-Performance Computing | NREL

    Science.gov Websites

    and maintain if you want notifications for files that will be removed within 7 days. Simply add a single email address to this file: /scratch/$USER/.notify-email The email you will receive will provide instructions as to where the files are located. You will only receive emails if there are files that will be

  18. Space-Based Sensorweb Monitoring of Wildfires in Thailand

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

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

  19. What Is a Heart Murmur?

    MedlinePlus

    ... Pressure Holes in the Heart How the Heart Works Stress Testing Tetralogy of Fallot Building 31 31 Center Drive Bethesda, MD 20892 Learn more about getting to NIH Get Email Alerts Receive automatic alerts about NHLBI related news and highlights from across the Institute. Learn ...

  20. How to Apply | FNLCR Staging

    Cancer.gov

    Getting started— You can begin byviewing current job openings. From this link you can also create a profile, apply online, and register for job alerts. Confirmation email — We will send you an automated confirmation email to let you k

  1. 78 FR 14740 - Disaster Assistance; Fire Management Assistance Grant (FMAG) Program-Deadline Extensions and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... [Docket ID FEMA-2013-0004] RIN 1660-AA78 Disaster Assistance; Fire Management Assistance Grant (FMAG..., DHS. ACTION: Proposed rule. SUMMARY: FEMA proposes to revise its Fire Management Assistance Grant...-2340, or (email) [email protected] . SUPPLEMENTARY INFORMATION: I. Background The Fire Management...

  2. 76 FR 31364 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Fire Brigades

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... for OMB Review; Comment Request; Fire Brigades ACTION: Notice. SUMMARY: The Department of Labor (DOL... collection request (ICR) titled, ``Fire Brigades,'' to the Office of Management and Budget (OMB) for review... by e-mail at [email protected] . SUPPLEMENTARY INFORMATION: The Fire Brigade Standard codified...

  3. SAC ALERT AREA AND FLIGHT LINE BUILDINGS, LOOKING TOWARD RESERVE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    SAC ALERT AREA AND FLIGHT LINE BUILDINGS, LOOKING TOWARD RESERVE FIRE TEAM FACILITY (BUILDING 3001) (CENTER). VIEW TO SOUTHEAST. - Plattsburgh Air Force Base, U.S. Route 9, Plattsburgh, Clinton County, NY

  4. How to Apply | Frederick National Laboratory for Cancer Research

    Cancer.gov

    Getting started— You can begin byviewing current job openings. From this link you can also create a profile, apply online, and register for job alerts. Confirmation email — We will send you an automated confirmation email to let you k

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

    NASA Astrophysics Data System (ADS)

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

    2009-03-01

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

  6. Ten Fire Safety Tips for Schools.

    ERIC Educational Resources Information Center

    Lake, James D.

    1999-01-01

    Provides 10 basic tips, compiled from the National Fire Protection Association's Life Safety Code 101, to ensure that educational facilities are fire safe. Tips include use of frequent and unexpected fire drills, limiting wall space of student artwork and teaching materials, being alert to preventing arson, planning speedy and safe emergency…

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

    PubMed

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

    2016-04-01

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

  8. Design and evaluation of a personal digital assistant–based alerting service for clinicians*†

    PubMed Central

    Johnson, E. Diane; Pancoast, Paul E.; Mitchell, Joyce A.; Shyu, Chi-Ren

    2004-01-01

    Purpose: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). Description: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via email during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. Results/Outcome: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and email-oriented users. PMID:15494759

  9. 78 FR 42818 - SafetyAlert: Safety Alert: Risks Associated With Liquid Petroleum (LP) Gas Odor Fade

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... stakeholders from industry, fire fighter associations, and other regulatory agencies in order to better... tanks are used. New or recently cleaned tanks may absorb the odorant into the metal shell of these tanks...

  10. Alert!: In Emergencies, Schools Use Technology to Get the Message out Quickly

    ERIC Educational Resources Information Center

    Violino, Bob

    2008-01-01

    This article describes how a growing number of community colleges have begun deploying emergency alert systems that can be used to send information via e-mail and text messaging directly to students' cell phones and other portable devices. Such systems enable authorized campus administrators to send messages to thousands of people within minutes.…

  11. Influencing Anesthesia Provider Behavior Using Anesthesia Information Management System Data for Near Real-Time Alerts and Post Hoc Reports.

    PubMed

    Epstein, Richard H; Dexter, Franklin; Patel, Neil

    2015-09-01

    In this review article, we address issues related to using data from anesthesia information management systems (AIMS) to deliver near real-time alerts via AIMS workstation popups and/or alphanumeric pagers and post hoc reports via e-mail. We focus on reports and alerts for influencing the behavior of anesthesia providers (i.e., anesthesiologists, anesthesia residents, and nurse anesthetists). Multiple studies have shown that anesthesia clinical decision support (CDS) improves adherence to protocols and increases financial performance through facilitation of billing, regulatory, and compliance documentation; however, improved clinical outcomes have not been demonstrated. We inform developers and users of feedback systems about the multitude of concerns to consider during development and implementation of CDS to increase its effectiveness and to mitigate its potentially disruptive aspects. We discuss the timing and modalities used to deliver messages, implications of outlier-only versus individualized feedback, the need to consider possible unintended consequences of such feedback, regulations, sustainability, and portability among systems. We discuss statistical issues related to the appropriate evaluation of CDS efficacy. We provide a systematic review of the published literature (indexed in PubMed) of anesthesia CDS and offer 2 case studies of CDS interventions using AIMS data from our own institution illustrating the salient points. Because of the considerable expense and complexity of maintaining near real-time CDS systems, as compared with providing individual reports via e-mail after the fact, we suggest that if the same goal can be accomplished via delayed reporting versus immediate feedback, the former approach is preferable. Nevertheless, some processes require near real-time alerts to produce the desired improvement. Post hoc e-mail reporting from enterprise-wide electronic health record systems is straightforward and can be accomplished using system-independent pathways (e.g., via built-in e-mail support provided by the relational database management system). However, for some of these enterprise-wide systems, near real-time data access, necessary for CDS that generates concurrent alerts, has been challenging to implement.

  12. 77 FR 74508 - Notice of Availability of the Draft Resource Management Plan Amendment, Draft Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-14

    ... Statement for the Ring of Fire Resource Management Plan--Haines Planning Area, Alaska AGENCY: Bureau of Land.../Draft Environmental Impact Statement (EIS) for the Ring of Fire RMP for the Haines Planning Area and by... Fire RMP-- Haines Planning Area Amendment by any of the following methods: Email: [email protected

  13. Temperature of aircraft cargo flame exposure during accidents involving fuel spills

    NASA Astrophysics Data System (ADS)

    Mansfield, J. A.

    1993-01-01

    This report describes an evaluation of flame exposure temperatures of weapons contained in alert (parked) bombers due to accidents that involve aircraft fuel fires. The evaluation includes two types of accident: collisions into an alert aircraft by an aircraft that is on landing or take-off; and engine start accidents. Both the B-1B and B-52 alert aircraft are included in the evaluation.

  14. Temperature of aircraft cargo flame exposure during accidents involving fuel spills

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

    Mansfield, J.A.

    1993-01-01

    This report describes an evaluation of flame exposure temperatures of weapons contained in alert (parked) bombers due to accidents that involve aircraft fuel fires. The evaluation includes two types of accident, collisions into an alert aircraft by an aircraft that is on landing or take-off, and engine start accidents. Both the B-1B and B-52 alert aircraft are included in the evaluation.

  15. Using the World Wide Web for GIDEP Problem Data Processing at Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    McPherson, John W.; Haraway, Sandra W.; Whirley, J. Don

    1999-01-01

    Since April 1997, Marshall Space Flight Center has been using electronic transfer and the web to support our processing of the Government-Industry Data Exchange Program (GIDEP) and NASA ALERT information. Specific aspects include: (1) Extraction of ASCII text information from GIDEP for loading into Word documents for e-mail to ALERT actionees; (2) Downloading of GIDEP form image formats in Adobe Acrobat (.pdf) for internal storage display on the MSFC ALERT web page; (3) Linkage of stored GRDEP problem forms with summary information for access from the MSFC ALERT Distribution Summary Chart or from an html table of released MSFC ALERTs (4) Archival of historic ALERTs for reference by GIDEP ID, MSFC ID, or MSFC release date; (5) On-line tracking of ALERT response status using a Microsoft Access database and the web (6) On-line response to ALERTs from MSFC actionees through interactive web forms. The technique, benefits, effort, coordination, and lessons learned for each aspect are covered herein.

  16. Functional Requirements for the Next Generation of Mass Notification

    ERIC Educational Resources Information Center

    Trumbo, Berkly

    2012-01-01

    While the latest update to National Fire Protection Association (NFPA) redefines mass notification as "emergency communications systems" (ECS), the end user community is formulating expectations related to the future functionality of today's alerting solutions. Numerous best practices have surfaced since alerting technology began its rapid,…

  17. Clinical decision support alert malfunctions: analysis and empirically derived taxonomy.

    PubMed

    Wright, Adam; Ai, Angela; Ash, Joan; Wiesen, Jane F; Hickman, Thu-Trang T; Aaron, Skye; McEvoy, Dustin; Borkowsky, Shane; Dissanayake, Pavithra I; Embi, Peter; Galanter, William; Harper, Jeremy; Kassakian, Steve Z; Ramoni, Rachel; Schreiber, Richard; Sirajuddin, Anwar; Bates, David W; Sittig, Dean F

    2018-05-01

    To develop an empirically derived taxonomy of clinical decision support (CDS) alert malfunctions. We identified CDS alert malfunctions using a mix of qualitative and quantitative methods: (1) site visits with interviews of chief medical informatics officers, CDS developers, clinical leaders, and CDS end users; (2) surveys of chief medical informatics officers; (3) analysis of CDS firing rates; and (4) analysis of CDS overrides. We used a multi-round, manual, iterative card sort to develop a multi-axial, empirically derived taxonomy of CDS malfunctions. We analyzed 68 CDS alert malfunction cases from 14 sites across the United States with diverse electronic health record systems. Four primary axes emerged: the cause of the malfunction, its mode of discovery, when it began, and how it affected rule firing. Build errors, conceptualization errors, and the introduction of new concepts or terms were the most frequent causes. User reports were the predominant mode of discovery. Many malfunctions within our database caused rules to fire for patients for whom they should not have (false positives), but the reverse (false negatives) was also common. Across organizations and electronic health record systems, similar malfunction patterns recurred. Challenges included updates to code sets and values, software issues at the time of system upgrades, difficulties with migration of CDS content between computing environments, and the challenge of correctly conceptualizing and building CDS. CDS alert malfunctions are frequent. The empirically derived taxonomy formalizes the common recurring issues that cause these malfunctions, helping CDS developers anticipate and prevent CDS malfunctions before they occur or detect and resolve them expediently.

  18. Evaluation of email alerts in practice: Part 2. Validation of the information assessment method.

    PubMed

    Pluye, Pierre; Grad, Roland M; Johnson-Lafleur, Janique; Bambrick, Tara; Burnand, Bernard; Mercer, Jay; Marlow, Bernard; Campbell, Craig

    2010-12-01

    The information assessment method (IAM) permits health professionals to systematically document the relevance, cognitive impact, use and health outcomes of information objects delivered by or retrieved from electronic knowledge resources. The companion review paper (Part 1) critically examined the literature, and proposed a 'Push-Pull-Acquisition-Cognition-Application' evaluation framework, which is operationalized by IAM. The purpose of the present paper (Part 2) is to examine the content validity of the IAM cognitive checklist when linked to email alerts. A qualitative component of a mixed methods study was conducted with 46 doctors reading and rating research-based synopses sent on email. The unit of analysis was a doctor's explanation of a rating of one item regarding one synopsis. Interviews with participants provided 253 units that were analysed to assess concordance with item definitions. The content relevance of seven items was supported. For three items, revisions were needed. Interviews suggested one new item. This study has yielded a 2008 version of IAM. © 2010 Blackwell Publishing Ltd.

  19. Chemical Safety Alert: Fire Hazard from Carbon Adsorption Deodorizing Systems

    EPA Pesticide Factsheets

    Activated carbon systems used to adsorb vapors for odor control may pose a fire hazard when used for certain types of substances, such as crude sulfate turpentine. Facilities should take precautions and proper procedures to avoid or mitigate these hazards.

  20. Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases.

    PubMed

    Nair, Bala G; Newman, Shu-Fang; Peterson, Gene N; Wu, Wei-Ying; Schwid, Howard A

    2010-11-01

    Administration of prophylactic antibiotics during surgery is generally performed by the anesthesia providers. Timely antibiotic administration within the optimal time window before incision is critical for prevention of surgical site infections. However, this often becomes a difficult task for the anesthesia team during the busy part of a case when the patient is being anesthetized. Starting with the implementation of an anesthesia information management system (AIMS), we designed and implemented several feedback mechanisms to improve compliance of proper antibiotic delivery and documentation. This included generating e-mail feedback of missed documentation, distributing monthly summary reports, and generating real-time electronic alerts with a decision support system. In 20,974 surgical cases for the period, June 2008 to January 2010, the interventions of AIMS install, e-mail feedback, summary reports, and real-time alerts changed antibiotic compliance by -1.5%, 2.3%, 4.9%, and 9.3%, respectively, when compared with the baseline value of 90.0% ± 2.9% when paper anesthesia records were used. Highest antibiotic compliance was achieved when using real-time alerts. With real-time alerts, monthly compliance was >99% for every month between June 2009 and January 2010. Installation of AIMS itself did not improve antibiotic compliance over that achieved with paper anesthesia records. However, real-time guidance and reminders through electronic messages generated by a computerized decision support system (Smart Anesthesia Messenger, or SAM) significantly improved compliance. With such a system a consistent compliance of >99% was achieved.

  1. PEER News Alerts | PEER News

    Science.gov Websites

    Email Address * First Name * Last Name * Title * Organization * Organization Type * Federal Government State Government Local Government Research Center Testing Lab Non-profit Earthquake Organization For

  2. What is Metabolic Syndrome?

    MedlinePlus

    ... 22, 2012 | News Release NIH launches trial to evaluate anti-inflammatory treatment for preventing heart attacks, strokes, ... and Usage No FEAR Act Grants and Funding Customer Service/Center for Health Information Email Alerts Jobs ...

  3. Mold Allergy

    MedlinePlus

    ... the AAAAI Foundation Donate Utility navigation Español Journals Pollen Counts Annual Meeting Member Login / My Membership Search ... email alert to keep tabs on mold and pollen counts in your area. • Keep away from uncut ...

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

    NASA Astrophysics Data System (ADS)

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

    2014-11-01

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

  5. Chemical Emergencies Overview

    MedlinePlus

    ... Populations Disaster Relief Volunteers Health Alert Network (HAN) Social Media Zombie Apocalypse What’s New Get Email Updates To ... involving the release of a chemical that could harm people’s health. This page provides information to help people ...

  6. E-Alerts: Environmental pollution and control (environmental health and safety). E-mail newsletter

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

    NONE

    Topics of discussion include the following: Effects of pollution on public health and safety; Toxicology; Industrial health; Physiology; Psychology; Clinical medicine; Radiobiology; Animals used as research experimental models.

  7. Leveraging Service Oriented Architecture to Enhance Information Sharing for Surface Transportation Security

    DTIC Science & Technology

    2008-09-01

    telephone, conference calls, emails, alert notifications, and blackberry . The RDTSF holds conference calls with its stakeholders to provide routine... tunnels ) is monitored by CCTV cameras with live feeds to WMATA’s Operations Control Center (OCC) to detect unauthorized entry into areas not intended for...message by email, blackberry and phone to the Security Coordinators. Dissemination of classified information however, is generally handled through the

  8. PubMed Informer: Monitoring MEDLINE/PubMed through E-mail Alerts, SMS, PDA downloads and RSS feeds

    PubMed Central

    Muin, Michael; Fontelo, Paul; Ackerman, Michael

    2005-01-01

    Summary PubMed Informer is a Web-based monitoring tool for topics of interest from MEDLINE/PubMed primarily designed for healthcare professionals. Five tracking methods are available: Web access, e-mail, Short Message Service (SMS), PDA downloads and RSS feeds. PubMed Informer delivers focused search updates and specific information to users with varying information-seeking practices. PMID:16779344

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  10. Indicator Systems for School and Teacher Evaluation: Fire-Fighting It Is!

    ERIC Educational Resources Information Center

    Fitz-Gibbon, C. T.

    In 1979, Gene Glass suggested that it might not be possible to evaluate schools nor to create widely applicable research findings, but that the complexity of education was such that merely "fire-fighting," establishing monitoring systems to alert about educational events, was the best approach. In the United Kingdom, monitoring systems…

  11. Assessment of Post Forest Fire Landslides in Uttarakhand Himalaya, India

    NASA Astrophysics Data System (ADS)

    Sharma, N.; Singh, R. B.

    2017-12-01

    According to Forest Survey of India-State Forest Report (2015), the total geographical area of Uttarakhand is 53, 483 covers km2 out of which 24,402 km2 area covers under total forest covers. As noticed during last week of April, 2016 forest of Uttarakhand mountains was gutted down due to major incidences of fire. This incident caused huge damage to different species of flora-fauna, human being, livestock, property and destruction of mountain ecosystem. As per media reports, six people were lost their lives and recorded several charred carcasses of livestock's due to this incident. The forest fire was affected the eleven out of total thirteen districts which roughly covers the 0.2% (approx.) of total vegetation covers.The direct impact of losses are easy to be estimated but indirect impacts of this forest fire are yet to be occurred. The threat of post Forest fire induced landslides during rainfall is themain concern. Since, after forest fire top soil and rocks are loose due to loss of vegetation as binding and protecting agent against rainfall. Therefore, the pore water pressure and weathering will be very high during rainy season which can cause many landslides in regions affected by forest fire. The demarcation of areas worse affected by forest fire is necessary for issuing alerts to habitations and important infrastructures. These alerts will be based upon region specific probable rainfall forecasting through Indian Meteorological Department (IMD). The main objective is to develop a tool for detecting early forest fire and to create awareness amongst mountain community, researchers and concerned government agencies to take an appropriate measures to minimize the incidences of Forest fire and impact of post forest fire landslides in future through implementation of sustainable mountain strategy.

  12. Sensor Alerting Capability

    NASA Astrophysics Data System (ADS)

    Henriksson, Jakob; Bermudez, Luis; Satapathy, Goutam

    2013-04-01

    There is a large amount of sensor data generated today by various sensors, from in-situ buoys to mobile underwater gliders. Providing sensor data to the users through standardized services, language and data model is the promise of OGC's Sensor Web Enablement (SWE) initiative. As the amount of data grows it is becoming difficult for data providers, planners and managers to ensure reliability of data and services and to monitor critical data changes. Intelligent Automation Inc. (IAI) is developing a net-centric alerting capability to address these issues. The capability is built on Sensor Observation Services (SOSs), which is used to collect and monitor sensor data. The alerts can be configured at the service level and at the sensor data level. For example it can alert for irregular data delivery events or a geo-temporal statistic of sensor data crossing a preset threshold. The capability provides multiple delivery mechanisms and protocols, including traditional techniques such as email and RSS. With this capability decision makers can monitor their assets and data streams, correct failures or be alerted about a coming phenomena.

  13. Fire fatality and alcohol intake: analysis of key risk factors.

    PubMed

    Bruck, Dorothy; Ball, Michelle; Thomas, Ian R

    2011-09-01

    After a brief review of the literature on the role of alcohol in residential fire deaths, a comparison of different risk factors for residential fire fatality was undertaken by closely analyzing the circumstances of fire victims as a function of alcohol intake. Analyses were based on Australian coroners' fire fatality records for the state of Victoria (1998-2006) and considered demographic, behavioral, and environmental factors for the 95 adult fire victims who were tested for alcohol (64 male, 31 female). Most (58%) had a positive blood alcohol concentration (BAC) test, with 31% of the total sample having a BAC of more than 0.20 gm per 100 ml. Odds ratio analyses showed that four variables were significantly more associated with victims who had consumed alcohol compared with sober victims. In descending odds ratio order, these variables were as follows: (a) being aged 18-60 years, (b) involving smoking materials (e.g. cigarettes, pipes), (c) having no conditions preventing escape, and (d) being male. An important new finding is that fire fatalities with positive BAC levels were more than three times less likely to have their clothing alight or exits blocked than sober fire victims. The risk of dying in a fire for alcohol-affected people who are capable of being alerted and escaping may be reduced if they can be alerted more quickly and effectively. Suitable measures for improving smoke alarms via interlinking and the use of an alarm signal demonstrated to be more effective at waking sleepers, including those who are alcohol affected, are discussed.

  14. WAN Optimization: A Business Process Reengineering and Knowledge Value Added Approach

    DTIC Science & Technology

    2011-03-01

    processing is not affected. Reliability The Customer or Order systems are unavailable. If either fails, order processing halts and alerts are...online immediately, and sends a fax to the customer who orders the container. The whole order processing process can be completed in one day. IT plays...Messages build up in the OrderQ until the email server restarts. Messages are then sent by the SendEmail component to remove the backlog. Order

  15. Collaboration via E-Mail and Internet Relay Chat: Understanding Time and Technology.

    ERIC Educational Resources Information Center

    Duin, Ann Hill; Archee, Ray

    1996-01-01

    Examines how college students working across distances used e-mail and Internet Relay Chat (IRC) to facilitate their collaboration and decision-making processes. Finds that students came to a decision more quickly using e-mail than with IRC, and when IRC was slow, students reverted to a series of rapid-fire e-mail messages. (RS)

  16. Applications of aerospace technology in industry, a technology transfer profile: Fire safety

    NASA Technical Reports Server (NTRS)

    Kottenstette, J. P.; Freeman, J. E.; Heins, C. R.; Hildred, W. M.; Johnson, F. D.; Staskin, E. R.

    1971-01-01

    The fire safety field is considered as being composed of three parts: an industry, a technology base, and a user base. An overview of the field is presented, including a perspective on the magnitude of the national fire safety problem. Selected NASA contributions to the technology of fire safety are considered. Communication mechanisms, particularly conferences and publications, used by NASA to alert the community to new developments in the fire safety field, are reviewed. Several examples of nonaerospace applications of NASA-generated fire safety technology are also presented. Issues associated with attempts to transfer this technology from the space program to other sectors of the American economy are outlined.

  17. The effect of automated alerts on preoperative anemia management.

    PubMed

    Dilla, Andrew; Wisniewski, Mary Kay; Waters, Jonathan H; Triulzi, Darrell J; Yazer, Mark H

    2015-04-01

    This study evaluated the role of an automated anemia notification system that alerted providers about anemic pre-operative patients. After scheduling surgery, the alert program continuously searched the patient's laboratory data for hemoglobin value(s) in the medical record. When an anemic patient according to the World Health Oganization's criteria was identified, an email was sent to the patient's surgeon, and/or assistant, and/or patient's primary care physician suggesting that the anemia be managed before surgery. Thirteen surgeons participated in this pilot study. In 11 months, there were 70 pre-surgery anemia alerts generated on 69 patients. The surgeries were 60 orthopedic, 7 thoracic, 2 general surgery, and 1 urological. The alerts were sent 15 ± 10 days before surgery. No pre-operative anemia treatment could be found in 37 of 69 (54%) patients. Some form of anemia management was found in 32 of 69 (46%) patients. Of the 23 patients who received iron, only 3 of 23 (13%) of these patients started iron shortly after the alert was generated. The alert likely resulted in the postponement of one surgery for anemia correction. Although anemia diagnosis and management can be complex, it was hoped that receipt of the alert would lead to the management of all anemic patients. Alerts are only effective if they are received and read by a healthcare provider empowered to treat the patient or to make an appropriate referral. Automated preoperative alerts alone are not likely to alter surgeons' anemia management practices. These alerts need to be part of a comprehensive anemia management strategy.

  18. COMESEP: bridging the gap between the SEP, CME, and terrestrial effects scientific communities

    NASA Astrophysics Data System (ADS)

    Crosby, Norma; Veronig, Astrid; Rodriguez, Luciano; Vrsnak, Bojan; Vennerstrøm, Susanne; Malandraki, Olga; Dalla, Silvia; Srivastava, Nandita

    2016-04-01

    In the past there has been a tendency for the geomagnetic storm and solar energetic particle (SEP) communities to work in parallel rather than to apply a cross-disciplinary work approach specifically in regard to space weather forecasting. To provide more awareness on the existing links between these communities, as well as further bridge this gap, the three-year EU FP7 COMESEP (COronal Mass Ejections and Solar Energetic Particles: forecasting the space weather impact) project emphasized cross-collaboration between the SEP, coronal mass ejection, and terrestrial effects scientific communities. COMESEP went from basic solar-terrestrial physics research to space weather operations by developing, validating and implementing multi-purpose tools into an operational 24/7 alert service. Launched in November 2013, the COMESEP alert system provides space weather stakeholders geomagnetic storm alerts ("Event based" and "Next 24 hours") and SEP (proton) storm alerts (E > 10 MeV and E > 60 MeV) without human intervention based on the COMESEP definition of risk. COMESEP alerts and forecasts are freely available on the COMESEP alert website (http://www.comesep.eu/alert), as well as disseminated by e-mail to registered users. Acknowledgement: This work has received funding from the European Commission FP7 Project COMESEP (263252).

  19. 75 FR 52713 - Nationwide Aerial Application of Fire Retardant on National Forest System Lands

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... DEPARTMENT OF AGRICULTURE Forest Service Nationwide Aerial Application of Fire Retardant on... statement for the continued nationwide aerial application of fire retardant on National Forest System lands... 26667, Salt Lake City, UT 84126-0667. Comments may also be sent via e- mail to Fire[email protected

  20. National Weather Service

    MedlinePlus

    ... Data SAFETY Floods Tsunami Beach Hazards Wildfire Cold Tornadoes Fog Air Quality Heat Hurricanes Lightning Safe Boating ... Winter Weather Forecasts River Flooding Latest Warnings Thunderstorm/Tornado Outlook Hurricanes Fire Weather Outlooks UV Alerts Drought ...

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

    PubMed

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

    2015-03-01

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

  2. Analysis of clinical decision support system malfunctions: a case series and survey

    PubMed Central

    Wright, Adam; Hickman, Thu-Trang T; McEvoy, Dustin; Aaron, Skye; Ai, Angela; Andersen, Jan Marie; Hussain, Salman; Ramoni, Rachel; Fiskio, Julie; Sittig, Dean F; Bates, David W

    2016-01-01

    Objective To illustrate ways in which clinical decision support systems (CDSSs) malfunction and identify patterns of such malfunctions. Materials and Methods We identified and investigated several CDSS malfunctions at Brigham and Women’s Hospital and present them as a case series. We also conducted a preliminary survey of Chief Medical Information Officers to assess the frequency of such malfunctions. Results We identified four CDSS malfunctions at Brigham and Women’s Hospital: (1) an alert for monitoring thyroid function in patients receiving amiodarone stopped working when an internal identifier for amiodarone was changed in another system; (2) an alert for lead screening for children stopped working when the rule was inadvertently edited; (3) a software upgrade of the electronic health record software caused numerous spurious alerts to fire; and (4) a malfunction in an external drug classification system caused an alert to inappropriately suggest antiplatelet drugs, such as aspirin, for patients already taking one. We found that 93% of the Chief Medical Information Officers who responded to our survey had experienced at least one CDSS malfunction, and two-thirds experienced malfunctions at least annually. Discussion CDSS malfunctions are widespread and often persist for long periods. The failure of alerts to fire is particularly difficult to detect. A range of causes, including changes in codes and fields, software upgrades, inadvertent disabling or editing of rules, and malfunctions of external systems commonly contribute to CDSS malfunctions, and current approaches for preventing and detecting such malfunctions are inadequate. Conclusion CDSS malfunctions occur commonly and often go undetected. Better methods are needed to prevent and detect these malfunctions. PMID:27026616

  3. Employment Security Tax

    Science.gov Websites

    Alaska > DOLWD > Employment Security Tax EMAIL SCAM ALERT (December 2012) On-line Employer Services Online Filing Demonstrations FAQs for TaxWeb Employer Report Notice Alaska Unemployment Insurance Tax Handbook The Employment Security Tax Section is responsible for providing assistance and information to

  4. 2005 Science and Technology for Chem-Bio Information Systems (S and T CBIS). Volume 2 - Wednesday

    DTIC Science & Technology

    2005-10-28

    historical example of using both an audible and visual alerting method. In April 1775, Revere hung two lanterns in the bell-tower of Christ Church in...individual building systems, outdoor systems, telephone notification systems and a network of alert sensors . Fire protection systems are often... sensor , be it a pushbutton at a gate, a wireless “panic” button or a CBRNE detector, may be programmed to trigger notifications without further

  5. Development of an Information Model for Kidney Transplant Wait List.

    PubMed

    Bircan, Hüseyin Yüce; Özçelik, Ümit; Uysal, Nida; Demirağ, Alp; Haberal, Mehmet

    2015-11-01

    Deceased-donor kidney transplant is unique among surgical procedures that are an urgent procedure performed in an elective population. It has not been possible to accurately determine when a given patient will be called for transplant. Patients on the active transplant list can be called for a transplant at any time. As a result, every effort must be made to optimize their health according to best practices and published clinical practice guidelines. Once the patient is placed on the transplant wait list after undergoing an initial extensive evaluation, continued surveillance is required. Therefore, we developed a kidney transplant wait list surveillance software program that alerts organ transplant coordinator on time regarding which patients need a work-up. The new designed software has a database of our waiting patients with their completed and pending controls. The software also has built-in functions to warn the responsible staff with an E-mail. If one of the controls of a recipient delayed, the software sends an automated E-mail to the staff regarding the patients delayed controls. The software is a Web application that works on any platform with a Web browser and Internet connection and allows access by multiple users. The software has been developed with NET platform. The database is SQL server. The software has the following functions: patient communication info, search, alert list, alert E-mail, control entry, and system management. As of January 2014, a total of 21 000 patients were registered on the National Kidney Transplant wait list in Turkey and the kidney transplant wait list had been expanding by 2000 to 3000 patients each year. Therefore computerized wait list programs are crucial to help to transplant centers to keep their patients up-to-date on time.

  6. The 2017 MCWL/FD Initiative Portfolio

    DTIC Science & Technology

    2016-09-15

    maintaining compatibility with infantry weapon systems and human factors limitations. Non-Kinetic Engagement - Enable the rifle squad to disrupt enemy...provide robust, responsive, and accurate fires for distributed operations. Purpose: Determine weapons and equipment in order to provide organic fire... weapons , white trucks or other things of interest to the small unit. The system will identify the items and send alerts to the unit’s leader asking for

  7. Personalized and automated remote monitoring of atrial fibrillation.

    PubMed

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

    2016-03-01

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

  8. Storm Prediction Center Convective Outlooks

    Science.gov Websites

    Current Watches Meso. Discussions Conv. Outlooks Tstm. Outlooks Fire Wx Outlooks XML logo RSS Feeds E-Mail : Retrieve Outlooks Weather Topics: Watches, Mesoscale Discussions, Outlooks, Fire Weather, All Products

  9. Assessing Mental Models of Emergencies Through Two Knowledge Elicitation Tasks.

    PubMed

    Whitmer, Daphne E; Sims, Valerie K; Torres, Michael E

    2017-05-01

    The goals of this study were to assess the risk identification aspect of mental models using standard elicitation methods and how university campus alerts were related to these mental models. People fail to follow protective action recommendations in emergency warnings. Past research has yet to examine cognitive processes that influence emergency decision-making. Study 1 examined 2 years of emergency alerts distributed by a large southeastern university. In Study 2, participants listed emergencies in a thought-listing task. Study 3 measured participants' time to decide if a situation was an emergency. The university distributed the most alerts about an armed person, theft, and fire. In Study 2, participants most frequently listed fire, car accident, heart attack, and theft. In Study 3, participants quickly decided a bomb, murder, fire, tornado, and rape were emergencies. They most slowly decided that a suspicious package and identify theft were emergencies. Recent interaction with warnings was only somewhat related to participants' mental models of emergencies. Risk identification precedes decision-making and applying protective actions. Examining these characteristics of people's mental representations of emergencies is fundamental to further understand why some emergency warnings go ignored. Someone must believe a situation is serious to categorize it as an emergency before taking the protective action recommendations in an emergency warning. Present-day research must continue to examine the problem of people ignoring warning communication, as there are important cognitive factors that have not yet been explored until the present research.

  10. Storm Prediction Center Storm Reports

    Science.gov Websites

    Current Watches Meso. Discussions Conv. Outlooks Tstm. Outlooks Fire Wx Outlooks XML logo RSS Feeds E-Mail , Mesoscale Discussions, Outlooks, Fire Weather, All Products, Contact Us NOAA / National Weather Service

  11. Storm Prediction Center Product & Report Archives

    Science.gov Websites

    Current Watches Meso. Discussions Conv. Outlooks Tstm. Outlooks Fire Wx Outlooks XML logo RSS Feeds E-Mail Archived Fire Weather Outlooks To view fire weather outlooks for a previous day, type in the date you wish to retrieve (e.g. 140503 for May 3, 2014). Data available since June 4, 2002. 150101 Retrieve Fire

  12. Aircraft Alerting Systems Standardization Study. Volume I. Candidate System Validation and Time-Critical Display Evaluation.

    DTIC Science & Technology

    1981-01-01

    SELCAL FLT ALT ATNI AUO ALT BRK CANSELCAL OVSO CALL CONTRL ALRT _ I7CT be SPLR b 0 11CALL Figure 5.4.4-1 Pilot’s Response Panel Figure 5.4.4-2 Flight...Galley bus off 27 GLY BUS OFF A RP ELEC CYCLE SWITCH Utility bus off 28 UTIL BUS OFF A RP ELEC CYCLE SWITCH Right engine 29 R ENG HYD PUMP A RP HYD...CYCLE SWITCH hydraulic pump Left engine 30 L ENG FIRE DET A RP FIRE RP FIRE fire detector Left brake overheat 31 L BRAKE OVHT A RP BRK RP BRK Right

  13. 20 CFR 401.45 - Verifying your identity.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....45 Employees' Benefits SOCIAL SECURITY ADMINISTRATION PRIVACY AND DISCLOSURE OF OFFICIAL RECORDS AND... online access option, such as a standard e-mail comment form on our Web site, and encryption is not being used, we alert you that personally identifiable information (such as your social security number...

  14. 20 CFR 401.45 - Verifying your identity.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....45 Employees' Benefits SOCIAL SECURITY ADMINISTRATION PRIVACY AND DISCLOSURE OF OFFICIAL RECORDS AND... online access option, such as a standard e-mail comment form on our Web site, and encryption is not being used, we alert you that personally identifiable information (such as your social security number...

  15. Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

    PubMed

    O'Connor, Stacy D; Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

    2016-03-01

    To assess whether integrating critical result management software--Alert Notification of Critical Results (ANCR)--with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Alert Response to Motion Onset in the Retina

    PubMed Central

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

    2013-01-01

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

  17. Analysis of clinical decision support system malfunctions: a case series and survey.

    PubMed

    Wright, Adam; Hickman, Thu-Trang T; McEvoy, Dustin; Aaron, Skye; Ai, Angela; Andersen, Jan Marie; Hussain, Salman; Ramoni, Rachel; Fiskio, Julie; Sittig, Dean F; Bates, David W

    2016-11-01

    To illustrate ways in which clinical decision support systems (CDSSs) malfunction and identify patterns of such malfunctions. We identified and investigated several CDSS malfunctions at Brigham and Women's Hospital and present them as a case series. We also conducted a preliminary survey of Chief Medical Information Officers to assess the frequency of such malfunctions. We identified four CDSS malfunctions at Brigham and Women's Hospital: (1) an alert for monitoring thyroid function in patients receiving amiodarone stopped working when an internal identifier for amiodarone was changed in another system; (2) an alert for lead screening for children stopped working when the rule was inadvertently edited; (3) a software upgrade of the electronic health record software caused numerous spurious alerts to fire; and (4) a malfunction in an external drug classification system caused an alert to inappropriately suggest antiplatelet drugs, such as aspirin, for patients already taking one. We found that 93% of the Chief Medical Information Officers who responded to our survey had experienced at least one CDSS malfunction, and two-thirds experienced malfunctions at least annually. CDSS malfunctions are widespread and often persist for long periods. The failure of alerts to fire is particularly difficult to detect. A range of causes, including changes in codes and fields, software upgrades, inadvertent disabling or editing of rules, and malfunctions of external systems commonly contribute to CDSS malfunctions, and current approaches for preventing and detecting such malfunctions are inadequate. CDSS malfunctions occur commonly and often go undetected. Better methods are needed to prevent and detect these malfunctions. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  18. Automated detection of optical counterparts to GRBs with RAPTOR

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

    Wozniak, P. R.; Vestrand, W. T.; Evans, S.

    2006-05-19

    The RAPTOR system (RAPid Telescopes for Optical Response) is an array of several distributed robotic telescopes that automatically respond to GCN localization alerts. Raptor-S is a 0.4-m telescope with 24 arc min. field of view employing a 1k x 1k Marconi CCD detector, and has already detected prompt optical emission from several GRBs within the first minute of the explosion. We present a real-time data analysis and alert system for automated identification of optical transients in Raptor-S GRB response data down to the sensitivity limit of {approx} 19 mag. Our custom data processing pipeline is designed to minimize the timemore » required to reliably identify transients and extract actionable information. The system utilizes a networked PostgreSQL database server for catalog access and distributes email alerts with successful detections.« less

  19. Smoke Detector

    NASA Technical Reports Server (NTRS)

    1979-01-01

    In the photo, Fire Chief Jay Stout of Safety Harbor, Florida, is explaining to young Richard Davis the workings of the Honeywell smoke and fire detector which probably saved Richard's life and that of his teen-age brother. Alerted by the detector's warning, the pair were able to escape their burning home. The detector in the Davis home was one of 1,500 installed in Safety Harbor residences in a cooperative program conducted by the city and Honeywell Inc.

  20. 49 CFR 176.905 - Motor vehicles or mechanical equipment powered by internal combustion engines.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of ignition. A motor vehicle or mechanical equipment showing any signs of leakage or electrical fault... smoke or fire detection system capable of alerting personnel on the bridge. (h) All electrical equipment...

  1. NASA Spacecraft Sees Dispersion of Smoke and Ash Across LA Basin from Colby Fire

    NASA Image and Video Library

    2014-01-18

    On Jan. 16, 2014, NASA Terra satellite passed over Glendora, Calif., where a large wildfire has claimed several homes, causing mandatory evacuations and prompting an air quality alert by public health officials.

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

    PubMed

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

    2014-09-01

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

  3. Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.

    PubMed

    Shah, Neil; Baker, Steven A; Spain, David; Shieh, Lisa; Shepard, John; Hadhazy, Eric; Maggio, Paul; Goodnough, Lawrence T

    2017-08-01

    To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. 78 FR 41342 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-10

    ... instructions for submitting comments. Email: ostigaard.crystal@epa.gov . Fax: (303) 312-6064 (please alert the.... FOR FURTHER INFORMATION CONTACT: Crystal Ostigaard, Air Program, U.S. Environmental Protection Agency....crystal@epa.gov . SUPPLEMENTARY INFORMATION: In the Rules section of this Federal Register, EPA is...

  5. 78 FR 57573 - Approval and Promulgation of Air Quality Implementation Plans; State of Colorado Second Ten-Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-19

    ... submitting comments. Email: ostigaard.crystal@epa.gov . Fax: (303) 312-6064 (please alert the individual.... FOR FURTHER INFORMATION CONTACT: Crystal Ostigaard, Air Program, U.S. Environmental Protection Agency....crystal@epa.gov . SUPPLEMENTARY INFORMATION: In the Rules section of this Federal Register, EPA is...

  6. Cannon Fire Soon to Accompany Bugle Call at Fort Detrick | Poster

    Cancer.gov

    Beginning June 14, the familiar bugle calls at Fort Detrick will be joined by a special percussion instrument: a cannon. A single cannon shot will be fired on the first note of “Reveille,” which signals the start of each day and is accompanied by the raising of the American flag. “Reveille” sounds at 6:30 a.m. At 5 p.m., Fort Detrick plays “Retreat,” which alerts the post that

  7. Warning! fire in the ICU.

    PubMed

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

    2014-06-01

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

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

    EPA Pesticide Factsheets

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

  9. Chemical Safety Alert: Shaft Blow-Out Hazard of Check and Butterfly Valves

    EPA Pesticide Factsheets

    Certain types of check and butterfly valves can undergo shaft-disk separation and fail catastrophically, even when operated within their design limits of pressure and temperature, causing toxic/flammable gas releases, fires, and vapor cloud explosions.

  10. Design and evaluation of a personal digital assistant- based alerting service for clinicians.

    PubMed

    Johnson, E Diane; Pancoast, Paul E; Mitchell, Joyce A; Shyu, Chi-Ren

    2004-10-01

    This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.

  11. Near-Real-Time Detection and Monitoring of Intense Pyroconvection from Geostationary Satellites

    NASA Astrophysics Data System (ADS)

    Peterson, D. A.; Fromm, M. D.; Hyer, E. J.; Surratt, M. L.; Solbrig, J. E.; Campbell, J. R.

    2016-12-01

    Intense fire-triggered thunderstorms, known as pyrocumulonimbus (or pyroCb), can alter fire behavior, influence smoke plume trajectories, and hinder fire suppression efforts. PyroCb are also known for injecting a significant quantity of aerosol mass into the upper-troposphere and lower-stratosphere (UTLS). Near-real-time (NRT) detection and monitoring of pyroCb is highly desirable for a variety of forecasting and research applications. The Naval Research Laboratory (NRL) recently developed the first automated NRT pyroCb detection algorithm for geostationary satellite sensors. The algorithm uses multispectral infrared observations to isolate deep convective clouds with the distinct microphysical signal of pyroCb. Application of this algorithm to 88 intense wildfires observed during the 2013 fire season in western North America resulted in detection of individual intense events, pyroCb embedded within traditional convection, and multiple, short-lived pulses of activity. Comparisons with a community inventory indicate that this algorithm captures the majority of pyroCb. The primary limitation of the current system is that pyroCb anvils can be small relative to satellite pixel size, especially in in regions with large viewing angles. The algorithm is also sensitive to some false positives from traditional convection that either ingests smoke or exhibits extreme updraft velocities. This algorithm has been automated using the GeoIPS processing system developed at NRL, which produces a variety of imagery products and statistical output for rapid analysis of potential pyroCb events. NRT application of this algorithm has been extended to the majority of regions worldwide known to have a high frequency of pyroCb occurrence. This involves a constellation comprised of GOES-East, GOES-West, and Himawari-8. Imagery is posted immediately to an NRL-maintained web page. Alerts are generated by the system and disseminated via email. This detection system also has potential to serve as a data source for other NRT environmental monitoring systems. While the current geostationary constellation has several important limitations, the next-generation of geostationary sensors will offer significant advantages for achieving the goal of global NRT pyroCb detection.

  12. A Forest Fire Sensor Web Concept with UAVSAR

    NASA Astrophysics Data System (ADS)

    Lou, Y.; Chien, S.; Clark, D.; Doubleday, J.; Muellerschoen, R.; Zheng, Y.

    2008-12-01

    We developed a forest fire sensor web concept with a UAVSAR-based smart sensor and onboard automated response capability that will allow us to monitor fire progression based on coarse initial information provided by an external source. This autonomous disturbance detection and monitoring system combines the unique capabilities of imaging radar with high throughput onboard processing technology and onboard automated response capability based on specific science algorithms. In this forest fire sensor web scenario, a fire is initially located by MODIS/RapidFire or a ground-based fire observer. This information is transmitted to the UAVSAR onboard automated response system (CASPER). CASPER generates a flight plan to cover the alerted fire area and executes the flight plan. The onboard processor generates the fuel load map from raw radar data, used with wind and elevation information, predicts the likely fire progression. CASPER then autonomously alters the flight plan to track the fire progression, providing this information to the fire fighting team on the ground. We can also relay the precise fire location to other remote sensing assets with autonomous response capability such as Earth Observation-1 (EO-1)'s hyper-spectral imager to acquire the fire data.

  13. Doppler Radar National Mosaic - NOAA's National Weather Service

    Science.gov Websites

    Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings

  14. Going for the Gold: Identifying Academic-Quality Internet Resources

    ERIC Educational Resources Information Center

    Axford, Mary; Renfro, Crystal

    2008-01-01

    The purpose of this article is to review some of the key directories of Internet resources, with a special focus on those that announce new academic-quality resources. Significant facets of the directories that will be incorporated in the discussion include scope of coverage, update frequency, identification of any e-mail alerts or RSS feeds…

  15. Forecasts - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  16. Observations - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  17. Warnings/Watches - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  18. NOAA's National Hydrologic Assessment

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  19. National Maps - Pacific - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  20. Weather Education/Outreach - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  1. Careers in Weather - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and Atmospheric Administration's Select to go to the NWS homepage National Weather Service Site Map News

  2. AGILE/GRID Science Alert Monitoring System: The Workflow and the Crab Flare Case

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Conforti, V.; Parmiggiani, N.

    2013-10-01

    During the first five years of the AGILE mission we have observed many gamma-ray transients of Galactic and extragalactic origin. A fast reaction to unexpected transient events is a crucial part of the AGILE monitoring program, because the follow-up of astrophysical transients is a key point for this space mission. We present the workflow and the software developed by the AGILE Team to perform the automatic analysis for the detection of gamma-ray transients. In addition, an App for iPhone will be released enabling the Team to access the monitoring system through mobile phones. In 2010 September the science alert monitoring system presented in this paper recorded a transient phenomena from the Crab Nebula, generating an automated alert sent via email and SMS two hours after the end of an AGILE satellite orbit, i.e. two hours after the Crab flare itself: for this discovery AGILE won the 2012 Bruno Rossi prize. The design of this alert system is maximized to reach the maximum speed, and in this, as in many other cases, AGILE has demonstrated that the reaction speed of the monitoring system is crucial for the scientific return of the mission.

  3. Speech Alarms Pilot Study

    NASA Technical Reports Server (NTRS)

    Sandor, A.; Moses, H. R.

    2016-01-01

    Currently on the International Space Station (ISS) and other space vehicles Caution & Warning (C&W) alerts are represented with various auditory tones that correspond to the type of event. This system relies on the crew's ability to remember what each tone represents in a high stress, high workload environment when responding to the alert. Furthermore, crew receive a year or more in advance of the mission that makes remembering the semantic meaning of the alerts more difficult. The current system works for missions conducted close to Earth where ground operators can assist as needed. On long duration missions, however, they will need to work off-nominal events autonomously. There is evidence that speech alarms may be easier and faster to recognize, especially during an off-nominal event. The Information Presentation Directed Research Project (FY07-FY09) funded by the Human Research Program included several studies investigating C&W alerts. The studies evaluated tone alerts currently in use with NASA flight deck displays along with candidate speech alerts. A follow-on study used four types of speech alerts to investigate how quickly various types of auditory alerts with and without a speech component - either at the beginning or at the end of the tone - can be identified. Even though crew were familiar with the tone alert from training or direct mission experience, alerts starting with a speech component were identified faster than alerts starting with a tone. The current study replicated the results from the previous study in a more rigorous experimental design to determine if the candidate speech alarms are ready for transition to operations or if more research is needed. Four types of alarms (caution, warning, fire, and depressurization) were presented to participants in both tone and speech formats in laboratory settings and later in the Human Exploration Research Analog (HERA). In the laboratory study, the alerts were presented by software and participants were asked to identify the alert as quickly and as accurately as possible. Reaction time and accuracy were measured. Participants identified speech alerts significantly faster than tone alerts. The HERA study investigated the performance of participants in a flight-like environment. Participants were instructed to complete items on a task list and respond to C&W alerts as they occurred. Reaction time and accuracy were measured to determine if the benefits of speech alarms are still present in an applied setting.

  4. Mission Statement - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings data, forecasts and warnings for the protection of life and property and enhancement of the national Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and

  5. National Maps - Alaska - NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings current Forecast for Alaska is produced by the NWS Anchorage Forecast Office. It is updated daily Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and

  6. The Use of Online Current Awareness Services by Natural Sciences and Engineering Faculty at Western Michigan University

    ERIC Educational Resources Information Center

    Leatherman, Carrie C.; Eckel, Edward J.

    2012-01-01

    Nearly every commercial database that covers natural sciences and engineering offers some type of current awareness (CA) service that provides regular updates to users on current literature in a selected field of interest. Current awareness services include e-mail alerts, tables of contents, and RSS feeds. This study was designed to find out what…

  7. Earthquake Warning Performance in Vallejo for the South Napa Earthquake

    NASA Astrophysics Data System (ADS)

    Wurman, G.; Price, M.

    2014-12-01

    In 2002 and 2003, Seismic Warning Systems, Inc. installed first-generation QuakeGuardTM earthquake warning devices at all eight fire stations in Vallejo, CA. These devices are designed to detect the P-wave of an earthquake and initiate predetermined protective actions if the impending shaking is estimated at approximately Modifed Mercalli Intensity V or greater. At the Vallejo fire stations the devices were set up to sound an audio alert over the public address system and to command the equipment bay doors to open. In August 2014, after more than 11 years of operating in the fire stations with no false alarms, the five units that were still in use triggered correctly on the MW 6.0 South Napa earthquake, less than 16 km away. The audio alert sounded in all five stations, providing fire fighters with 1.5 to 2.5 seconds of warning before the arrival of the S-wave, and the equipment bay doors opened in three of the stations. In one station the doors were disconnected from the QuakeGuard device, and another station lost power before the doors opened completely. These problems highlight just a small portion of the complexity associated with realizing actionable earthquake warnings. The issues experienced in this earthquake have already been addressed in subsequent QuakeGuard product generations, with downstream connection monitoring and backup power for critical systems. The fact that the fire fighters in Vallejo were afforded even two seconds of warning at these epicentral distances results from the design of the QuakeGuard devices, which focuses on rapid false positive rejection and ground motion estimates. We discuss the performance of the ground motion estimation algorithms, with an emphasis on the accuracy and timeliness of the estimates at close epicentral distances.

  8. Effectiveness of Provider Education Followed by Computerized Provider Order Entry Alerts in Reducing Inappropriate Red Blood Cell Transfusion.

    PubMed

    Patel, Vijay M; Rains, Anna W; Clark, Christopher T

    2016-01-01

    To reduce the rate of inappropriate red blood cell transfusion, a provider education program, followed by alerts in the computerized provider order entry system (CPOE), was established to encourage AABB transfusion guidelines. Metrics were established for nonemergent inpatient transfusions. Service lines with high order volume were targeted with formal education regarding AABB 2012 transfusion guidelines. Transfusion orders were reviewed in real time with email communications sent to ordering providers falling outside of AABB recommendations. After 12 months of provider education, alerts were activated in CPOE. With provider education alone, the incidence of pretransfusion hemoglobin levels greater than 8 g/dL decreased from 16.64% to 6.36%, posttransfusion hemoglobin levels greater than 10 g/dL from 14.03% to 3.78%, and number of nonemergent two-unit red blood cell orders from 45.26% to 22.66%. Red blood cell utilization decreased by 13%. No additional significant reduction in nonemergent two-unit orders was observed with CPOE alerts. Provider education, an effective and low-cost method, should be considered as a first-line method for reducing inappropriate red blood cell transfusion rates in stable adult inpatients. Alerts in the computerized order entry system did not significantly lower the percentage of two-unit red blood cells orders but may help to maintain educational efforts.

  9. The agile alert system for gamma-ray transients

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

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.

    2014-01-20

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a newmore » algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.« less

  10. The AGILE Alert System for Gamma-Ray Transients

    NASA Astrophysics Data System (ADS)

    Bulgarelli, A.; Trifoglio, M.; Gianotti, F.; Tavani, M.; Parmiggiani, N.; Fioretti, V.; Chen, A. W.; Vercellone, S.; Pittori, C.; Verrecchia, F.; Lucarelli, F.; Santolamazza, P.; Fanari, G.; Giommi, P.; Beneventano, D.; Argan, A.; Trois, A.; Scalise, E.; Longo, F.; Pellizzoni, A.; Pucella, G.; Colafrancesco, S.; Conforti, V.; Tempesta, P.; Cerone, M.; Sabatini, P.; Annoni, G.; Valentini, G.; Salotti, L.

    2014-01-01

    In recent years, a new generation of space missions has offered great opportunities for discovery in high-energy astrophysics. In this article we focus on the scientific operations of the Gamma-Ray Imaging Detector (GRID) on board the AGILE space mission. AGILE-GRID, sensitive in the energy range of 30 MeV-30 GeV, has detected many γ-ray transients of both galactic and extragalactic origin. This work presents the AGILE innovative approach to fast γ-ray transient detection, which is a challenging task and a crucial part of the AGILE scientific program. The goals are to describe (1) the AGILE Gamma-Ray Alert System, (2) a new algorithm for blind search identification of transients within a short processing time, (3) the AGILE procedure for γ-ray transient alert management, and (4) the likelihood of ratio tests that are necessary to evaluate the post-trial statistical significance of the results. Special algorithms and an optimized sequence of tasks are necessary to reach our goal. Data are automatically analyzed at every orbital downlink by an alert pipeline operating on different timescales. As proper flux thresholds are exceeded, alerts are automatically generated and sent as SMS messages to cellular telephones, via e-mail, and via push notifications from an application for smartphones and tablets. These alerts are crosschecked with the results of two pipelines, and a manual analysis is performed. Being a small scientific-class mission, AGILE is characterized by optimization of both scientific analysis and ground-segment resources. The system is capable of generating alerts within two to three hours of a data downlink, an unprecedented reaction time in γ-ray astrophysics.

  11. The Explosive Universe with Gaia

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

  12. The Schoolhouse Is Raining

    ERIC Educational Resources Information Center

    Yee, Roger

    1974-01-01

    Built into 26 new Chicago school designs are two features: physical plants offering educators latitude to remove nearly all internal partitions for open plan teaching or to return to a traditional "eggorate" format if need be; and a new fire control technology placing a building on electronic alert for immediate reaction to dangerous symptoms with…

  13. 49 CFR 238.445 - Automated monitoring.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... performance of the following systems or components: (1) Reception of cab signals and train control signals; (2) Truck hunting; (3) Dynamic brake status; (4) Friction brake status; (5) Fire detection systems; (6) Head end power status; (7) Alerter or deadman control; (8) Horn and bell; (9) Wheel slide; (10) Tilt system...

  14. Centralized Alert-Processing and Asset Planning for Sensorwebs

    NASA Technical Reports Server (NTRS)

    Castano, Rebecca; Chien, Steve A.; Rabideau, Gregg R.; Tang, Benyang

    2010-01-01

    A software program provides a Sensorweb architecture for alert-processing, event detection, asset allocation and planning, and visualization. It automatically tasks and re-tasks various types of assets such as satellites and robotic vehicles in response to alerts (fire, weather) extracted from various data sources, including low-level Webcam data. JPL has adapted cons iderable Sensorweb infrastructure that had been previously applied to NASA Earth Science applications. This NASA Earth Science Sensorweb has been in operational use since 2003, and has proven reliability of the Sensorweb technologies for robust event detection and autonomous response using space and ground assets. Unique features of the software include flexibility to a range of detection and tasking methods including those that require aggregation of data over spatial and temporal ranges, generality of the response structure to represent and implement a range of response campaigns, and the ability to respond rapidly.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  16. Utilization of geoinformation tools for the development of forest fire hazard mapping system: example of Pekan fire, Malaysia

    NASA Astrophysics Data System (ADS)

    Mahmud, Ahmad Rodzi; Setiawan, Iwan; Mansor, Shattri; Shariff, Abdul Rashid Mohamed; Pradhan, Biswajeet; Nuruddin, Ahmed

    2009-12-01

    A study in modeling fire hazard assessment will be essential in establishing an effective forest fire management system especially in controlling and preventing peat fire. In this paper, we have used geographic information system (GIS), in combination with other geoinformation technologies such as remote sensing and computer modeling, for all aspects of wild land fire management. Identifying areas that have a high probability of burning is an important component of fire management planning. The development of spatially explicit GIS models has greatly facilitated this process by allowing managers to map and analyze variables contributing to fire occurrence across large, unique geographic units. Using the model and its associated software engine, the fire hazard map was produced. Extensive avenue programming scripts were written to provide additional capabilities in the development of these interfaces to meet the full complement of operational software considering various users requirements. The system developed not only possesses user friendly step by step operations to deliver the fire vulnerability mapping but also allows authorized users to edit, add or modify parameters whenever necessary. Results from the model can support fire hazard mapping in the forest and enhance alert system function by simulating and visualizing forest fire and helps for contingency planning.

  17. NOAA's National Weather Service

    Science.gov Websites

    select the go button to submit request City, St Go Sign-up for Email Alerts RSS Feeds RSS Feeds Warnings prepares the Annual Flood Loss summary for the U.S. Army Corps of Engineers. 2014 2013 2012 2011 2010 2009 Skip Navigation Links weather.gov NOAA logo-Select to go to the NOAA homepage National Oceanic and

  18. Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts.

    PubMed

    Basner, Mathias; Dinges, David F; Shea, Judy A; Small, Dylan S; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Volpp, Kevin G

    2017-04-01

    Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  19. MyEEW: A Smartphone App for the ShakeAlert System

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  20. Mid-term fire danger index based on satellite imagery and ancillary geographic data

    NASA Astrophysics Data System (ADS)

    Stefanidou, A.; Dragozi, E.; Tompoulidou, M.; Stepanidou, L.; Grigoriadis, D.; Katagis, T.; Stavrakoudis, D.; Gitas, I.

    2017-09-01

    Fire danger forecast constitutes one of the most important components of integrated fire management since it provides crucial information for efficient pre-fire planning, alertness and timely response to a possible fire event. The aim of this work is to develop an index that has the capability of predicting accurately fire danger on a mid-term basis. The methodology that is currently under development is based on an innovative approach that employs dry fuel spatial connectivity as well as biophysical and topological variables for the reliable prediction of fire danger. More specifically, the estimation of the dry fuel connectivity is based on a previously proposed automated procedure implemented in R software that uses Moderate Resolution Imaging Spectrometer (MODIS) time series data. Dry fuel connectivity estimates are then combined with other ancillary data such as fuel type and proximity to roads in order to result in the generation of the proposed mid-term fire danger index. The innovation of the proposed index—which will be evaluated by comparison to historical fire data—lies in the fact that its calculation is almost solely affected by the availability of satellite data. Finally, it should be noted that the index is developed within the framework of the National Observatory of Forest Fires (NOFFi) project.

  1. Microcomputer keeps watch at Emerald Mine

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

    Not Available

    1987-04-01

    Where there's smoke, there's fire. Take the old adage a step further: ''Where there's carbon monoxide, there's likely to be a fire.'' That's the principle behind the mine monitoring system being used at the Emerald Mine operated by Emway Resources. Instead of watching for smoke or temperature rises, the system uses carbon monoxide (CO) sensors to detect fires - before they break out. CO, a gaseous product of incomplete combustion, is present in the early stages of a fire. Carried by the mine ventilation air, CO can be quickly traced by electrochemical gas sensors that are wired to a centralmore » computer. When preset levels are reached, alarms can alert mine personnel of the trouble. The Emerald Mine is located in southwestern Pennsylvania, near Waynesburg, and mines the Pittsburgh Seam, the nation's most heavily mined seam. Emerald is one of a number of progressive mines that are turning to computers to improve safety and productivity.« less

  2. To act or not to act: responses to electronic health record prompts by family medicine clinicians.

    PubMed

    Zazove, Philip; McKee, Michael; Schleicher, Lauren; Green, Lee; Kileny, Paul; Rapai, Mary; Mulhem, Elie

    2017-03-01

    A major focus of health care today is a strong emphasis on improving the health and quality of care for entire patient populations. One common approach utilizes electronic clinical alerts to prompt clinicians when certain interventions are due for individual patients being seen. However, these alerts have not been consistently effective, particularly for less visible (though important) conditions such as hearing loss (HL) screening. We conducted hour-long cognitive task analysis interviews to explore how family medicine clinicians view, perceive, and use electronic clinical alerts, and to utilize this information to design a more effective alert using HL identification and referral as a model diagnosis. Four key direct barriers were identified that impeded alert use: poor standardization and formatting, time pressures in primary care, clinic workflow variations, and mental models of the condition being prompted (in this case, HL). One indirect barrier was identified: electronic health record and institution/government regulations. We identified that clinicians' mental model of the condition being prompted was probably the major barrier, though this was often expressed as time pressure. We discuss solutions to each of the 5 identified barriers, such as addressing physicians' mental models, by focusing on physicians' expertise rather than knowledge to improve their comfort when caring for patients with the conditions being prompted. To unleash the potential of electronic clinical alerts, electronic health record and health care institutions need to address some key barriers. We outline these barriers and propose solutions. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. The Spacecraft Emergency Response System (SERS) for Autonomous Mission Operations

    NASA Technical Reports Server (NTRS)

    Breed, Julia; Chu, Kai-Dee; Baker, Paul; Starr, Cynthia; Fox, Jeffrey; Baitinger, Mick

    1998-01-01

    Today, most mission operations are geared toward lowering cost through unmanned operations. 7-day/24-hour operations are reduced to either 5-day/8-hour operations or become totally autonomous, especially for deep-space missions. Proper and effective notification during a spacecraft emergency could mean success or failure for an entire mission. The Spacecraft Emergency Response System (SERS) is a tool designed for autonomous mission operations. The SERS automatically contacts on-call personnel as needed when crises occur, either on-board the spacecraft or within the automated ground systems. Plus, the SERS provides a group-ware solution to facilitate the work of the person(s) contacted. The SERS is independent of the spacecraft's automated ground system. It receives and catalogues reports for various ground system components in near real-time. Then, based on easily configurable parameters, the SERS determines whom, if anyone, should be alerted. Alerts may be issued via Sky-Tel 2-way pager, Telehony, or e-mail. The alerted personnel can then review and respond to the spacecraft anomalies through the Netscape Internet Web Browser, or directly review and respond from the Sky-Tel 2-way pager.

  4. Effect of station-specific alerting and ramp-up tones on firefighters' alarm time heart rates.

    PubMed

    MacNeal, James J; Cone, David C; Wistrom, Christopher L

    2016-11-01

    A number of long-term health effects are suffered by emergency responders, some influenced by psychological stress and fatigue. This study explored if stress and fatigue can be reduced by changing the method by which firefighters are alerted to emergency responses. Over several months, the method by which responders at a fire department were alerted was altered. Firefighter heart rates were measured first with standard alerting as a control (phase 1: all stations alerted simultaneously, with high-volume tones). The department then implemented station-specific (phase 2) and gradual volume ramp-up (phase 3) tone alerting, and heart rate increases were compared. The Fatigue Severity Score was used to examine firefighter fatigue, and the department administered a follow-up survey on personnel preferences. Individual heart rate increases (Δbpm) ranged from 2-48 bpm. Median increases were 7 bpm (IQR 4-11 bpm) during phase 1 (72.2% of alarms Δbpm<10), 7 bpm (IQR 5-12 bpm) during phase 2 (60.7% of alarms Δbpm<10), and 5 bpm (IQR 3-8 bpm) during phase 3 (82.7% of alarms Δbpm<10). The difference in medians was lower for phases 1 and 2 than for phase 3 (p = 0.0069), and more alarms in phase 3 resulted in increases of <10 bpm than in phase 2 (p = 0.0089). The Fatigue Severity Scale showed little variability: median scores 7 in phase 1, 8 in phase 2, and 7 in phase 3. Firefighters reported a strong preference for the "ramp-up" tones, and were roughly evenly divided between preferring alerting all stations simultaneously 24/7 (40% rating this 4 or 5 on a five-point Likert scale), station-specific alerting 24/7 (47.5%), or all stations during the day but station-specific at night (40%). Ramp-up tones were perceived as the best method to reduce stress during the day and overnight. Small but significant decreases in the amount of tachycardic response to station alerting are associated with simple alterations in alerting methods. Station-specific and ramp-up tones improve perceived working conditions for emergency responders.

  5. Performance assessment of fire-sat monitoring system based on satellite time series for fire danger estimation : the experience of the pre-operative application in the Basilicata Region (Italy)

    NASA Astrophysics Data System (ADS)

    Lanorte, Antonio; Desantis, Fortunato; Aromando, Angelo; Lasaponara, Rosa

    2013-04-01

    This paper presents the results we obtained in the context of the FIRE-SAT project during the 2012 operative application of the satellite based tools for fire monitoring. FIRE_SAT project has been funded by the Civil Protection of the Basilicata Region in order to set up a low cost methodology for fire danger monitoring and fire effect estimation based on satellite Earth Observation techniques. To this aim, NASA Moderate Resolution Imaging Spectroradiometer (MODIS), ASTER, Landsat TM data were used. Novel data processing techniques have been developed by researchers of the ARGON Laboratory of the CNR-IMAA for the operative monitoring of fire. In this paper we only focus on the danger estimation model which has been fruitfully used since 2008 to 2012 as an reliable operative tool to support and optimize fire fighting strategies from the alert to the management of resources including fire attacks. The daily updating of fire danger is carried out using satellite MODIS images selected for their spectral capability and availability free of charge from NASA web site. This makes these data sets very suitable for an effective systematic (daily) and sustainable low-cost monitoring of large areas. The preoperative use of the integrated model, pointed out that the system properly monitor spatial and temporal variations of fire susceptibility and provide useful information of both fire severity and post fire regeneration capability.

  6. EVALUATION OF METEOROLOGICAL ALERT CHAIN IN CASTILLA Y LEÓN (SPAIN): How can the meteorological risk managers help researchers?

    NASA Astrophysics Data System (ADS)

    López, Laura; Guerrero-Higueras, Ángel Manuel; Sánchez, José Luis; Matía, Pedro; Ortiz de Galisteo, José Pablo; Rodríguez, Vicente; Lorente, José Manuel; Merino, Andrés; Hermida, Lucía; García-Ortega, Eduardo; Fernández-Manso, Oscar

    2013-04-01

    Evaluating the meteorological alert chain, or, how information is transmitted from the meteorological forecasters to the final users, passing through risk managers, is a useful tool that benefits all the links of the chain, especially the meteorology researchers and forecasters. In fact, the risk managers can help significantly to improve meteorological forecasts in different ways. Firstly, by pointing out the most appropriate type of meteorological format, and its characteristics when representing the meteorological information, consequently improving the interpretation of the already-existing forecasts. Secondly, by pointing out the specific predictive needs in their workplaces related to the type of significant meteorological parameters, temporal or spatial range necessary, meteorological products "custom-made" for each type of risk manager, etc. In order to carry out an evaluation of the alert chain in Castilla y León, we opted for the creation of a Panel of Experts made up of personnel specialized in risk management (Responsible for Protection Civil, Responsible for Alert Services and Hydrological Planning of Hydrographical Confederations, Responsible for highway maintenance, and management of fires, fundamentally). In creating this panel, a total of twenty online questions were evaluated, and the majority of the questions were multiple choice or open-ended. Some of the results show how the risk managers think that it would be interesting, or very interesting, to carry out environmental educational campaigns about the meteorological risks in Castilla y León. Another result is the elevated importance that the risk managers provide to the observation data in real-time (real-time of wind, lightning, relative humidity, combined indices of risk of avalanches, snowslides, index of fires due to convective activity, etc.) Acknowledgements The authors would like to thank the Junta de Castilla y León for its financial support through the project LE220A11-2.

  7. Prevalence of hydrogen cyanide and carboxyhaemoglobin in victims of smoke inhalation during enclosed-space fires: a combined toxicological risk.

    PubMed

    Grabowska, Teresa; Skowronek, Rafał; Nowicka, Joanna; Sybirska, Halina

    2012-09-01

    Hydrogen cyanide (HCN) is one of the most toxic components of fire smoke, but insufficient attention is paid to its potential role as a cause of injury or death in victims (alive or dead) of enclosed-space fires. To analyse the prevalence of toxic HCN exposure in fire victims and factors that may influence its toxicity, particularly the co-presence of carbon monoxide (CO) and ethanol. Blood samples from fire victims and persons rescued from fires were analysed. A positive result for HCN (mean concentration 16.83 mg/l) was detected in blood samples from 169 of 285 fire-related deaths (59%). Ethanol was present in 91 (65%) of 139 samples with coincident presence of HCN and carboxyhaemoglobin (COHb). HCN (mean 4.0 mg/l) was also detected in 20 of 40 (50%) fire survivors. The high prevalence of coincident CO and HCN in enclosed-space, fire-related deaths should alert clinicians to suspect toxic HCN exposure in all persons rescued from fire with signs and symptoms of respiratory distress. Medical procedures in persons rescued from enclosed-space fires, especially in the pre-hospital setting, should be augmented to cover the possibility of toxic HCN exposure, particularly in individuals who do not respond to standard supportive therapy. Likewise, post-mortem investigations should routinely include assays for HCN when determining probable cause of death.

  8. Information Framework of Pervasive Real Time Monitoring System: Case of Peat Land Forest Fires and Air Quality in South Sumatera, Indonesia

    NASA Astrophysics Data System (ADS)

    Nurmaini, Siti; Firsandaya Malik, Reza; Stiawan, Deris; Firdaus; Saparudin; Tutuko, Bambang

    2017-04-01

    The information framework aims to holistically address the problems and issues posed by unwanted peat and land fires within the context of the natural environment and socio-economic systems. Informed decisions on planning and allocation of resources can only be made by understanding the landscape. Therefore, information on fire history and air quality impacts must be collected for future analysis. This paper proposes strategic framework based on technology approach with data fusion strategy to produce the data analysis about peat land fires and air quality management in in South Sumatera. The research framework should use the knowledge, experience and data from the previous fire seasons to review, improve and refine the strategies and monitor their effectiveness for the next fire season. Communicating effectively with communities and the public and private sectors in remote and rural landscapes is important, by using smartphones and mobile applications. Tools such as one-stop information based on web applications, to obtain information such as early warning to send and receive fire alerts, could be developed and promoted so that all stakeholders can share important information with each other.

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

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

  10. Volume 51, Issue 7-8Copyright © 2003 WILEY-VCH Verlag GmbH & Co. KGaA, WeinheimSave Title to My Profile

    E-MailPrint

    Volume 51, Issue 7-8, Pages 639-896(July 2003)

    Preface

    Preface

    NASA Astrophysics Data System (ADS)

    Andreev, O.

    2003-07-01

    We briefly review a possible scheme for getting the known QCD scaling laws within string theory. In particular, we consider amplitudes for exclusive scattering of hadrons at large momentum transfer and hadronic form factors.

  11. Fire regime, not time-since-fire, affects soil fungal community diversity and composition in temperate grasslands.

    PubMed

    Egidi, Eleonora; McMullan-Fisher, Sapphire; Morgan, John W; May, Tom; Zeeman, Ben; Franks, Ashley E

    2016-09-01

    Frequent burning is commonly undertaken to maintain diversity in temperate grasslands of southern Australia. How burning affects below-ground fungal community diversity remains unknown. We show, using a fungal rDNA metabarcoding approach (Illumina MiSeq), that the fungal community composition was influenced by fire regime (frequency) but not time-since-fire. Fungal community composition was resilient to direct fire effects, most likely because grassland fires transfer little heat to the soil. Differences in the fungal community composition due to fire regime was likely due to associated changes that occur in vegetation with recurrent fire, via the break up of obligate symbiotic relationships. However, fire history only partially explains the observed dissimilarity in composition among the soil samples, suggesting a distinctiveness in composition in each grassland site. The importance of considering changes in soil microbe communities when managing vegetation with fire is highlighted. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Improving the effect of FDA-mandated drug safety alerts with Internet-based continuing medical education.

    PubMed

    Kraus, Carl N; Baldwin, Alan T; McAllister, R G

    2013-02-01

    The US Food and Drug Administration (FDA) requires risk communication as an element of Risk Evaluation and Mitigation Strategies (REMS) to alert and educate healthcare providers about severe toxicities associated with approved drugs. The educational effectiveness of this approach has not been evaluated. To support the communication plan element of the ipilimumab REMS, a Medscape Safe Use Alert (SUA) letter was distributed by Medscape via email and mobile device distribution to clinicians specified in the REMS. This alert contained the FDA-approved Dear Healthcare Provider (DHCP) letter mandated for distribution. A continuing medical education (CME) activity describing ipilimumab toxicities and the appropriate management was simultaneously posted on the website and distributed to Medscape members. Data were collected over a 6-month period regarding the handling of the letter and the responses to pre- and post-test questions for those who participated in the CME activity. Analysis of the answers to the pre- and posttest questions showed that participation in the CME activity resulted in an improvement in correct answer responses of 47%. Our experience shows that there are likely distinct information sources that are utilized by different HCP groups. The ready availability of a brief CME activity was utilized by 24,063 individuals, the majority of whom showed enhanced understanding of ipilimumab toxicity by improvement in post-test scores, educational data that are not available via implementation of standard safety alert communications. These results demonstrate that improvement in understanding of specific drug toxicities is enhanced by a CME intervention.

  13. Sensor data monitoring and decision level fusion scheme for early fire detection

    NASA Astrophysics Data System (ADS)

    Rizogiannis, Constantinos; Thanos, Konstantinos Georgios; Astyakopoulos, Alkiviadis; Kyriazanos, Dimitris M.; Thomopoulos, Stelios C. A.

    2017-05-01

    The aim of this paper is to present the sensor monitoring and decision level fusion scheme for early fire detection which has been developed in the context of the AF3 Advanced Forest Fire Fighting European FP7 research project, adopted specifically in the OCULUS-Fire control and command system and tested during a firefighting field test in Greece with prescribed real fire, generating early-warning detection alerts and notifications. For this purpose and in order to improve the reliability of the fire detection system, a two-level fusion scheme is developed exploiting a variety of observation solutions from air e.g. UAV infrared cameras, ground e.g. meteorological and atmospheric sensors and ancillary sources e.g. public information channels, citizens smartphone applications and social media. In the first level, a change point detection technique is applied to detect changes in the mean value of each measured parameter by the ground sensors such as temperature, humidity and CO2 and then the Rate-of-Rise of each changed parameter is calculated. In the second level the fire event Basic Probability Assignment (BPA) function is determined for each ground sensor using Fuzzy-logic theory and then the corresponding mass values are combined in a decision level fusion process using Evidential Reasoning theory to estimate the final fire event probability.

  14. AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS.

    PubMed

    Bevan, Amanda; Patel, Niesh

    2016-09-01

    Whilst the prescribing of both in-patient and discharge medicines is electronic, there was no automatic notification to clinical pharmacists when a discharge prescription was ready to be screened. The notification required a member of medical or nursing staff to bleep their pharmacist informing them of a prescription's availability. This manual process led to a delay in pharmacist screening which impacted on discharge. Prescriptions designated for pre-packed or patient's own medicine use were not seen at all by a clinical pharmacist. The initial intention was to develop a text messaging service; however this was not possible due to significant cost implications and its inflexibility. To decrease the time to clinical pharmacist screening for children's discharge prescriptions. A clinical pharmacist prescription alerting system was designed and implemented. The hospital's eDischarge Summaries are created and stored in the Trust's EPR database. A database query is executed that examines documents that have been signed by a prescriber which contain drug orders. The query runs every 15 minutes, Monday to Friday from 0800-2000. The database query exports a HTML data extract which is then packaged and sent using Exchange.Email was preferred as users access hospital WiFi, only receiving notifications on those laptops or smartphones connected to the Trust's email application. The HTML is embedded within the email body. The email is sent to named individuals within a given distribution list. The function is scalable to support all areas using Trust eDischarge Summaries.The system was introduced in April 2015. Data from before (June 2014-January 2015) and after (June 2015) implementation was compared. Prior to the introduction of an electronic alerting system the average time from a prescriber signing a prescription to clinical pharmacist screening was 93 minutes. Three months after starting the new system this time has reduced to 62 minutes, a reduction of 31 minutes or 33%. During the same time period, the number of discharge prescriptions screened by pharmacists rose from 172 to 218, an increase in workload of 26%.It has been possible to intervene on prescriptions containing errors which the clinical pharmacists would not previously have screened. The use of an electronic messaging system has met its primary aim to decrease the time delay from signing to pharmacist screening it has also increased pharmacist efficiency as evidenced by the increased workload.One limitation of this system is that it requires a regular e-mail check, for available prescriptions. The report runs every 15 minutes, an email is only sent if a prescription is found.The notification of all discharge prescriptions containing medicines has led to the identification of errors which have required intervention, in those prescriptions that a pharmacist would not have previously seen. These interventions have been for children who have received pre-packed antibiotics directly from the wards or for those where we have provided one-stop dispensing.It is hoped to role out this system across other areas of the organisation which should also enjoy this significant improvement in discharge prescription turnaround. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. AGU Public Affairs: How to Get Involved in Science Policy

    NASA Astrophysics Data System (ADS)

    Landau, E. A.; Hankin, E. R.; Uhlenbrock, K. M.

    2012-12-01

    AGU Public Affairs offers many ways for its members to get involved in science policy at different levels of participation, whether you would love to spend a year working as a resident science expert in a congressional office in Washington, D.C., or would rather simply receive email alerts about Earth and space science policy news. How you can get involved: Sign up for AGU Science Policy Alerts to receive the most relevant Earth and space science policy information delivered to your email inbox. Participate in one of AGU's Congressional Visits Days to speak with your legislators about important science issues. Attend the next AGU Science Policy Conference in spring 2013. Participate in events happening on Capitol Hill, and watch video of past events. Learn about AGU Embassy Lectures, where countries come together to discuss important Earth and space science topics. Learn how you can comment on AGU Position Statements. Apply to be an AGU Congressional Science Fellow, where you can work in a congressional office for one year and serve as a resident science expert, or to be an AGU Public Affairs Intern, where you can work in the field of science policy for three months. The AGU Public Affairs Team will highlight ways members can be involved as well as provide information on how the team is working to shape policy and inform society about the excitement of AGU science.

  16. The fire-safe cigarette: a burn prevention tool.

    PubMed

    Barillo, D J; Brigham, P A; Kayden, D A; Heck, R T; McManus, A T

    2000-01-01

    Cigarettes are the most common ignition source for fatal house fires, which cause approximately 29% of the fire deaths in the United States. A common scenario is the delayed ignition of a sofa, chair, or mattress by a lit cigarette that is forgotten or dropped by a smoker whose alertness is impaired by alcohol or medication. Cigarettes are designed to continue burning when left unattended. If they are dropped on mattresses, upholstered furniture, or other combustible material while still burning, their propensity to start fires varies depending on the cigarette design and content. The term "fire-safe" has evolved to describe cigarettes designed to have a reduced propensity for igniting mattresses and upholstered furniture. Legislative interest in the development of fire-safe smoking materials has existed for more than 50 years. Studies that showed the technical and economic feasibility of commercial production of fire-safe cigarettes were completed more than 10 years ago. Despite this, commercial production of fire-safe smoking materials has not been undertaken. The current impasse relates to the lack of consensus on a uniform test method on which to base a standard for fire-safe cigarettes. Although the fire-safe cigarette is a potentially important burn prevention tool, commercial production of such cigarettes will not occur until a standard against which fire-starting performance can be measured has been mandated by law at the state or federal level. The burn care community can play a leadership role in such legislative efforts.

  17. Distinct Developmental Origins Manifest in the Specialized Encoding of Movement by Adult Neurons of the External Globus Pallidus

    PubMed Central

    Dodson, Paul D.; Larvin, Joseph T.; Duffell, James M.; Garas, Farid N.; Doig, Natalie M.; Kessaris, Nicoletta; Duguid, Ian C.; Bogacz, Rafal; Butt, Simon J.B.; Magill, Peter J.

    2015-01-01

    Summary Transcriptional codes initiated during brain development are ultimately realized in adulthood as distinct cell types performing specialized roles in behavior. Focusing on the mouse external globus pallidus (GPe), we demonstrate that the potential contributions of two GABAergic GPe cell types to voluntary action are fated from early life to be distinct. Prototypic GPe neurons derive from the medial ganglionic eminence of the embryonic subpallium and express the transcription factor Nkx2-1. These neurons fire at high rates during alert rest, and encode movements through heterogeneous firing rate changes, with many neurons decreasing their activity. In contrast, arkypallidal GPe neurons originate from lateral/caudal ganglionic eminences, express the transcription factor FoxP2, fire at low rates during rest, and encode movements with robust increases in firing. We conclude that developmental diversity positions prototypic and arkypallidal neurons to fulfil distinct roles in behavior via their disparate regulation of GABA release onto different basal ganglia targets. PMID:25843402

  18. Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation.

    PubMed

    Zijlstra, Jolande A; Beesems, Stefanie G; De Haan, Rob J; Koster, Rudolph W

    2015-07-01

    We studied the short-term psychological impact and post-traumatic stress disorder (PTSD)-related symptoms in lay rescuers performing cardiopulmonary resuscitation (CPR) after a text message (TM)-alert for out-of-hospital-cardiac arrest, and assessed which factors contribute to a higher level of PTSD-related symptoms. The lay rescuers received a TM-alert and simultaneously an email with a link to an online questionnaire. We analyzed all questionnaires from February 2013 until October 2014 measuring the short-term psychological impact. We interviewed by telephone all first arriving lay rescuers performing bystander CPR and assessed PTSD-related symptoms with the Impact of Event Scale (IES) 4-6 weeks after the resuscitation. IES-scores 0-8 reflected no stress, 9-25 mild, 26-43 moderate, and 44-75 severe stress. A score ≥ 26 indicated PTSD symptomatology. Of all alerted lay rescuers, 6572 completed the online questionnaire. Of these, 1955 responded to the alert and 507 assisted in the resuscitation. We interviewed 203 first arriving rescuers of whom 189 completed the IES. Of these, 41% perceived no/mild short-term impact, 46% bearable impact and 13% severe impact. On the IES, 81% scored no stress and 19% scored mild stress. None scored moderate or severe stress. Using a multivariable logistic regression model we identified three factors with an independent impact on mild stress level: no automated external defibrillator connected by the lay rescuer, severe short-term impact, and no (very) positive experience. Lay rescuers alerted by text messages, do not show PTSD-related symptoms 4-6 weeks after performing bystander CPR, even if they perceive severe short-term psychological impact. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. The discovery of fire by humans: a long and convoluted process

    PubMed Central

    2016-01-01

    Numbers of animal species react to the natural phenomenon of fire, but only humans have learnt to control it and to make it at will. Natural fires caused overwhelmingly by lightning are highly evident on many landscapes. Birds such as hawks, and some other predators, are alert to opportunities to catch animals including invertebrates disturbed by such fires and similar benefits are likely to underlie the first human involvements with fires. Early hominins would undoubtedly have been aware of such fires, as are savanna chimpanzees in the present. Rather than as an event, the discovery of fire use may be seen as a set of processes happening over the long term. Eventually, fire became embedded in human behaviour, so that it is involved in almost all advanced technologies. Fire has also influenced human biology, assisting in providing the high-quality diet which has fuelled the increase in brain size through the Pleistocene. Direct evidence of early fire in archaeology remains rare, but from 1.5 Ma onward surprising numbers of sites preserve some evidence of burnt material. By the Middle Pleistocene, recognizable hearths demonstrate a social and economic focus on many sites. The evidence of archaeological sites has to be evaluated against postulates of biological models such as the ‘cooking hypothesis' or the ‘social brain’, and questions of social cooperation and the origins of language. Although much remains to be worked out, it is plain that fire control has had a major impact in the course of human evolution. This article is part of the themed issue ‘The interaction of fire and mankind’. PMID:27216521

  20. The discovery of fire by humans: a long and convoluted process.

    PubMed

    Gowlett, J A J

    2016-06-05

    Numbers of animal species react to the natural phenomenon of fire, but only humans have learnt to control it and to make it at will. Natural fires caused overwhelmingly by lightning are highly evident on many landscapes. Birds such as hawks, and some other predators, are alert to opportunities to catch animals including invertebrates disturbed by such fires and similar benefits are likely to underlie the first human involvements with fires. Early hominins would undoubtedly have been aware of such fires, as are savanna chimpanzees in the present. Rather than as an event, the discovery of fire use may be seen as a set of processes happening over the long term. Eventually, fire became embedded in human behaviour, so that it is involved in almost all advanced technologies. Fire has also influenced human biology, assisting in providing the high-quality diet which has fuelled the increase in brain size through the Pleistocene. Direct evidence of early fire in archaeology remains rare, but from 1.5 Ma onward surprising numbers of sites preserve some evidence of burnt material. By the Middle Pleistocene, recognizable hearths demonstrate a social and economic focus on many sites. The evidence of archaeological sites has to be evaluated against postulates of biological models such as the 'cooking hypothesis' or the 'social brain', and questions of social cooperation and the origins of language. Although much remains to be worked out, it is plain that fire control has had a major impact in the course of human evolution.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Authors.

  1. SPS' Digest: the Swiss Proteomics Society selection of proteomics articles.

    PubMed

    Hoogland, Christine; Lion, Niels; Palagi, Patricia M; Sanchez, Jean-Charles; Tissot, Jean-Daniel

    2005-08-01

    Despite the consolidation of the specialized proteomics literature around a few established journals, such as Proteomics, Molecular and Cellular Proteomics, and the Journal of Proteome Research, a lot of information is still spread in many different publications from different fields, such as analytical sciences, MS, bioinformatics, etc. The purpose of SPS' Digest is to gather a selection of proteomics articles, to categorize them, and to make the list available on a periodic basis through a web page and email alerts.

  2. Dynamics of Multistable States during Ongoing and Evoked Cortical Activity

    PubMed Central

    Mazzucato, Luca

    2015-01-01

    Single-trial analyses of ensemble activity in alert animals demonstrate that cortical circuits dynamics evolve through temporal sequences of metastable states. Metastability has been studied for its potential role in sensory coding, memory, and decision-making. Yet, very little is known about the network mechanisms responsible for its genesis. It is often assumed that the onset of state sequences is triggered by an external stimulus. Here we show that state sequences can be observed also in the absence of overt sensory stimulation. Analysis of multielectrode recordings from the gustatory cortex of alert rats revealed ongoing sequences of states, where single neurons spontaneously attain several firing rates across different states. This single-neuron multistability represents a challenge to existing spiking network models, where typically each neuron is at most bistable. We present a recurrent spiking network model that accounts for both the spontaneous generation of state sequences and the multistability in single-neuron firing rates. Each state results from the activation of neural clusters with potentiated intracluster connections, with the firing rate in each cluster depending on the number of active clusters. Simulations show that the model's ensemble activity hops among the different states, reproducing the ongoing dynamics observed in the data. When probed with external stimuli, the model predicts the quenching of single-neuron multistability into bistability and the reduction of trial-by-trial variability. Both predictions were confirmed in the data. Together, these results provide a theoretical framework that captures both ongoing and evoked network dynamics in a single mechanistic model. PMID:26019337

  3. ShakeAlert Users Transition to the Production Prototype System

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

  4. Speech Alarms Pilot Study

    NASA Technical Reports Server (NTRS)

    Sandor, Aniko; Moses, Haifa

    2016-01-01

    Speech alarms have been used extensively in aviation and included in International Building Codes (IBC) and National Fire Protection Association's (NFPA) Life Safety Code. However, they have not been implemented on space vehicles. Previous studies conducted at NASA JSC showed that speech alarms lead to faster identification and higher accuracy. This research evaluated updated speech and tone alerts in a laboratory environment and in the Human Exploration Research Analog (HERA) in a realistic setup.

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

    ERIC Educational Resources Information Center

    Rogers, Rick

    2011-01-01

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

  6. Colleges Weigh When to Alert Students of Danger

    ERIC Educational Resources Information Center

    Hoover, Eric; Lipka, Sara

    2007-01-01

    At the University of Chicago, the third Monday in November began with an hour of violence. Around 12:30 a.m., an assailant fired a shot at a staff member who was walking on the campus. At 1:15 a group of men robbed two female students on a nearby street. Just before 1:30, Amadou Cisse, a doctoral student, was shot and killed while walking to his…

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

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  8. 77 FR 15814 - PPL Susquehanna, LLC; Application and Amendment to Facility Operating License Involving: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-16

    ... decrease the probability that a fire-induced hot short will cause equipment malfunctions. The current...-stamps the document and sends the submitter an email notice confirming receipt of the document. The E...

  9. CrossTalk: The Journal of Defense Software Engineering. Volume 19, Number 10

    DTIC Science & Technology

    2006-10-01

    301) 975-4553 E-mail: davydov@nist.gov Norman A. Sanford, Ph.D., is project leader of the optical materials metrology project at NIST in Boulder, CO...dimension tables that allow the level of granularity of the facts to be drilled into or rolled up along relevant vectors. For example, budget allotment...thermometers, safety valves, pressure gauges , or other modern technology. Boats drenched with Greek Fire burned – and sailors were unable to quench the fire

  10. In vivo analysis of Purkinje cell firing properties during postnatal mouse development

    PubMed Central

    Arancillo, Marife; White, Joshua J.; Lin, Tao; Stay, Trace L.

    2014-01-01

    Purkinje cell activity is essential for controlling motor behavior. During motor behavior Purkinje cells fire two types of action potentials: simple spikes that are generated intrinsically and complex spikes that are induced by climbing fiber inputs. Although the functions of these spikes are becoming clear, how they are established is still poorly understood. Here, we used in vivo electrophysiology approaches conducted in anesthetized and awake mice to record Purkinje cell activity starting from the second postnatal week of development through to adulthood. We found that the rate of complex spike firing increases sharply at 3 wk of age whereas the rate of simple spike firing gradually increases until 4 wk of age. We also found that compared with adult, the pattern of simple spike firing during development is more irregular as the cells tend to fire in bursts that are interrupted by long pauses. The regularity in simple spike firing only reached maturity at 4 wk of age. In contrast, the adult complex spike pattern was already evident by the second week of life, remaining consistent across all ages. Analyses of Purkinje cells in alert behaving mice suggested that the adult patterns are attained more than a week after the completion of key morphogenetic processes such as migration, lamination, and foliation. Purkinje cell activity is therefore dynamically sculpted throughout postnatal development, traversing several critical events that are required for circuit formation. Overall, we show that simple spike and complex spike firing develop with unique developmental trajectories. PMID:25355961

  11. Saturday-morning television: do sponsors promote high-risk behavior for burn injury?

    PubMed

    Palmieri, Tina L; Aoki, Traci; Combs, Elena; Curri, Terese; Garma, Sylvia; Kaulkin, Cammie; Lawless, Mary Beth; Nelson, Kate; Sanders, Johanna; Warden, Nancy; Greenhalgh, David G

    2004-01-01

    Television has become an important tool for learning and socialization in children. Although television violence has been associated with adverse effects, data on depiction of fire and burn injury are lacking. We sought to determine whether Saturday-morning television programming, viewed primarily by children, depicts fire and burn injury as safe or without consequence, thus potentially increasing the incidence of burn injury in children. This was a prospective observational study. Saturday-morning children's television programs were videotaped from 7 AM to 11 AM for eight different television networks during a 6-month period. Tapes were scored for scenes depicting fire or smoke by independent observers. Recorded items included show category, scene type, gender target, context of fire, and outcome after exposure to flame. Fire events were documented during programs and their associated commercials. A total of 108 hours of children's programs, 16 hours per network, were recorded. Scenes depicting fire or smoke were identified 1960 times, with 39% of events occurring during the program itself and 61% in commercials. Fire was depicted as either safe or without consequence in 64% of incidents. Action adventure stories accounted for 56% of flame depictions. Overall, one incident involving flame and fire was portrayed for each 3 minutes of television programming. Saturday-morning television programming frequently depicts fire as safe, empowering, or exciting. The incidence of flame use in programming varies between stations but is most prevalent in action/adventure stories. Television commercials, although brief, provide the majority of the misinformation regarding fire. Medical professional societies should alert the public to this potential hazard and recommend responsible portrayal of fire in children's television programming.

  12. Fire Alarm Wallpaper Based on Fire-Resistant Hydroxyapatite Nanowire Inorganic Paper and Graphene Oxide Thermosensitive Sensor.

    PubMed

    Chen, Fei-Fei; Zhu, Ying-Jie; Chen, Feng; Dong, Li-Ying; Yang, Ri-Long; Xiong, Zhi-Chao

    2018-04-24

    Wallpaper with multiple functions, such as fire resistance and an automatic alarm in fire disasters, will be attractive for the interior decoration of houses. Herein, we report a smart fire alarm wallpaper prepared using fire-resistant inorganic paper based on ultralong hydroxyapatite nanowires (HNs) and graphene oxide (GO) thermosensitive sensors. At room temperature, the GO thermosensitive sensor is in a state of electrical insulation; however, it becomes electrically conductive at high temperatures. In a fire disaster, high temperature will rapidly remove the oxygen-containing groups of GO, leading to the transformation process of GO from an electrically insulated state into an electrically conductive one. In this way, the alarm lamp and alarm buzzer connected with the GO thermosensitive sensor will send out the alerts to people immediately for taking emergency actions. After the surface modification with polydopamine of GO (PGO), the sensitivity and flame retardancy of the GO thermosensitive sensor are further improved, resulting in a low responsive temperature (126.9 °C), fast response (2 s), and sustained working time in the flame (at least 5 min). Compared with combustible commercial wallpaper, the smart fire alarm wallpaper based on HNs and GO (or PGO) is superior owing to excellent nonflammability and high-temperature resistance of HNs, which can protect the GO (or PGO) thermosensitive sensor from the flames. The smart fire alarm wallpaper can be processed into various shapes, dyed with different colors, and printed with the commercial printer and thus has promising applications in high-safety interior decoration of houses.

  13. Techniques for searching the CINAHL database using the EBSCO interface.

    PubMed

    Lawrence, Janna C

    2007-04-01

    The cumulative index to Nursing and Allied Health Literature (CINAHL) is a useful research tool for accessing articles of interest to nurses and health care professionals. More than 2,800 journals are indexed by CINAHL and can be searched easily using assigned subject headings. Detailed instructions about conducting, combining, and saving searches in CINAHL are provided in this article. Establishing an account at EBSCO further allows a nurse to save references and searches and to receive e-mail alerts when new articles on a topic of interest are published.

  14. Use of MODIS-Derived Fire Radiative Energy to Estimate Smoke Aerosol Emissions over Different Ecosystems

    NASA Technical Reports Server (NTRS)

    Ichoku, Charles; Kaufman, Yoram J.

    2003-01-01

    Biomass burning is the main source of smoke aerosols and certain trace gases in the atmosphere. However, estimates of the rates of biomass consumption and emission of aerosols and trace gases from fires have not attained adequate reliability thus far. Traditional methods for deriving emission rates employ the use of emission factors e(sub x), (in g of species x per kg of biomass burned), which are difficult to measure from satellites. In this era of environmental monitoring from space, fire characterization was not a major consideration in the design of the early satellite-borne remote sensing instruments, such as AVHRR. Therefore, although they are able to provide fire location information, they were not adequately sensitive to variations in fire strength or size, because their thermal bands used for fire detection saturated at the lower end of fire radiative temperature range. As such, hitherto, satellite-based emission estimates employ proxy techniques using satellite derived fire pixel counts (which do not express the fire strength or rate of biomass consumption) or burned areas (which can only be obtained after the fire is over). The MODIS sensor, recently launched into orbit aboard EOS Terra (1999) and Aqua (2002) satellites, have a much higher saturation level and can, not only detect the fire locations 4 times daily, but also measures the at-satellite fire radiative energy (which is a measure of the fire strength) based on its 4 micron channel temperature. Also, MODIS measures the optical thickness of smoke and other aerosols. Preliminary analysis shows appreciable correlation between the MODIS-derived rates of emission of fire radiative energy and smoke over different regions across the globe. These relationships hold great promise for deriving emission coefficients, which can be used for estimating smoke aerosol emissions from MODIS active fire products. This procedure has the potential to provide more accurate emission estimates in near real-time, providing opportunities for various disaster management applications such as alerts, evacuation and, smoke dispersion forecasting.

  15. Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.

    PubMed

    Caputo, Maria Luce; Muschietti, Sandro; Burkart, Roman; Benvenuti, Claudio; Conte, Giulio; Regoli, François; Mauri, Romano; Klersy, Catherine; Moccetti, Tiziano; Auricchio, Angelo

    2017-05-01

    We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP). The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mobile APP. Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was significantly reduced by the APP-based system (3.5 [2.8-5.2]) compared to the SMS-based system (5.6 [4.2-8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, p<0.01) with the APP. Earlier arrival of a first responder or of a lay responder determined a higher survival rate. The mobile APP system is highly efficient in the recruitment of first responders, significantly reducing the time to the initiation of CPR thus increasing survival rates. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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

    PubMed

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

    2016-02-01

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

  17. Driving photomask supplier quality through automation

    NASA Astrophysics Data System (ADS)

    Russell, Drew; Espenscheid, Andrew

    2007-10-01

    In 2005, Freescale Semiconductor's newly centralized mask data prep organization (MSO) initiated a project to develop an automated global quality validation system for photomasks delivered to Freescale Semiconductor fabs. The system handles Certificate of Conformance (CofC) quality metric collection, validation, reporting and an alert system for all photomasks shipped to Freescale fabs from all qualified global suppliers. The completed system automatically collects 30+ quality metrics for each photomask shipped. Other quality metrics are generated from the collected data and quality metric conformance is automatically validated to specifications or control limits with failure alerts emailed to fab photomask and mask data prep engineering. A quality data warehouse stores the data for future analysis, which is performed quarterly. The improved access to data provided by the system has improved Freescale engineers' ability to spot trends and opportunities for improvement with our suppliers' processes. This paper will review each phase of the project, current system capabilities and quality system benefits for both our photomask suppliers and Freescale.

  18. Disentangling the Lexicons of Disaster Response in Twitter

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

    Hodas, Nathan O.; Ver Steeg, Greg; Harrison, Joshua J.

    Abstract: People around the world use social media platforms such as Twitter heavily to express their opinion about various as- pects of daily life. In the same way social media changes communication in daily life, it also is transforming the way individuals communicate during disasters and emergencies. Emergency officials have come to rely on social media to communicate alerts and updates. How do users communi- cate risk on social media? We used a novel information- theoretic unsupervised learning tool, CorEx, to extract and classify highly relevant words used by the public on Twit- ter during known emergencies, such as fires,more » explosions, and hurricanes. By utilizing the resulting classification strategy, authorities can use the derived language to craft more rel- evant risk communication to maximize the effectiveness of short-message broadcasts such as the Wireless Emergency Alerts (WEA) service.« less

  19. Near real-time monitoring systems for adaptive management and improved forest governance

    NASA Astrophysics Data System (ADS)

    Musinsky, J.; Tabor, K.; Cano, A.

    2012-12-01

    The destruction and degradation of the world's forests from deforestation, illegal logging and fire has wide-ranging environmental and economic impacts, including biodiversity loss, the degradation of ecosystem services and the emission of greenhouse gases. In an effort to strengthen local capacity to respond to these threats, Conservation International has developed a suite of near real-time satellite monitoring systems generating daily alerts, maps and reports of forest fire, fire risk, deforestation and degradation that are used by national and sub-national government agencies, NGO's, scientists, communities, and the media to respond to and report on threats to forest resources. Currently, the systems support more than 1000 subscribers from 45 countries, focusing on Madagascar, Indonesia, Bolivia and Peru. This presentation will explore the types of innovative applications users have found for these data, challenges they've encountered in data acquisition and accuracy, and feedback they've given on the usefulness of these systems for REDD+ implementation, protected areas management and improved forest governance.;

  20. Remote humidity and temperature real time monitoring system for studying seed biology

    NASA Astrophysics Data System (ADS)

    Balachandran, Thiruparan

    This thesis discusses the design, prototyping, and testing of a remote monitoring system that is used to study the biology of seeds under various controlled conditions. Seed scientists use air-tight boxes to maintain relative humidity, which influences seed longevity and seed dormancy break. The common practice is the use of super-saturated solutions either with different chemicals or different concentrations of LiCl to create various relative humidity. Theretofore, no known system has been developed to remotely monitor the environmental conditions inside these boxes in real time. This thesis discusses the development of a remote monitoring system that can be used to accurately monitor and measure the relative humidity and temperature inside sealed boxes for the study of seed biology. The system allows the remote and real-time monitoring of these two parameters in five boxes with different conditions. It functions as a client that is connected to the internet using Wireless Fidelity (Wi-Fi) technology while Google spreadsheet is used as the server for uploading and plotting the data. This system directly gets connected to the Google sever through Wi-Fi and uploads the sensors' values in a Google spread sheet. Application-specific software is created and the user can monitor the data in real time and/or download the data into Excel for further analyses. Using Google drive app the data can be viewed using a smart phone or a tablet. Furthermore, an electronic mail (e-mail) alert is also integrated into the system. Whenever measured values go beyond the threshold values, the user will receive an e-mail alert.

  1. More stapler firings increase the risk of perioperative morbidity after laparoscopic sleeve gastrectomy.

    PubMed

    Major, Piotr; Wysocki, Michał; Pędziwiatr, Michał; Pisarska, Magdalena; Małczak, Piotr; Wierdak, Mateusz; Dembiński, Marcin; Migaczewski, Marcin; Rubinkiewicz, Mateusz; Budzyński, Andrzej

    2018-03-01

    Staple-line bleeding and leakage are the most common serious complications of laparoscopic sleeve gastrectomy. The relationship between multiple stapler firings and higher risk of postoperative complications is well defined in colorectal surgery but has not been addressed in bariatric procedures so far. Identification of new factors such as "the numbers of stapler firings used during laparoscopic sleeve gastrectomy (LSG)" as a predictor for complications can lead to optimization of the patient care at bariatric centers. To determine the association between perioperative morbidity and the number of stapler firings during laparoscopic sleeve gastrectomy. This observational study was based on retrospective analysis of prospectively collected data in patients operated on for morbid obesity in a teaching hospital/tertiary referral center for general surgery. The patients who underwent LSG were analyzed in terms of the number of stapler firings used as a new potential risk predictor for postoperative complications after surgery, adjusting for other patient- and treatment-related factors. The study included 333 patients (209 women, 124 men, mean age: 40 ±11). During the first 30 days after surgery, complications were observed in 18 (5.41%) patients. Multivariate analysis showed that prolonging operative time increased morbidity (every minute, OR = 1.01; 95% CI: 1.00-1.02) and the complication rate increased with the number of stapler firings (every firing, OR = 1.91; 95% CI: 1.09-3.33; p = 0.023). Additional stapler firings above the usual number and a prolonged operation should alert a surgeon and the whole team about increased risk of postoperative complications.

  2. Evaluating the Emergency Notification Systems of the NASA White Sands Test

    NASA Technical Reports Server (NTRS)

    Chavez, Alfred Paul

    2004-01-01

    The problem was that the NASA Fire and Emergency Services did not know if the current emergency notification systems on the NASA White Sands Test Facility were appropriate for alerting the employees of an emergency. The purpose of this Applied Research Project was to determine if the current emergency notification systems of the White Sands Test Facility are appropriate for alerting the employees of an emergency. This was a descriptive research project. The research questions were: 1) What are similar facilities using to alert the employees of an emergency?; 2) Are the current emergency notification systems suitable for the community hazards on the NASA White Sands Test Facility?; 3) What is the NASA Fire and Emergency Services currently using to measure the effectiveness of the emergency notification systems?; and 4) What are the current training methods used to train personnel to the emergency notification systems at the NASA White Sands Test Facility? The procedures involved were to research other established facilities, research published material from credible sources, survey the facility to determine the facility perception of the emergency notification systems, and evaluate the operating elements of the established emergency notification systems for the facility. The results were that the current systems are suitable for the type of hazards the facility may endure. The emergency notification systems are tested frequently to ensure effectiveness in the event of an emergency. Personnel are trained and participate in a yearly drill to make certain personnel are educated on the established systems. The recommendations based on the results were to operationally improve the existing systems by developing and implementing one system that can overall notify the facility of a hazard. Existing procedures and training should also be improved to ensure that all personnel are educated on what to do when the emergency notification systems are activated.

  3. Global multi-sensor satellite monitoring of volcanic SO2 and ash emissions in support to aviation control

    NASA Astrophysics Data System (ADS)

    Brenot, H.; Theys, N.; van Gent, J.; Van Roozendael, M.; van der A, R.; Clarisse, L.; Hurtmans, D.; Ngadi, Y.; Coheur, P.-F.; Clerbaux, C.

    2012-04-01

    The "Support to Aviation Control Service" (SACS; http://sacs.aeronomie.be) is an ESA-funded project hosted by the Belgian Institute for Space Aeronomy. The service provides near real-time (NRT) global SO2 and volcanic ash data, as well as alerts in case of volcanic eruptions. The SACS service is primarily designed to support the Volcanic Ash Advisory Centers (VAACs) in their mandate to gather information on volcanic clouds and give advice to airline and air traffic control organisations. SACS also serves other users that subscribe to the service, in particular local volcano observatories and research scientists. SACS is based on the combined use of UV-visible (SCIAMACHY, OMI, GOME-2) and infrared (AIRS, IASI) satellite instruments. When a volcanic eruption is detected, SACS issues an alert that takes the form of a notification sent by e-mail to users. This notification points to a dedicated web page where all relevant information is available and can be visualized with user-friendly tools. The strength of a multi-sensor approach relies in the use of satellite data with different overpasses times, minimizing the time-lag for detection and enhancing the reliability of such alerts. This paper will give a general presentation of the SACS service, different techniques used to detect volcanic plumes. It will also highlight the strengths and limitations of the service and measurements.

  4. Attentional Lapses of Adults with Attention Deficit Hyperactivity Disorder in Tasks of Sustained Attention.

    PubMed

    Gmehlin, Dennis; Fuermaier, Anselm B M; Walther, Stephan; Tucha, Lara; Koerts, Janneke; Lange, Klaus W; Tucha, Oliver; Weisbrod, Matthias; Aschenbrenner, Steffen

    2016-06-01

    Adults with attention deficit hyperactivity disorder (ADHD) show attentional dysfunction such as distractibility and mind-wandering, especially in lengthy tasks. However, fundamentals of dysfunction are ambiguous and relationships of neuropsychological test parameters with self-report measures of ADHD symptoms are marginal. We hypothesize that basic deficits in sustaining attention explain more complex attentional dysfunction in persons with ADHD and relate to ADHD symptoms. Attentional function was analyzed by computing ex-Gaussian parameters for 3 time Blocks in a 20 min test of sustained alertness. Changes in performance across these blocks were analyzed by comparing adult persons with ADHD (n = 24) with healthy matched controls (n = 24) and correlated with neuropsychological measures of selective and divided attention as well as self-report measures of ADHD symptoms. We found a significantly steeper increase in the number of slow responses (ex-Gaussian parameter τ) in persons with ADHD with time on task in basic sustained alertness. They also performed significantly worse in tasks of sustained selective and divided attention. However, after controlling for an increase in τ during the alertness task, significant differences between groups disappeared for divided and partly selective attention. Increases in τ in the sustained alertness task correlated significantly with self-report measures of ADHD symptoms. Our results provide evidence that very basic deficits in sustaining attention in adults with ADHD are related to infrequent slow responses (=attentional lapses), with changes over time being relevant for more complex attentional function and experienced ADHD symptoms in everyday life. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. A prospective study of the feasibility and acceptability of a Web-based, electronic patient-reported outcome system in assessing patient recovery after major gynecologic cancer surgery.

    PubMed

    Andikyan, Vaagn; Rezk, Youssef; Einstein, M Heather; Gualtiere, Gina; Leitao, Mario M; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Basch, Ethan M; Chi, Dennis S

    2012-11-01

    The purposes of this study are to evaluate the feasibility of capturing patient-reported outcomes (PROs) electronically and to identify the most common distressing symptoms in women recovering from major gynecologic cancer surgery. This was a prospective, single-arm pilot study. Eligible participants included those scheduled for a laparotomy for presumed or known gynecologic malignancy. Patients completed a Web-based "STAR" (Symptom Tracking and Reporting for Patients) questionnaire once preoperatively and weekly during the 6-week postoperative period. The questionnaire consisted of the patient adaptation of the NCI CTCAE 3.0 and EORTC QLQ-C30 3.0. When a patient submitted a response that was concerning, an automated email alert was sent to the clinician. The patient's assessment of STAR's usefulness was measured via an exit survey. Forty-nine patients completed the study. The procedures included the following: hysterectomy±staging (67%), resection of tumor (22%), salpingo-oophorectomy (6%), and other (4%). Most patients (82%) completed at least 4 sessions in STAR. The CTC generated 43 alerts. These alerts resulted in 25 telephone contacts with patients, 2 ER referrals, one new appointment, and one pharmaceutical prescription. The 3 most common patient-reported symptoms generating an alert were as follows: poor performance status (19%), nausea (18%), and fatigue (17%). Most patients found STAR useful (80%) and would recommend it to others (85%). Application of a Web-based, electronic STAR system is feasible in the postoperative period, highly accepted by patients, and warrants further study. Poor performance status, nausea, and fatigue were the most common distressing patient-reported symptoms. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Use and Perceived Benefits of Handheld Computer-based Clinical References

    PubMed Central

    Rothschild, Jeffrey M.; Fang, Edward; Liu, Vincent; Litvak, Irina; Yoon, Cathy; Bates, David W.

    2006-01-01

    Objective Clinicians are increasingly using handheld computers (HC) during patient care. We sought to assess the role of HC-based clinical reference software in medical practice by conducting a survey and assessing actual usage behavior. Design During a 2-week period in February 2005, 3600 users of a HC-based clinical reference application were asked by e-mail to complete a survey and permit analysis of their usage patterns. The software includes a pharmacopeia, an infectious disease reference, a medical diagnostic and therapeutic reference and transmits medical alerts and other notifications during HC synchronizations. Software usage data were captured during HC synchronization for the 4 weeks prior to survey completion. Measurements Survey responses and software usage data. Results The survey response rate was 42% (n = 1501). Physicians reported using the clinical reference software for a mean of 4 years and 39% reported using the software during more than half of patient encounters. Physicians who synchronized their HC during the data collection period (n = 1249; 83%) used the pharmacopeia for unique drug lookups a mean of 6.3 times per day (SD 12.4). The majority of users (61%) believed that in the prior 4 weeks, use of the clinical reference prevented adverse drug events or medication errors 3 or more times. Physicians also believed that alerts and other notifications improved patient care if they were public health warnings (e.g. about influenza), new immunization guidelines or drug alert warnings (e.g. rofecoxib withdrawal). Conclusion Current adopters of HC-based medical references use these tools frequently, and found them to improve patient care and be valuable in learning of recent alerts and warnings. PMID:16929041

  7. Potential role of antitachycardia pacing alerts for the reduction of emergency presentations following shocks in patients with implantable cardioverter-defibrillators: implications for the implementation of remote monitoring.

    PubMed

    Boulé, Stéphane; Ninni, Sandro; Finat, Loïc; Botcherby, Edward J; Kouakam, Claude; Klug, Didier; Marquié, Christelle; Brigadeau, François; Lacroix, Dominique; Kacet, Salem; Guédon-Moreau, Laurence

    2016-12-01

    Despite increased use of remote monitoring (RM) to follow up implantable cardioverter-defibrillator (ICD) recipients, many patients still receive ICD shocks in the community and present to the emergency department. Our aim was to identify the best predictors of impending shock delivery that can be measured with an ICD and to identify the most appropriate activities to alert physicians to during RM follow-up. All patients presenting to our institution for ICD shock, from November 2011 to November 2014, were enrolled in this prospective study. Patient characteristics, investigation results, and details of electrical activities from ICD interrogation were recorded at presentation. Presentations were classified as potentially avoidable if activities from a list of set criteria were apparent more than 48 h before index shock. Univariate and multivariate analyses were then used to identify predictors of potentially avoidable shocks. In total, 109 emergency presentations were recorded in 90 patients (male: 85%; 57 ± 16 years; ischaemic cardiomyopathy: 49%; LVEF: 34 ± 13%; electrical storm: 40%), of which 26 (24%) were potentially avoidable. Antitachycardia pacing (ATP) episodes were the most important predictor of impending shock. Potentially avoidable shocks were preceded by more episodes of ATP than unavoidable shocks (13 [3-67] vs. 3 [0-10]; P < 0.001). Patients followed up with RM systems configured to generate alerts following ATP delivery experienced significantly less ICD shocks (24 vs. 16%, P < 0.01). Remote monitoring systems that generate alerts following ATP delivery could reduce emergency presentations for ICD shock by 24%, as ATP is a key predictor of impending shock delivery. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  8. On Alarm Protocol in Wireless Sensor Networks

    NASA Astrophysics Data System (ADS)

    Cichoń, Jacek; Kapelko, Rafał; Lemiesz, Jakub; Zawada, Marcin

    We consider the problem of efficient alarm protocol for ad-hoc radio networks consisting of devices that try to gain access for transmission through a shared radio communication channel. The problem arise in tasks that sensors have to quickly inform the target user about an alert situation such as presence of fire, dangerous radiation, seismic vibrations, and more. In this paper, we present a protocol which uses O(logn) time slots and show that Ω(logn/loglogn) is a lower bound for used time slots.

  9. Coding of Velocity Storage in the Vestibular Nuclei.

    PubMed

    Yakushin, Sergei B; Raphan, Theodore; Cohen, Bernard

    2017-01-01

    Semicircular canal afferents sense angular acceleration and output angular velocity with a short time constant of ≈4.5 s. This output is prolonged by a central integrative network, velocity storage that lengthens the time constants of eye velocity. This mechanism utilizes canal, otolith, and visual (optokinetic) information to align the axis of eye velocity toward the spatial vertical when head orientation is off-vertical axis. Previous studies indicated that vestibular-only (VO) and vestibular-pause-saccade (VPS) neurons located in the medial and superior vestibular nucleus could code all aspects of velocity storage. A recently developed technique enabled prolonged recording while animals were rotated and received optokinetic stimulation about a spatial vertical axis while upright, side-down, prone, and supine. Firing rates of 33 VO and 8 VPS neurons were studied in alert cynomolgus monkeys. Majority VO neurons were closely correlated with the horizontal component of velocity storage in head coordinates, regardless of head orientation in space. Approximately, half of all tested neurons (46%) code horizontal component of velocity in head coordinates, while the other half (54%) changed their firing rates as the head was oriented relative to the spatial vertical, coding the horizontal component of eye velocity in spatial coordinates. Some VO neurons only coded the cross-coupled pitch or roll components that move the axis of eye rotation toward the spatial vertical. Sixty-five percent of these VO and VPS neurons were more sensitive to rotation in one direction (predominantly contralateral), providing directional orientation for the subset of VO neurons on either side of the brainstem. This indicates that the three-dimensional velocity storage integrator is composed of directional subsets of neurons that are likely to be the bases for the spatial characteristics of velocity storage. Most VPS neurons ceased firing during drowsiness, but the firing rates of VO neurons were unaffected by states of alertness and declined with the time constant of velocity storage. Thus, the VO neurons are the prime components of the mechanism of coding for velocity storage, whereas the VPS neurons are likely to provide the path from the vestibular to the oculomotor system for the VO neurons.

  10. Coding of Velocity Storage in the Vestibular Nuclei

    PubMed Central

    Yakushin, Sergei B.; Raphan, Theodore; Cohen, Bernard

    2017-01-01

    Semicircular canal afferents sense angular acceleration and output angular velocity with a short time constant of ≈4.5 s. This output is prolonged by a central integrative network, velocity storage that lengthens the time constants of eye velocity. This mechanism utilizes canal, otolith, and visual (optokinetic) information to align the axis of eye velocity toward the spatial vertical when head orientation is off-vertical axis. Previous studies indicated that vestibular-only (VO) and vestibular-pause-saccade (VPS) neurons located in the medial and superior vestibular nucleus could code all aspects of velocity storage. A recently developed technique enabled prolonged recording while animals were rotated and received optokinetic stimulation about a spatial vertical axis while upright, side-down, prone, and supine. Firing rates of 33 VO and 8 VPS neurons were studied in alert cynomolgus monkeys. Majority VO neurons were closely correlated with the horizontal component of velocity storage in head coordinates, regardless of head orientation in space. Approximately, half of all tested neurons (46%) code horizontal component of velocity in head coordinates, while the other half (54%) changed their firing rates as the head was oriented relative to the spatial vertical, coding the horizontal component of eye velocity in spatial coordinates. Some VO neurons only coded the cross-coupled pitch or roll components that move the axis of eye rotation toward the spatial vertical. Sixty-five percent of these VO and VPS neurons were more sensitive to rotation in one direction (predominantly contralateral), providing directional orientation for the subset of VO neurons on either side of the brainstem. This indicates that the three-dimensional velocity storage integrator is composed of directional subsets of neurons that are likely to be the bases for the spatial characteristics of velocity storage. Most VPS neurons ceased firing during drowsiness, but the firing rates of VO neurons were unaffected by states of alertness and declined with the time constant of velocity storage. Thus, the VO neurons are the prime components of the mechanism of coding for velocity storage, whereas the VPS neurons are likely to provide the path from the vestibular to the oculomotor system for the VO neurons. PMID:28861030

  11. When Animators Attack

    ERIC Educational Resources Information Center

    Read, Brock

    2006-01-01

    College administrators across the US are learning that chatter on e-mail, blogs, and social-networking sites can turn even minor faux pas into major controversies. The issue is discussed with reference to the firing of a teaching assistant whose Web site lampooned the president of Columbia College Chicago and left the institution facing serious…

  12. Repeated Habitat Disturbances by Fire Decrease Local Effective Population Size.

    PubMed

    Schrey, Aaron W; Ragsdale, Alexandria K; McCoy, Earl D; Mushinsky, Henry R

    2016-07-01

    Effective population size is a fundamental parameter in population genetics, and factors that alter effective population size will shape the genetic characteristics of populations. Habitat disturbance may have a large effect on genetic characteristics of populations by influencing immigration and gene flow, particularly in fragmented habitats. We used the Florida Sand Skink (Plestiodon reynoldsi) to investigate the effect of fire-based habitat disturbances on the effective population size in the highly threatened, severely fragmented, and fire dependent Florida scrub habitat. We screened 7 microsatellite loci in 604 individuals collected from 12 locations at Archbold Biological Station. Archbold Biological Station has an active fire management plan and detailed records of fires dating to 1967. Our objective was to determine how the timing, number, and intervals between fires affect effective population size, focusing on multiple fires in the same location. Effective population size was higher in areas that had not been burned for more than 10 years and decreased with number of fires and shorter time between fires. A similar pattern was observed in abundance: increasing abundance with time-since-fire and decreasing abundance with number of fires. The ratio of effective population size to census size was higher at sites with more recent fires and tended to decrease with time-since-last-fire. These results suggest that habitat disturbances, such as fire, may have a large effect in the genetic characteristics of local populations and that Florida Sand Skinks are well adapted to the natural fire dynamics required to maintain Florida scrub. © The American Genetic Association. 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. The FDA alert on suicidality and antiepileptic drugs: Fire or false alarm?

    PubMed

    Hesdorffer, Dale C; Kanner, Andres M

    2009-05-01

    In January 2008, the U.S. Food and Drug Administration (FDA) issued an alert about an increased risk for suicidality in 199 clinical trials of 11 antiepileptic drugs (AEDs) for three different indications, including epilepsy. An advisory panel voted against a black-box warning on AED labels, and the FDA has accepted this recommendation. We discuss three potential problems with the alert. First, adverse event data were used rather than systematically collected data. Second, the 11 drugs grouped together as a single class of AEDs have different mechanisms of action and very different relative risks, many of which were not statistically significant and some of which were smaller than one. These facts suggest that they should not be grouped as a class. Third, the risk of adverse effects from uncontrolled seizures almost certainly outweighs the small risk of suicidality. We place our comments in the context of a review of the literature on suicidality and depression in epilepsy and the sparse literature on AEDs and suicidality. We recommend that all patients with epilepsy be routinely evaluated for depression, anxiety, and suicidality, and that future clinical trials include validated instruments to systematically assess these conditions to determine whether the possible signal observed by the FDA is real.

  14. More stapler firings increase the risk of perioperative morbidity after laparoscopic sleeve gastrectomy

    PubMed Central

    Major, Piotr; Pędziwiatr, Michał; Pisarska, Magdalena; Małczak, Piotr; Wierdak, Mateusz; Dembiński, Marcin; Migaczewski, Marcin; Rubinkiewicz, Mateusz; Budzyński, Andrzej

    2017-01-01

    Introduction Staple-line bleeding and leakage are the most common serious complications of laparoscopic sleeve gastrectomy. The relationship between multiple stapler firings and higher risk of postoperative complications is well defined in colorectal surgery but has not been addressed in bariatric procedures so far. Identification of new factors such as “the numbers of stapler firings used during laparoscopic sleeve gastrectomy (LSG)” as a predictor for complications can lead to optimization of the patient care at bariatric centers. Aim To determine the association between perioperative morbidity and the number of stapler firings during laparoscopic sleeve gastrectomy. Material and methods This observational study was based on retrospective analysis of prospectively collected data in patients operated on for morbid obesity in a teaching hospital/tertiary referral center for general surgery. The patients who underwent LSG were analyzed in terms of the number of stapler firings used as a new potential risk predictor for postoperative complications after surgery, adjusting for other patient- and treatment-related factors. The study included 333 patients (209 women, 124 men, mean age: 40 ±11). Results During the first 30 days after surgery, complications were observed in 18 (5.41%) patients. Multivariate analysis showed that prolonging operative time increased morbidity (every minute, OR = 1.01; 95% CI: 1.00–1.02) and the complication rate increased with the number of stapler firings (every firing, OR = 1.91; 95% CI: 1.09–3.33; p = 0.023). Conclusions Additional stapler firings above the usual number and a prolonged operation should alert a surgeon and the whole team about increased risk of postoperative complications. PMID:29643964

  15. Smokey Bear is Dead: A New Era of Wildfires in the Western U.S

    NASA Astrophysics Data System (ADS)

    Pierce, J. L.; Duffin, J.; Lindquist, E.; Wuerzer, T.; Pellant, M.

    2013-12-01

    High fuel densities, combined with increasingly severe drought, make the western US highly susceptible to changes in the timing of snowmelt and increases in the length of the fire season. The forests and rangelands of Idaho are especially prone to wildfire; in 2012, over 1.7 million acres burned across Idaho, more acres than in any other state. Climate change is projected to increase summer temperatures and decrease summer precipitation in Idaho, and a drier, warmer, and more variable climate will increase the risk of stand-replacing fires. While infrastructure and alert systems are in place to warn residents about threats from hurricanes, floods and tornados, there is limited protection for communities in the ';fire-plain.' Part of this lack of preparation may stem from the belief that fires can be prevented or stopped; a perception that has been perpetuated by ';Smokey Bear,' and the generally successful interval of fire suppression during the 1960's-1980's. However, in the mid-1980's, severe drought, rising temperatures, and early snowmelt have brought an era of ';mega-fires' to the American West. Periods of recurring high wildfire activity across the western US are not unprecedented in the paleo-record, but the frequency of large fires (> 400 ha) and the annual area burned have increased in the modern. For example, in the past 10 years in Idaho, 17 fires burned over 100,000 acres each: six of those fires occurred in 2012. Likewise, the size and severity of rangeland fires in the Western U.S. has increased by almost an order of magnitude in recent decades; in the early 1980's, range fire extents over 100,000 acres was unheard of, but has become increasingly common in recent years (Pellant, 2013). Boise State University's departments of Geoscience, Community and Regional Planning, and the Public Policy Center are examining the risks and impacts of fire along the Boise WUI. The research integrates the perspectives of the geosciences and social sciences by combining physically-based fire hazards, effective fire management policies, and Planning in the West.

  16. Alert Notification System Router

    NASA Technical Reports Server (NTRS)

    Gurganus, Joseph; Carey, Everett; Antonucci, Robert; Hitchener, Peter

    2009-01-01

    The Alert Notification System Router (ANSR) software provides satellite operators with notifications of key events through pagers, cell phones, and e-mail. Written in Java, this application is specifically designed to meet the mission-critical standards for mission operations while operating on a variety of hardware environments. ANSR is a software component that runs inside the Mission Operations Center (MOC). It connects to the mission's message bus using the GMSEC [Goddard Space Flight Center (GSFC) Mission Services Evolution Center (GMSEC)] standard. Other components, such as automation and monitoring components, can use ANSR to send directives to notify users or groups. The ANSR system, in addition to notifying users, can check for message acknowledgements from a user and escalate the notification to another user if there is no acknowledgement. When a firewall prevents ANSR from accessing the Internet directly, proxies can be run on the other side of the wall. These proxies can be configured to access the Internet, notify users, and poll for their responses. Multiple ANSRs can be run in parallel, providing a seamless failover capability in the event that one ANSR system becomes incapacitated.

  17. Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists.

    PubMed

    Hand, Kieran S; Cumming, Debbie; Hopkins, Susan; Ewings, Sean; Fox, Andy; Theminimulle, Sandya; Porter, Robert J; Parker, Natalie; Munns, Joanne; Sheikh, Adel; Keyser, Taryn; Puleston, Richard

    2017-04-01

    The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test. Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P  <   0.001), allergy checker ( P  =   0.003), treatment protocols ( P  =   0.003), drug-indication mismatch alerts ( P  =   0.031) and prolonged course alerts ( P  =   0.041) and lower priority to a dose checker for adults ( P  =   0.02) and an interaction checker ( P  <   0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure. The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Special Issue: Tenth International Conference on Finite Elements in Fluids, Tucson, Arizona.Copyright © 1999 John Wiley & Sons, Ltd.Save Title to My Profile

    E-MailPrint

    Volume 31, Issue 1, Pages 1-406(15 September 1999)

    Preface

    Preface

    NASA Astrophysics Data System (ADS)

    Oden, J. T.; Prudhomme, S.

    1999-09-01

    We present a new approach to deliver reliable approximations of the norm of the residuals resulting from finite element solutions to the Stokes and Oseen equations. The method is based upon a global solve in a bubble space using iterative techniques. This provides an alternative to the classical equilibrated element residual methods for which it is necessary to construct proper boundary conditions for each local problem. The method is first used to develop a global a posteriori error estimator. It is then applied in a strategy to control the numerical error in specific outputs or quantities of interest which are functions of the solutions to the Stokes and Oseen equations. Copyright

  19. Special Issue: Very large eddy simulation. Issue Edited by Dimitris Drikakis.Copyright © 2002 John Wiley & Sons, Ltd.Save Title to My Profile

    E-MailPrint

    Volume 39, Issue 9, Pages 763-864(30 July 2002)

    Research Article

    Embedded turbulence model in numerical methods for hyperbolic conservation laws

    NASA Astrophysics Data System (ADS)

    Drikakis, D.

    2002-07-01

    The paper describes the use of numerical methods for hyperbolic conservation laws as an embedded turbulence modelling approach. Different Godunov-type schemes are utilized in computations of Burgers' turbulence and a two-dimensional mixing layer. The schemes include a total variation diminishing, characteristic-based scheme which is developed in this paper using the flux limiter approach. The embedded turbulence modelling property of the above methods is demonstrated through coarsely resolved large eddy simulations with and without subgrid scale models. Copyright

  20. Building health information technology capacity: they may come but will they use it?

    PubMed

    Burke-Bebee, Suzie; Wilson, Marisa; Buckley, Kathleen M

    2012-10-01

    Medical errors remain a major safety problem more than a decade after the Institute of Medicine reported 98 000 related deaths occur yearly in US hospitals. Medication errors account for one-third of these errors. Although medication reconciliation is an accepted care standard for patient safety, little evidence is available to make practice recommendations for primary care. The purpose of this study was to evaluate the effectiveness of using secure e-mail alerts within the reconciliation process on patient medication safety in clinics where electronic and personal health records are used. A nonexperimental, descriptive design with a convenience sample of 62 patients from two Veterans Health Administration clinics was used. Patients received secure e-mail instructing them to review their online medication list, update it based on home medications, and bring it to the appointment for discussion with their provider. A retrospective chart review was conducted examining changes made to medication lists in the electronic record after reconciliation. Data revealed the organization's adoption of secure e-mail did not guarantee its meaningful use by providers and patients, a clear barrier to implementing technology as an adjunct to care in context of complex clinical processes such as medication reconciliation. Lessons learned from the project's implementation are discussed.

  1. A model of metastable dynamics during ongoing and evoked cortical activity

    NASA Astrophysics Data System (ADS)

    La Camera, Giancarlo

    The dynamics of simultaneously recorded spike trains in alert animals often evolve through temporal sequences of metastable states. Little is known about the network mechanisms responsible for the genesis of such sequences, or their potential role in neural coding. In the gustatory cortex of alert rates, state sequences can be observed also in the absence of overt sensory stimulation, and thus form the basis of the so-called `ongoing activity'. This activity is characterized by a partial degree of coordination among neurons, sharp transitions among states, and multi-stability of single neurons' firing rates. A recurrent spiking network model with clustered topology can account for both the spontaneous generation of state sequences and the (network-generated) multi-stability. In the model, each network state results from the activation of specific neural clusters with potentiated intra-cluster connections. A mean field solution of the model shows a large number of stable states, each characterized by a subset of simultaneously active clusters. The firing rate in each cluster during ongoing activity depends on the number of active clusters, so that the same neuron can have different firing rates depending on the state of the network. Because of dense intra-cluster connectivity and recurrent inhibition, in finite networks the stable states lose stability due to finite size effects. Simulations of the dynamics show that the model ensemble activity continuously hops among the different states, reproducing the ongoing dynamics observed in the data. Moreover, when probed with external stimuli, the model correctly predicts the quenching of single neuron multi-stability into bi-stability, the reduction of dimensionality of the population activity, the reduction of trial-to-trial variability, and a potential role for metastable states in the anticipation of expected events. Altogether, these results provide a unified mechanistic model of ongoing and evoked cortical dynamics. NSF IIS-1161852, NIDCD K25-DC013557, NIDCD R01-DC010389.

  2. Breaking Open the Black Box: Isolating the Most Potent Features of a Web and Mobile Phone-Based Intervention for Depression, Anxiety, and Stress.

    PubMed

    Whitton, Alexis E; Proudfoot, Judith; Clarke, Janine; Birch, Mary-Rose; Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan

    2015-01-01

    Internet-delivered mental health (eMental Health) interventions produce treatment effects similar to those observed in face-to-face treatment. However, there is a large degree of variation in treatment effects observed from program to program, and eMental Health interventions remain somewhat of a black box in terms of the mechanisms by which they exert their therapeutic benefit. Trials of eMental Health interventions typically use large sample sizes and therefore provide an ideal context within which to systematically investigate the therapeutic benefit of specific program features. Furthermore, the growth and impact of mobile phone technology within eMental Health interventions provides an opportunity to examine associations between symptom improvement and the use of program features delivered across computer and mobile phone platforms. The objective of this study was to identify the patterns of program usage associated with treatment outcome in a randomized controlled trial (RCT) of a fully automated, mobile phone- and Web-based self-help program, "myCompass", for individuals with mild-to-moderate symptoms of depression, anxiety, and/or stress. The core features of the program include interactive psychotherapy modules, a symptom tracking feature, short motivational messages, symptom tracking reminders, and a diary, with many of these features accessible via both computer and mobile phone. Patterns of program usage were recorded for 231 participants with mild-to-moderate depression, anxiety, and/or stress, and who were randomly allocated to receive access to myCompass for seven weeks during the RCT. Depression, anxiety, stress, and functional impairment were examined at baseline and at eight weeks. Log data indicated that the most commonly used components were the short motivational messages (used by 68.4%, 158/231 of participants) and the symptom tracking feature (used by 61.5%, 142/231 of participants). Further, after controlling for baseline symptom severity, increased use of these alert features was associated with significant improvements in anxiety and functional impairment. Associations between use of symptom tracking reminders and improved treatment outcome remained significant after controlling for frequency of symptom tracking. Although correlations were not statistically significant, reminders received via SMS (ie, text message) were more strongly associated with symptom reduction than were reminders received via email. These findings indicate that alerts may be an especially potent component of eMental Health interventions, both via their association with enhanced program usage, as well as independently. Although there was evidence of a stronger association between symptom improvement and use of alerts via the mobile phone platform, the degree of overlap between use of email and SMS alerts may have precluded identification of alert delivery modalities that were most strongly associated with symptom reduction. Future research using random assignment to computer and mobile delivery is needed to fully determine the most ideal platform for delivery of this and other features of online interventions. Australian New Zealand Clinical Trials Registry (ACTRN): 12610000625077; http://www.anzctr.org.au/TrialSearch.aspx? (Archived by WebCite http://www.webcitation.org/6WPqHK0mQ).

  3. Breaking Open the Black Box: Isolating the Most Potent Features of a Web and Mobile Phone-Based Intervention for Depression, Anxiety, and Stress

    PubMed Central

    Proudfoot, Judith; Clarke, Janine; Birch, Mary-Rose; Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan

    2015-01-01

    Background Internet-delivered mental health (eMental Health) interventions produce treatment effects similar to those observed in face-to-face treatment. However, there is a large degree of variation in treatment effects observed from program to program, and eMental Health interventions remain somewhat of a black box in terms of the mechanisms by which they exert their therapeutic benefit. Trials of eMental Health interventions typically use large sample sizes and therefore provide an ideal context within which to systematically investigate the therapeutic benefit of specific program features. Furthermore, the growth and impact of mobile phone technology within eMental Health interventions provides an opportunity to examine associations between symptom improvement and the use of program features delivered across computer and mobile phone platforms. Objective The objective of this study was to identify the patterns of program usage associated with treatment outcome in a randomized controlled trial (RCT) of a fully automated, mobile phone- and Web-based self-help program, “myCompass”, for individuals with mild-to-moderate symptoms of depression, anxiety, and/or stress. The core features of the program include interactive psychotherapy modules, a symptom tracking feature, short motivational messages, symptom tracking reminders, and a diary, with many of these features accessible via both computer and mobile phone. Methods Patterns of program usage were recorded for 231 participants with mild-to-moderate depression, anxiety, and/or stress, and who were randomly allocated to receive access to myCompass for seven weeks during the RCT. Depression, anxiety, stress, and functional impairment were examined at baseline and at eight weeks. Results Log data indicated that the most commonly used components were the short motivational messages (used by 68.4%, 158/231 of participants) and the symptom tracking feature (used by 61.5%, 142/231 of participants). Further, after controlling for baseline symptom severity, increased use of these alert features was associated with significant improvements in anxiety and functional impairment. Associations between use of symptom tracking reminders and improved treatment outcome remained significant after controlling for frequency of symptom tracking. Although correlations were not statistically significant, reminders received via SMS (ie, text message) were more strongly associated with symptom reduction than were reminders received via email. Conclusions These findings indicate that alerts may be an especially potent component of eMental Health interventions, both via their association with enhanced program usage, as well as independently. Although there was evidence of a stronger association between symptom improvement and use of alerts via the mobile phone platform, the degree of overlap between use of email and SMS alerts may have precluded identification of alert delivery modalities that were most strongly associated with symptom reduction. Future research using random assignment to computer and mobile delivery is needed to fully determine the most ideal platform for delivery of this and other features of online interventions. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN): 12610000625077; http://www.anzctr.org.au/TrialSearch.aspx? (Archived by WebCite http://www.webcitation.org/6WPqHK0mQ). PMID:26543909

  4. Earthquake Early Warning: New Strategies for Seismic Hardware

    NASA Astrophysics Data System (ADS)

    Allardice, S.; Hill, P.

    2017-12-01

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

  5. WIFIRE: A Scalable Data-Driven Monitoring, Dynamic Prediction and Resilience Cyberinfrastructure for Wildfires

    NASA Astrophysics Data System (ADS)

    Altintas, I.; Block, J.; Braun, H.; de Callafon, R. A.; Gollner, M. J.; Smarr, L.; Trouve, A.

    2013-12-01

    Recent studies confirm that climate change will cause wildfires to increase in frequency and severity in the coming decades especially for California and in much of the North American West. The most critical sustainability issue in the midst of these ever-changing dynamics is how to achieve a new social-ecological equilibrium of this fire ecology. Wildfire wind speeds and directions change in an instant, and first responders can only be effective when they take action as quickly as the conditions change. To deliver information needed for sustainable policy and management in this dynamically changing fire regime, we must capture these details to understand the environmental processes. We are building an end-to-end cyberinfrastructure (CI), called WIFIRE, for real-time and data-driven simulation, prediction and visualization of wildfire behavior. The WIFIRE integrated CI system supports social-ecological resilience to the changing fire ecology regime in the face of urban dynamics and climate change. Networked observations, e.g., heterogeneous satellite data and real-time remote sensor data is integrated with computational techniques in signal processing, visualization, modeling and data assimilation to provide a scalable, technological, and educational solution to monitor weather patterns to predict a wildfire's Rate of Spread. Our collaborative WIFIRE team of scientists, engineers, technologists, government policy managers, private industry, and firefighters architects implement CI pathways that enable joint innovation for wildfire management. Scientific workflows are used as an integrative distributed programming model and simplify the implementation of engineering modules for data-driven simulation, prediction and visualization while allowing integration with large-scale computing facilities. WIFIRE will be scalable to users with different skill-levels via specialized web interfaces and user-specified alerts for environmental events broadcasted to receivers before, during and after a wildfire. Scalability of the WIFIRE approach allows many sensors to be subjected to user-specified data processing algorithms to generate threshold alerts within seconds. Integration of this sensor data into both rapidly available fire image data and models will better enable situational awareness, responses and decision support at local, state, national, and international levels. The products of WIFIRE will be initially disseminated to our collaborators (SDG&E, CAL FIRE, USFS), covering academic, private, and government laboratories while generating values to emergency officials, and consequently to the general public. WIFIRE may be used by government agencies in the future to save lives and property during wildfire events, test the effectiveness of response and evacuation scenarios before they occur and assess the effectiveness of high-density sensor networks in improving fire and weather predictions. WIFIRE's high-density network, therefore, will serve as a testbed for future applications worldwide.

  6. EVALUATION OF SMOKE AND GAS SENSOR RESPONSES FOR FIRES OF COMMON MINE COMBUSTIBLES

    PubMed Central

    Perera, Inoka Eranda; Litton, Charles D.

    2015-01-01

    Experiments were conducted to evaluate the response characteristics of commercially available gas, smoke, and flame sensors to fires of common combustible mine materials. The experiments were conducted in the large-scale Fire gallery located at the National Institute for Occupational Safety and Health (NIOSH) Lake Lynn Laboratory (LLL) in Fairchance, PA, using Ponderosa Pine, Red Oak, Douglas-fir, high and low volatile coals, PVC and SBR conveyor belt, No. 2 diesel fuel, and diesel exhaust. All the experiments (except those using No. 2 diesel fuel and the diesel exhaust tests) were conducted in a similar manner, with combustible materials heated rapidly by electrical strip heaters producing smoldering fires that quickly transitioned into flaming fires. The sensors included a diffusion-type carbon monoxide (CO) sensor, photoelectric- and ionization-type smoke sensors, a video smoke/flame detector, and an optical flame detector. Simultaneous measurements were obtained for average gas concentrations, smoke mass concentrations, and smoke optical densities in order to quantify the levels of combustion products at the alert and alarm times of the sensors. Because the required sensor alarm levels are 10 ppm and 0.044 m−1 optical density for CO and smoke sensors, respectively, the different sensor alarms are compared to the time at which the CO and smoke reached these alarm levels (1). In addition, the potential impact of using smoke sensors that have met the performance standards from accredited testing laboratories is also evaluated using the response of an Underwriters’ Laboratory (UL)-approved combination photoelectric/ionization smoke detector. The results are discussed relative to fire sensor needs that can have a positive impact on mine fire safety. PMID:26229418

  7. EVALUATION OF SMOKE AND GAS SENSOR RESPONSES FOR FIRES OF COMMON MINE COMBUSTIBLES.

    PubMed

    Perera, Inoka Eranda; Litton, Charles D

    Experiments were conducted to evaluate the response characteristics of commercially available gas, smoke, and flame sensors to fires of common combustible mine materials. The experiments were conducted in the large-scale Fire gallery located at the National Institute for Occupational Safety and Health (NIOSH) Lake Lynn Laboratory (LLL) in Fairchance, PA, using Ponderosa Pine, Red Oak, Douglas-fir, high and low volatile coals, PVC and SBR conveyor belt, No. 2 diesel fuel, and diesel exhaust. All the experiments (except those using No. 2 diesel fuel and the diesel exhaust tests) were conducted in a similar manner, with combustible materials heated rapidly by electrical strip heaters producing smoldering fires that quickly transitioned into flaming fires. The sensors included a diffusion-type carbon monoxide (CO) sensor, photoelectric- and ionization-type smoke sensors, a video smoke/flame detector, and an optical flame detector. Simultaneous measurements were obtained for average gas concentrations, smoke mass concentrations, and smoke optical densities in order to quantify the levels of combustion products at the alert and alarm times of the sensors. Because the required sensor alarm levels are 10 ppm and 0.044 m -1 optical density for CO and smoke sensors, respectively, the different sensor alarms are compared to the time at which the CO and smoke reached these alarm levels (1). In addition, the potential impact of using smoke sensors that have met the performance standards from accredited testing laboratories is also evaluated using the response of an Underwriters' Laboratory (UL)-approved combination photoelectric/ionization smoke detector. The results are discussed relative to fire sensor needs that can have a positive impact on mine fire safety.

  8. Personalized Alert Notifications and Evacuation Routes in Indoor Environments

    PubMed Central

    Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

    2012-01-01

    The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

  9. 78 FR 21086 - Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition to List Two...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-09

    ... same taxon as a consequence of physical, physiological, ecological, or behavioral factors (quantitative.... 2012, pp. 57-60). The petitioners provide a variety of study results showing that post-fire salvage...; Arlington, VA 22203. We will not accept emails or faxes. We will post all information we receive on http...

  10. Benefits of Earthquake Early Warning to Large Municipalities (Invited)

    NASA Astrophysics Data System (ADS)

    Featherstone, J.

    2013-12-01

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

  11. Real-time notification and improved situational awareness in fire emergencies using geospatial-based publish/subscribe

    NASA Astrophysics Data System (ADS)

    Kassab, Ala'; Liang, Steve; Gao, Yang

    2010-12-01

    Emergency agencies seek to maintain situational awareness and effective decision making through continuous monitoring of, and real-time alerting about, sources of information regarding current incidents and developing fire hazards. The nature of this goal requires integrating different, potentially numerous, sources of dynamic geospatial information on the one side, and a large number of clients having heterogeneous and specific interests in data on the other side. In such scenarios, the traditional request/reply communication style may function inefficiently, as it is based on point-to-point, synchronous, and pulling mode interaction between consumer clients and information providers/services. In this work, we propose Geospatial-based Publish/ Subscribe, an interaction framework that serves as a middleware for real-time transacting of spatially related information of interest, termed geospatial events, in distributed systems. Expressive data models, including geospatial event and geospatial subscription, as well as an efficient matching approach for fast dissemination of geospatial events to interested clients, are introduced. The proposed interaction framework is realized through the development of a Real-Time Fire Emergency Response System (RFERS) prototype. The prototype is designed for transacting several topics of geospatial events that are crucial within the context of fire emergencies, including GPS locations of emergency assets, meteorological observations of wireless sensors, fire incidents reports, and temporal sequences of remote sensing images of active wildfires. The performance of the system prototype has been evaluated in order to demonstrate its efficiency.

  12. Changes in tracheid and ray traits in fire scars of North American conifers and their ecophysiological implications.

    PubMed

    Arbellay, Estelle; Stoffel, Markus; Sutherland, Elaine K; Smith, Kevin T; Falk, Donald A

    2014-08-01

    Fire scars have been widely used as proxies for the reconstruction of fire history; however, little is known about the impact of fire injury on wood anatomy. This study investigates changes in tracheid and ray traits in fire scars of Douglas fir (Pseudotsuga menziesii), western larch (Larix occidentalis) and ponderosa pine (Pinus ponderosa), and discusses their ecophysiological implications for tree recovery from fire. Transverse and tangential microsections were prepared for light microscopy and image analysis. Measurements of tracheids and rays were made in the three spatial dimensions: axially (at different section heights), radially (in different rings) and tangentially (with increasing distance from the wound margin). Changes were strongest in the first year after fire injury, with a decrease in tracheid size (by 25-30 %) and an increase in tracheid density (by 21-53 %) for the three species. In addition, an increase in ray size (by 5-27 %) and an increase in ray density (by 19-36 %) were found in P. menziesii and L. occidentalis. Changes were comparable along the fire-injured stem and were often most marked close to the fire scar. The differentiation after fire injury of narrower and more numerous tracheids expresses a trade-off between hydraulic safety and hydraulic efficiency, while that of larger and more numerous rays serves compartmentalization and wound closure, mechanical strength and defence responses. Pinus ponderosa does not generally produce more ray tissue after fire injury and thus appears to be more adapted to fire. © The Author 2014. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. The Impact of Tropical Peat Fire on Termite Assemblage in Sumatra, Indonesia: Reduced Complexity of Community Structure and Survival Strategies.

    PubMed

    Neoh, Kok-Boon; Bong, Lee-Jin; Muhammad, Ahmad; Itoh, Masayuki; Kozan, Osamu; Takematsu, Yoko; Yoshimura, Tsuyoshi

    2016-10-01

    Tropical peat swamp forests in Southeast Asia account for approximately 72% of global peatland. However, extensive forest exploitation following peat drainage for agricultural expansion has been leading to catastrophic peat fires. In this study, we compared the termite assemblage in burnt and unburnt peats in Sumatra, Indonesia. We also identified which taxonomic group is particularly resistant to fire disturbance and the traits that correlate with its persistence in fire-impacted peatlands. Overall, the termite species richness in fire-impacted peats was up to 40% lower than that of the total species found in peat swamp forests. Although the estimated species richness values in fire-impacted peats and peat swamp forests were not significantly different, fire changed termite community structure significantly. Only termites of the family Rhinotermitidae survived in the fire event, whereas members of the Termitidae that were reportedly resilient to fire and open habitats elsewhere disappeared during the fire events. The rhinotermitids found in the burnt sites were exclusively wood nesters. This suggests that the desiccation tolerance of termites in open habitat is not the simple underlying survival strategy, but tree branches and barks might have provided a refuge from heat during fire. The result also suggests that the high similarity in species composition in recently burnt peats and long burnt peats implies low species turnover. Thus, regardless of how much time had passed since the fire-impacted peats were abandoned or cultivated, the increase in habitat complexity did not favor colonization by the forest-dependent group. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Tsunami.gov: NOAA's Tsunami Information Portal

    NASA Astrophysics Data System (ADS)

    Shiro, B.; Carrick, J.; Hellman, S. B.; Bernard, M.; Dildine, W. P.

    2014-12-01

    We present the new Tsunami.gov website, which delivers a single authoritative source of tsunami information for the public and emergency management communities. The site efficiently merges information from NOAA's Tsunami Warning Centers (TWC's) by way of a comprehensive XML feed called Tsunami Event XML (TEX). The resulting unified view allows users to quickly see the latest tsunami alert status in geographic context without having to understand complex TWC areas of responsibility. The new site provides for the creation of a wide range of products beyond the traditional ASCII-based tsunami messages. The publication of modern formats such as Common Alerting Protocol (CAP) can drive geographically aware emergency alert systems like FEMA's Integrated Public Alert and Warning System (IPAWS). Supported are other popular information delivery systems, including email, text messaging, and social media updates. The Tsunami.gov portal allows NOAA staff to easily edit content and provides the facility for users to customize their viewing experience. In addition to access by the public, emergency managers and government officials may be offered the capability to log into the portal for special access rights to decision-making and administrative resources relevant to their respective tsunami warning systems. The site follows modern HTML5 responsive design practices for optimized use on mobile as well as non-mobile platforms. It meets all federal security and accessibility standards. Moving forward, we hope to expand Tsunami.gov to encompass tsunami-related content currently offered on separate websites, including the NOAA Tsunami Website, National Tsunami Hazard Mitigation Program, NOAA Center for Tsunami Research, National Geophysical Data Center's Tsunami Database, and National Data Buoy Center's DART Program. This project is part of the larger Tsunami Information Technology Modernization Project, which is consolidating the software architectures of NOAA's existing TWC's into a single system. We welcome your feedback to help Tsunami.gov become an effective public resource for tsunami information and a medium to enable better global tsunami warning coordination.

  15. On The Usage Of Fire Smoke Emissions In An Air Quality Forecasting System To Reduce Particular Matter Forecasting Error

    NASA Astrophysics Data System (ADS)

    Huang, H. C.; Pan, L.; McQueen, J.; Lee, P.; ONeill, S. M.; Ruminski, M.; Shafran, P.; DiMego, G.; Huang, J.; Stajner, I.; Upadhayay, S.; Larkin, N. K.

    2016-12-01

    Wildfires contribute to air quality problems not only towards primary emissions of particular matters (PM) but also emitted ozone precursor gases that can lead to elevated ozone concentration. Wildfires are unpredictable and can be ignited by natural causes such as lightning or accidently by human negligent behavior such as live cigarette. Although wildfire impacts on the air quality can be studied by collecting fire information after events, it is extremely difficult to predict future occurrence and behavior of wildfires for real-time air quality forecasts. Because of the time constraints of operational air quality forecasting, assumption of future day's fire behavior often have to be made based on observed fire information in the past. The United States (U.S.) NOAA/NWS built the National Air Quality Forecast Capability (NAQFC) based on the U.S. EPA CMAQ to provide air quality forecast guidance (prediction) publicly. State and local forecasters use the forecast guidance to issue air quality alerts in their area. The NAQFC fine particulates (PM2.5) prediction includes emissions from anthropogenic and biogenic sources, as well as natural sources such as dust storms and fires. The fire emission input to the NAQFC is derived from the NOAA NESDIS HMS fire and smoke detection product and the emission module of the US Forest Service BlueSky Smoke Modeling Framework. This study focuses on the error estimation of NAQFC PM2.5 predictions resulting from fire emissions. The comparisons between the NAQFC modeled PM2.5 and the EPA AirNow surface observation show that present operational NAQFC fire emissions assumption can lead to a huge error in PM2.5 prediction as fire emissions are sometimes placed at wrong location and time. This PM2.5 prediction error can be propagated from the fire source in the Northwest U.S. to downstream areas as far as the Southeast U.S. From this study, a new procedure has been identified to minimize the aforementioned error. An additional 24 hours reanalysis-run of NAQFC using same-day observed fire emission are being tested. Preliminary results have shown that this procedure greatly improves the PM2.5 predictions at both nearby and downstream areas from fire sources. The 24 hours reanalysis-run is critical and necessary especially during extreme fire events to provide better PM2.5 predictions.

  16. The Simulations of Wildland Fire Smoke PM25 in the NWS Air Quality Forecasting Systems

    NASA Astrophysics Data System (ADS)

    Huang, H. C.; Pan, L.; McQueen, J.; Lee, P.; ONeill, S. M.; Ruminski, M.; Shafran, P.; Huang, J.; Stajner, I.; Upadhayay, S.; Larkin, N. K.

    2017-12-01

    The increase of wildland fire intensity and frequency in the United States (U.S.) has led to property loss, human fatality, and poor air quality due to elevated particulate matters and surface ozone concentrations. The NOAA/National Weather Service (NWS) built the National Air Quality Forecast Capability (NAQFC) based on the U.S. Environmental Protection Agency (EPA) Community Multi-scale Air Quality (CMAQ) Modeling System driven by the NCEP North American Mesoscale Forecast System meteorology to provide ozone and fine particulate matter (PM2.5) forecast guidance publicly. State and local forecasters use the NWS air quality forecast guidance to issue air quality alerts in their area. The NAQFC PM2.5 predictions include emissions from anthropogenic and biogenic sources, as well as natural sources such as dust storms and wildland fires. The wildland fire emission inputs to the NAQFC is derived from the NOAA National Environmental Satellite, Data, and Information Service Hazard Mapping System fire and smoke detection product and the emission module of the U.S. Forest Service (USFS) BlueSky Smoke Modeling Framework. Wildland fires are unpredictable and can be ignited by natural causes such as lightning or be human-caused. It is extremely difficult to predict future occurrences and behavior of wildland fires, as is the available bio-fuel to be burned for real-time air quality predictions. Assumptions of future day's wildland fire behavior often have to be made from older observed wildland fire information. The comparisons between the NAQFC modeled PM2.5 and the EPA AirNow surface observation show that large errors in PM2.5 prediction can occur if fire smoke emissions are sometimes placed at the wrong location and/or time. A configuration of NAQFC CMAQ-system to re-run previous 24 hours, during which wildland fires were observed from satellites has been included recently. This study focuses on the effort performed to minimize the error in NAQFC PM2.5 predictions resulting from incorporating fire smoke emissions into the NAQFC from a recently updated newer version of USFS BlueSky system. This study will show how new approaches has improved the PM2.5 predictions at both nearby and downstream areas from fire sources. Furthermore, Environment and Climate Change Canada (ECCC) fire emissions data are being tested.

  17. Conceptual Questions and Challenge Problems

    NASA Astrophysics Data System (ADS)

    Nurrenbern, Susan C.; Robinson, William R.

    1998-11-01

    The JCE Internet Conceptual Question and Challenge Problem Web site is a source of questions and problems that can be used in teaching and assessing conceptual understanding and problem solving in chemistry. Here you can find a library of free-response and multiple-choice conceptual questions and challenge problems, tips for writing these questions and problems, and a discussion of types of conceptual questions. This site is intended to be a means of sharing conceptual questions and challenge problems among chemical educators. This is a living site that will grow as you share conceptual questions and challenge problems and as we find new sources of information. We would like to make this site as inclusive as possible. Please share your questions and problems with us and alert us to references or Web sites that could be included on the site. You can use email, fax, or regular mail. Email: nurrenbern@purdue.edu or wrrobin@purdue.edu Fax: 765/494-0239 Mailing address: Susan C. Nurrenbern or William R. Robinson; Department of Chemistry; Purdue University; 1393 Brown Building; West Lafayette, IN 47907-1393. The Conceptual Questions and Challenge Problems Web site can be found here.

  18. Fire Increases Genetic Diversity of Populations of Six-Lined Racerunner.

    PubMed

    Ragsdale, Alexandria K; Frederick, Bridget M; Dukes, David W; Liebl, Andrea L; Ashton, Kyle G; McCoy, Earl D; Mushinsky, Henry R; Schrey, Aaron W

    2016-01-01

    Wildfires are highly variable and can disturb habitats, leading to direct and indirect effects on the genetic characteristics of local populations. Florida scrub is a fire-dependent, highly fragmented, and severely threatened habitat. Understanding the effect of fire on genetic characteristics of the species that use this habitat is critically important. We investigated one such lizard, the Six-lined Racerunner (Aspidoscelis sexlineata), which has a strong preference for open areas. We collected Six-lined Racerunners (n = 154) from 11 sites in Highlands County, FL, and defined 2 time-since-last-fire (TSF) categories: recently burned and long unburned. We screened genetic variation at 6 microsatellites to estimate genetic differentiation and compare genetic diversity among sites to determine the relationship with TSF. A clear pattern exists between genetic diversity and TSF in the absence of strong genetic differentiation. Genetic diversity was greater and inbreeding was lower in sites with more recent TSF, and genetic characteristics had significantly larger variance in long unburned sites compared with more recently burned sites. Our results suggest that fire suppression increases variance in genetic characteristics of the Six-lined Racerunner. More generally, fire may benefit genetic characteristics of some species that use fire-dependent habitats and management efforts for such severely fragmented habitat will be challenged by the presence of multiple species with incompatible fire preferences. © The American Genetic Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Separating Spike Count Correlation from Firing Rate Correlation

    PubMed Central

    Vinci, Giuseppe; Ventura, Valérie; Smith, Matthew A.; Kass, Robert E.

    2016-01-01

    Populations of cortical neurons exhibit shared fluctuations in spiking activity over time. When measured for a pair of neurons over multiple repetitions of an identical stimulus, this phenomenon emerges as correlated trial-to-trial response variability via spike count correlation (SCC). However, spike counts can be viewed as noisy versions of firing rates, which can vary from trial to trial. From this perspective, the SCC for a pair of neurons becomes a noisy version of the corresponding firing-rate correlation (FRC). Furthermore, the magnitude of the SCC is generally smaller than that of the FRC, and is likely to be less sensitive to experimental manipulation. We provide statistical methods for disambiguating time-averaged drive from within-trial noise, thereby separating FRC from SCC. We study these methods to document their reliability, and we apply them to neurons recorded in vivo from area V4, in an alert animal. We show how the various effects we describe are reflected in the data: within-trial effects are largely negligible, while attenuation due to trial-to-trial variation dominates, and frequently produces comparisons in SCC that, because of noise, do not accurately reflect those based on the underlying FRC. PMID:26942746

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

    PubMed

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

    2011-04-01

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

  1. Cat vestibular neurons that exhibit different responses to active and passive yaw head rotations

    NASA Technical Reports Server (NTRS)

    Robinson, F. R.; Tomko, D. L.

    1987-01-01

    Neurons in the vestibular nuclei were recorded in alert cats during voluntary yaw rotations of the head and during the same rotations delivered with a turntable driven from a record of previous voluntary movements. During both voluntary and passive rotations, 35 percent (6/17) of neurons tested responded at higher rates or for a larger part of the movement during voluntary movements than during the same rotations delivered with the turntable. Neck sensory input was evaluated separately in many of these cells and can account qualitatively for the extra firing present during active movement.

  2. Contribution of biomass burning to particles matter smaller than ten microns in Mexico City during April 2013.

    NASA Astrophysics Data System (ADS)

    Mendoza Campos, Alejandra; Agustin Garcia Reynoso, Jóse; Castro Romero, Telma; Carbajal Perez, Jóse Noel; Gerardo Ruiz Suarez, Luis; Peralta Rosales, Oscar Augusto

    2015-04-01

    A forest fire is a natural combustion process in a specific geographic area, it's depends on meteorological variables, topography and vegetation type, The wildfires are potential sources of large amounts of pollutants. The main air pollutants emitted in a forest fire are the particles (PM10 and PM2.5) Carbon Monoxide (CO), Nitrogen Oxides (NOx), Volatile Organic Compounds (VOCs) and a negligible amount of Sulfur Dioxide (SO2) (Chow 1995), The study of the impact of air quality in Mexico City for a forest fire occurred on April 14 of 2013 was conducted a duration of 26 hours of grassland burning and consuming an extension of 150 ha, the WRF-Chem, WRF-fire and METv3 models were used to perform the study, for the study two modeling were made, one including emissions from forest fires and the other one no emission-fire, when interpolation is made between the two modeling and obtained the impact of air quality in Mexico City, performing calculating emissions and modeling, the impact on air quality for PM10particles were observed arriving at a concentration of 350 mg/m3 due to wildfire occurred, this issue exceeds the maximum permissible limit of PM10particles governed by NOM-025-SSA1-1993 that establishes a maximum of 120 mg/m3 on average for 24 hours, the modeling results with measured data is corroborated weather Stations the environmental monitoring network of the Mexico City, that alerts an environmental contingency for particles for the post-wildfire day. Until now is review the rule which establishes a maximum of 75 mg/m3 on average for 24 hours, implying greater involvement in air quality.

  3. Axonal Conduction Delays, Brain State, and Corticogeniculate Communication

    PubMed Central

    2017-01-01

    Thalamocortical conduction times are short, but layer 6 corticothalamic axons display an enormous range of conduction times, some exceeding 40–50 ms. Here, we investigate (1) how axonal conduction times of corticogeniculate (CG) neurons are related to the visual information conveyed to the thalamus, and (2) how alert versus nonalert awake brain states affect visual processing across the spectrum of CG conduction times. In awake female Dutch-Belted rabbits, we found 58% of CG neurons to be visually responsive, and 42% to be unresponsive. All responsive CG neurons had simple, orientation-selective receptive fields, and generated sustained responses to stationary stimuli. CG axonal conduction times were strongly related to modulated firing rates (F1 values) generated by drifting grating stimuli, and their associated interspike interval distributions, suggesting a continuum of visual responsiveness spanning the spectrum of axonal conduction times. CG conduction times were also significantly related to visual response latency, contrast sensitivity (C-50 values), directional selectivity, and optimal stimulus velocity. Increasing alertness did not cause visually unresponsive CG neurons to become responsive and did not change the response linearity (F1/F0 ratios) of visually responsive CG neurons. However, for visually responsive CG neurons, increased alertness nearly doubled the modulated response amplitude to optimal visual stimulation (F1 values), significantly shortened response latency, and dramatically increased response reliability. These effects of alertness were uniform across the broad spectrum of CG axonal conduction times. SIGNIFICANCE STATEMENT Corticothalamic neurons of layer 6 send a dense feedback projection to thalamic nuclei that provide input to sensory neocortex. While sensory information reaches the cortex after brief thalamocortical axonal delays, corticothalamic axons can exhibit conduction delays of <2 ms to 40–50 ms. Here, in the corticogeniculate visual system of awake rabbits, we investigate the functional significance of this axonal diversity, and the effects of shifting alert/nonalert brain states on corticogeniculate processing. We show that axonal conduction times are strongly related to multiple visual response properties, suggesting a continuum of visual responsiveness spanning the spectrum of corticogeniculate axonal conduction times. We also show that transitions between awake brain states powerfully affect corticogeniculate processing, in some ways more strongly than in layer 4. PMID:28559382

  4. Douglas flight deck design philosophy

    NASA Technical Reports Server (NTRS)

    Oldale, Paul

    1990-01-01

    The systems experience gained from 17 years of DC-10 operation was used during the design of the MD-11 to automate system operation and reduce crew workload. All functions, from preflight to shutdown at the termination of flight, require little input from the crew. The MD-11 aircraft systems are monitored for proper operation by the Aircraft Systems Controllers (ASC). In most cases, system reconfiguration as a result of a malfunction is automated. Manual input is required for irreversible actions such as engine shutdown, fuel dump, fire agent discharge, or Integrated Drive Generator (IDG) disconnect. During normal operations, when the cockpit is configured for flight, all annunciators on the overhead panel will be extinguished. This Dark Cockpit immediately confirms to the crew that the panels are correctly configured and that no abnormalities are present. Primary systems annunciations are shown in text on the Alert Area of the Engine and Alert Display (EAD). This eliminates the need to scan the overhead. The MD-11 aircraft systems can be manually controlled from the overhead area of the cockpit. The center portion of the overhead panel is composed of the primary aircraft systems panels, which include FUEL, AIR, Electrical (ELEC) and Hydraulic (HYD) systems, which are easily accessible from both flight crew positions. Each Aircraft Systems Controller (ASC) has two automatic channels and a manual mode. All rectangular lights are annunciators. All square lights are combined switches and annunciators called switch/lights. Red switch/lights on the overhead (Level 3 alerts) are for conditions requiring immediate crew action. Amber (Level 2 or Level 1 alerts) indicates a fault or switch out of position requiring awareness or crew interaction. Overhead switches used in normal operating conditions will illuminate blue when in use (Level 0 alerts) such as WING ANTI-ICE - ON. An overhead switch/light with BLACK LETTERING on an amber or red background indicates a system failure and that crew interaction is required. A switch/light with blue or amber lettering and a BLACK BACKGROUND indicates a switch out of normal position and that crew action is necessary only if the system is in manual operation.

  5. Managing the Risks and Rewards of Instant Messaging

    ERIC Educational Resources Information Center

    Goldsborough, Reid

    2004-01-01

    You probably think instant messaging (IM) as something teenagers do to chat up friends online, whether across the street or across the world. But IM has some buttoned-down business benefits, as well as some risks you may not be aware of. Unlike e-mail, in which you fire off messages to recipients who read them when they next check their in-box,…

  6. Aerosol Microphysics and Radiation Integration

    DTIC Science & Technology

    2003-09-30

    656-4769 email: reidj@nrlmry.navy.mil Award Number: N0001403WX20570 http://www.nrlmry.navy.mil/aerosol/ http://www.nrlmry.navy.mil/ flambe ...Fire Locating and Modeling of Burning Emissions ( FLAMBE ) project, which also provides NAAPS with a real-time biomass burning source function. In...Locating and Modeling of Burning Emissions ( FLAMBE ) project are currently being utilized by internet community, Air quality/human health research

  7. Drinking from a Fire Hose: A Study of Information Interactions in the Personal Offices of Members of Congress

    ERIC Educational Resources Information Center

    Weissmann, Deborah

    2010-01-01

    Although much as been written about information technologies and politics, less is known about how information is handled in congressional personal offices. What happens when a constituent sends an email to their Congressman? How does a Senator get information about the pros and cons of a proposed bill? A study was conducted to understand the…

  8. Cambial injury in lodgepole pine (Pinus contorta): mountain pine beetle vs fire.

    PubMed

    Arbellay, Estelle; Daniels, Lori D; Mansfield, Shawn D; Chang, Alice S

    2017-12-01

    Both mountain pine beetle (MPB) Dendroctonus ponderosae Hopkins and fire leave scars with similar appearance on lodgepole pine Pinus contorta Dougl. ex Loud. var. latifolia Engelm. that have never been compared microscopically, despite the pressing need to determine the respective effects of MPB and fire injury on tree physiology. We analysed changes in wood formation in naturally caused scars on lodgepole pine, and tested the hypotheses that (i) MPB and fire injury elicit distinct anomalies in lodgepole pine wood and (ii) anomalies differ in magnitude and/or duration between MPB and fire. Mountain pine beetle and fire injury reduced radial growth in the first year post-injury. Otherwise, radial growth and wood density increased over more than 10 years in both MPB and fire scars. We found that the general increase in radial growth was of greater magnitude (up to 27%) and of longer duration (up to 5 years) in fire scars compared with MPB scars, as shown in earlywood width. We also observed that the increase in latewood density was of greater magnitude (by 12%) in MPB scars, but of longer duration (by 4 years) in fire scars. Crystallinity decreased following MPB and fire injury, while microfibril angle increased. These changes in fibre traits were of longer duration (up to 4 years) in MPB scars compared with fire scars, as shown in microfibril angle. We found no significant changes in carbon and nitrogen concentrations. In conclusion, we stress that reduced competition and resistance to cavitation play an important role alongside cambial injury in influencing the type and severity of changes. In addition, more research is needed to validate the thresholds introduced in this study. Our findings serve as a foundation for new protocols to distinguish between bark beetle and fire disturbance, which is essential for improving our knowledge of historical bark beetle and fire regimes, and their interactions. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Effects of a computerized feedback intervention on safety performance by junior doctors: results from a randomized mixed method study

    PubMed Central

    2013-01-01

    Background The behaviour of doctors and their responses to warnings can inform the effective design of Clinical Decision Support Systems. We used data from a University hospital electronic prescribing and laboratory reporting system with hierarchical warnings and alerts to explore junior doctors’ behaviour. The objective of this trial was to establish whether a Junior Doctor Dashboard providing feedback on prescription warning information and laboratory alerting acceptance rates was effective in changing junior doctors’ behaviour. Methods A mixed methods approach was employed which included a parallel group randomised controlled trial, and individual and focus group interviews. Junior doctors below the specialty trainee level 3 grade were recruited and randomised to two groups. Every doctor (N = 42) in the intervention group was e-mailed a link to a personal dashboard every week for 4 months. Nineteen participated in interviews. The 44 control doctors did not receive any automated feedback. The outcome measures were the difference in responses to prescribing warnings (of two severities) and laboratory alerting (of two severities) between the months before and the months during the intervention, analysed as the difference in performance between the intervention and the control groups. Results No significant differences were observed in the rates of generating prescription warnings, or in the acceptance of laboratory alarms. However, responses to laboratory alerts differed between the pre-intervention and intervention periods. For the doctors of Foundation Year 1 grade, this improvement was significantly (p = 0.002) greater in the group with access to the dashboard (53.6% ignored pre-intervention compared to 29.2% post intervention) than in the control group (47.9% ignored pre-intervention compared to 47.0% post intervention). Qualitative interview data indicated that while junior doctors were positive about the electronic prescribing functions, they were discriminating in the way they responded to other alerts and warnings given that from their perspective these were not always immediately clinically relevant or within the scope of their responsibility. Conclusions We have only been able to provide weak evidence that a clinical dashboard providing individualized feedback data has the potential to improve safety behaviour and only in one of several domains. The construction of metrics used in clinical dashboards must take account of actual work processes. Trial registration ISRCTN: ISRCTN72253051 PMID:23734871

  10. Fire timing in relation to masting: an important determinant of post-fire recruitment success for the obligate-seeding arid zone soft spinifex (Triodia pungens).

    PubMed

    Wright, Boyd R; Fensham, Roderick J

    2018-01-25

    Plant species with fire-triggered germination are common in many fire-prone ecosystems. For such plants, fire timing in relation to the timing of reproduction may strongly influence post-fire population regeneration if: (a) flowering occurs infrequently (e.g. plants are mast seeders); and (b) seed survival rates are low and input from the current year's flowering therefore contributes a large proportion of the viable dormant seedbank. The role of fire timing in relation to masting as a driver of post-fire recruitment has rarely been examined directly, so this study tested the hypothesis that fires shortly after masting trigger increased recruitment of the obligate-seeding arid zone spinifex, Triodia pungens R. Br., an iteroparous masting grass with smoke-cued germination. Phenological monitoring of T. pungens was conducted over 5 years, while a longitudinal seedbank study assessed the influence of seeding events on soil-stored seedbank dynamics. Concurrently, a fire experiment with randomized blocking was undertaken to test whether T. pungens hummocks burnt shortly after masting have greater post-fire recruitment than hummocks burnt when there has not been recent input of seeds. Triodia pungens flowered in all years, though most flowerings were characterized by high rates of flower abortion. A mast flowering with high seed set in 2012 triggered approx. 200-fold increases in seedbank densities, and seedbank densities remained elevated for 24 months after this event. The fire experiment showed significantly higher recruitment around hummocks burnt 6 months after the 2012 mast event than around hummocks that were burnt but prevented from masting by having inflorescences clipped. Fires shortly after masting trigger mass recruitment in T. pungens because such fires synchronize an appropriate germination cue (smoke) with periods when seedbank densities are elevated. Interactions between natural fire regimes, seedbank dynamics and fire management prescriptions must be considered carefully when managing fire-sensitive masting plants such as T. pungens. © The Author(s) 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. A long-term follow-up evaluation of electronic health record prescribing safety

    PubMed Central

    Abramson, Erika L; Malhotra, Sameer; Osorio, S Nena; Edwards, Alison; Cheriff, Adam; Cole, Curtis; Kaushal, Rainu

    2013-01-01

    Objective To be eligible for incentives through the Electronic Health Record (EHR) Incentive Program, many providers using older or locally developed EHRs will be transitioning to new, commercial EHRs. We previously evaluated prescribing errors made by providers in the first year following transition from a locally developed EHR with minimal prescribing clinical decision support (CDS) to a commercial EHR with robust CDS. Following system refinements, we conducted this study to assess the rates and types of errors 2 years after transition and determine the evolution of errors. Materials and methods We conducted a mixed methods cross-sectional case study of 16 physicians at an academic-affiliated ambulatory clinic from April to June 2010. We utilized standardized prescription and chart review to identify errors. Fourteen providers also participated in interviews. Results We analyzed 1905 prescriptions. The overall prescribing error rate was 3.8 per 100 prescriptions (95% CI 2.8 to 5.1). Error rates were significantly lower 2 years after transition (p<0.001 compared to pre-implementation, 12 weeks and 1 year after transition). Rates of near misses remained unchanged. Providers positively appreciated most system refinements, particularly reduced alert firing. Discussion Our study suggests that over time and with system refinements, use of a commercial EHR with advanced CDS can lead to low prescribing error rates, although more serious errors may require targeted interventions to eliminate them. Reducing alert firing frequency appears particularly important. Our results provide support for federal efforts promoting meaningful use of EHRs. Conclusions Ongoing error monitoring can allow CDS to be optimally tailored and help achieve maximal safety benefits. Clinical Trials Registration ClinicalTrials.gov, Identifier: NCT00603070. PMID:23578816

  12. Development of a staff recall system for mass casualty incidents using cell phone text messaging.

    PubMed

    Epstein, Richard H; Ekbatani, Ali; Kaplan, Javier; Shechter, Ronen; Grunwald, Zvi

    2010-03-01

    After a mass casualty incident (MCI), rapid mobilization of hospital personnel is required because of an expected surge of victims. Risk assessment of our department's manual phone tree recall system revealed multiple weaknesses that would limit an effective response. Because cell phone use is widespread within the department, we developed and tested a staff recall system, based in our anesthesia information management system (AIMS), using Short Message Service (SMS) text messaging. We sent test text messages to anesthesia staff members' cell phone numbers, determined the distance from their home to the hospital, and stored this information in our AIMS. Latency testing for the time from transmission of SMS test messages from the server to return of an e-mail reply was determined at 2 different times on 2 different dates, 1 of which was a busy holiday weekend, using volunteers within the department. Two unannounced simulated disaster recall drills were conducted, with text messages sent asking for the anticipated time to return to the hospital. A timeline of available staff on site was determined. Reasons for failure to respond to the disaster notification message were tabulated. Latency data were fit by a log-normal distribution with an average of 82 seconds from message transmission to e-mail reply. Replies to the simulated disaster alert were received from approximately 50% of staff, with 16 projecting that they would have been able to be back at the hospital within 30 minutes on both dates. There would have been 21 and 23 staff in-house at 30 minutes, and 32 and 37 staff in-house at 60 minutes on the first and second test date, respectively, including in-house staff. Of the nonresponders to the alert, 48% indicated that their cell phone was not with them or was turned off, whereas 22% missed the message. Our SMS staff recall system is likely to be able to rapidly mobilize sufficient numbers of anesthesia personnel in response to an MCI, but actual performance cannot be predicted with confidence. Using our AIMS as the source for contact information and from which to send messages was simple, inexpensive, and easy to implement. Updating contact information, periodic testing, and analysis of responses to simulated disaster alerts are essential for the effective functioning of such a system. However, maintenance of alternative methods of communication is recommended, because there may be more significant message transmission delays and failures during an actual MCI, and not all staff will receive the text message in a timely fashion.

  13. Challenges in the Development and Evolution of Secure Open Architecture Command and Control Systems (Briefing Charts)

    DTIC Science & Technology

    2013-06-01

    widgets for an OA system Design-time architecture: Browser, email, widget, DB, OS Go ogle Instance architecture: Chrome, Gmail, Google...provides functionally similar components or applications compatible with an OA system design Firefox Browser, WP, calendar Opera Instance...architecture: Firefox , AbiWord, Evolution, Fedora GPL Ab1Word Google Docs Instance ardlitecture: Fire fox, OR Google cal., Google Docs, Fedora

  14. Automated detection of physiologic deterioration in hospitalized patients.

    PubMed

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

    2015-03-01

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

  15. Hospitalization event notifications and reductions in readmissions of Medicare fee-for-service beneficiaries in the Bronx, New York.

    PubMed

    Unruh, Mark Aaron; Jung, Hye-Young; Kaushal, Rainu; Vest, Joshua R

    2017-04-01

    Follow-up with a primary care provider after hospital discharge has been associated with a reduced likelihood of readmission. However, primary care providers are frequently unaware of their patients' hospitalizations. Event notification may be an effective tool for reducing readmissions by notifying primary care providers when their patients have been admitted to and discharged from a hospital. We examined the effect of an event notification system on 30-day readmissions in the Bronx, New York. The Bronx has among the highest readmission rates in the country and is a particularly challenging setting to improve care due to the low socioeconomic status of the county and high rates of poor health behaviors among its residents. The study cohort included 2559 Medicare fee-for-service beneficiaries associated with 14 141 hospital admissions over the period January 2010 through June 2014. Linear regression models with beneficiary-level fixed-effects were used to estimate the impact of event notifications on readmissions by comparing the likelihood of rehospitalization for a beneficiary before and after event notifications were active. The unadjusted 30-day readmission rate when event notifications were not active was 29.5% compared to 26.5% when alerts were active. Regression estimates indicated that active hospitalization alert services were associated with a 2.9 percentage point reduction in the likelihood of readmission (95% confidence interval: -5.5, -0.4). Alerting providers through event notifications may be an effective tool for improving the quality and efficiency of care among high-risk populations. © 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

  16. Impact of the 11 March, 2011, Tohoku earthquake and tsunami on the chemical industry

    NASA Astrophysics Data System (ADS)

    Krausmann, E.; Cruz, A. M.

    2012-04-01

    An earthquake of magnitude 9.0 occurred off the Pacific coast of Tohoku, Japan, on March 11, 2011, at 14:46:23 Japan Standard Time (5:46:23 UTC). It generated a tsunami 130 km off the coast of Miyagi Prefecture in northeast Japan, which inundated over 400 km2 of land. The death toll has reached >15,800 according to the Japan National Policy Agency with over 3,700 still missing as of 26 October 2011. Significant damage to or complete collapse of houses also resulted. The earthquake generated strong ground motion; nevertheless most damage was caused by the tsunami, which is a tribute to the effectiveness of Japan's earthquake damage reduction measures in saving lives and property. Nonetheless, the direct losses amount to more than 200 billion US dollars (not counting the costs of the accident at the Fukushima nuclear power plant). The earthquake and tsunami had a significant impact on all types of industry, and in particular on the petrochemical and chemical industry in the affected areas, resulting in hazardous-materials releases, fires and explosions and forcing businesses to interrupt production. These so-called Natech accidents pose an immediate or even long-term threat to the population and the environment, and can also interrupt the supply chain. Overall, the earthquake and tsunami took over 30% of Japan's oil production offline, and two refineries are still not or only partially in operation to repair the damage caused by the fires and explosions. The fire-fighting efforts could only be started 4 days after the disaster due to the absence of personnel that had been evacuated and because of the continuing tsunami alerts. In one of the affected refineries the fires could only be extinguished 10 days after the disasters. Many petrochemical and chemical companies reported problems either due to damage to facilities or because of power outages. In fact, in facilities that suffered no or only minor damage the resuming of operations was hampered by continuous aftershocks, tsunami alerts, the evacuation of personnel, a lack of utilities (water, electricity), damage to infrastructures (berths, roads etc.) and the shortage of raw materials. The Tohoku disaster showed that even prepared countries are at risk and consequently many lessons can be learned for future Natech prevention and mitigation. An in-depth analysis is required to single out the main reasons for the widespread industrial damage and downtime. This analysis, based on information from companies and authorities, in addition to a field visit to the affected areas, is presented.

  17. Neural basis for eye velocity generation in the vestibular nuclei of alert monkeys during off-vertical axis rotation

    NASA Technical Reports Server (NTRS)

    Reisine, H.; Raphan, T.; Cohen, B. (Principal Investigator)

    1992-01-01

    Activity of "vestibular only" (VO) and "vestibular plus saccade" (VPS) units was recorded in the rostral part of the medial vestibular nucleus and caudal part of the superior vestibular nucleus of alert rhesus monkeys. By estimating the "null axes" of recorded units (n = 79), the optimal plane of activation was approximately the mean plane of reciprocal semicircular canals, i.e., lateral canals, left anterior-right posterior (LARP) canals or right anterior-left posterior (RALP) canals. All units were excited by rotation in a direction that excited a corresponding ipsilateral semicircular canal. Thus, they all displayed a "type I" response. With the animal upright, there were rapid changes in firing rates of both VO and VPS units in response to steps of angular velocity about a vertical axis. The units were bidirectionally activated during vestibular nystagmus (VN), horizontal optokinetic nystagmus (OKN), optokinetic after-nystagmus (OKAN) and off-vertical axis rotation (OVAR). The rising and falling time constants of the responses to rotation indicated that they were closely linked to velocity storage. There were differences between VPS and VO neurons in that activity of VO units followed the expected time course in response to a stimulus even during periods of drowsiness, when eye velocity was reduced. Firing rates of VPS units, on the other hand, were significantly reduced in the drowsy state. Lateral canal-related units had average firing rates that were linearly related to the bias or steady state level of horizontal eye velocity during OVAR over a range of +/- 60 deg/s. These units could be further divided into two classes according to whether they were modulated during OVAR. Non-modulated units (n = 5) were VO types and all modulated units (n = 5) were VPS types. There was no significant difference between the bias level sensitivities relative to eye velocity of the units with and without modulation (P > 0.05). The modulated units had no sustained change in firing rate in response to static head tilts and their phases relative to head position varied from unit to unit. The phase did not appear to be linked to the modulation of horizontal eye velocity during OVAR. The sensitivities of unit activity to eye velocity were similar during all stimulus modalities despite the different gains of eye velocity vs stimulus velocity during VN, OKN and OVAR. Therefore, VO and VPS units are likely to carry an eye velocity signal related to velocity storage.(ABSTRACT TRUNCATED AT 400 WORDS).

  18. Assessing the predictability of fire occurrence and area burned across phytoclimatic regions in Spain

    NASA Astrophysics Data System (ADS)

    Bedia, J.; Herrera, S.; Gutiérrez, J. M.

    2014-01-01

    Most fire protection agencies throughout the world have developed forest fire risk forecast systems, usually building upon existing fire danger indices and meteorological forecast data. In this context, the daily predictability of wildfires is of utmost importance in order to allow the fire protection agencies to issue timely fire hazard alerts. In this study, we address the predictability of daily fire occurrence using the components of the Canadian Fire Weather Index (FWI) System and related variables calculated from the latest ECMWF (European Centre for Medium Range Weather Forecasts) reanalysis, ERA-Interim. We develop daily fire occurrence models in peninsular Spain for the period 1990-2008 and, considering different minimum burned area thresholds for fire definition, assess their ability to reproduce the inter-annual fire frequency variability. We based the analysis on a phytoclimatic classification aiming the stratification of the territory into homogeneous units in terms of climatic and fuel type characteristics, allowing to test model performance under different climate/fuel conditions. We then extend the analysis in order to assess the predictability of monthly burned areas. The sensitivity of the models to the level of spatial aggregation of the data is also evaluated. Additionally, we investigate the gain in model performance with the inclusion of socioeconomic and land use/land cover (LULC) covariates in model formulation. Fire occurrence models have attained good performance in most of the phytoclimatic zones considered, being able to faithfully reproduce the inter-annual variability of fire frequency. Total area burned has exhibited some dependence on the meteorological drivers, although model performance was poor in most cases. We identified temperature and some FWI system components as the most important explanatory variables, highlighting the adequacy of the FWI system for fire occurrence prediction in the study area. The results were improved when using aggregated data across regions compared to when data were sampled at the grid-box level. The inclusion of socioeconomic and LULC covariates contributed marginally to the improvement of the models, and in most cases attained no relevant contribution to total explained variance - excepting northern Spain, where anthropogenic factors are known to be the major driver of fires. Models of monthly fire counts performed better in the case of fires larger than 0.1 ha, and for the rest of the thresholds (1, 10 and 100 ha) the daily occurrence models improved the predicted inter-annual variability, indicating the added value of daily models. Fire frequency predictions may provide a preferable basis for past fire history reconstruction, long-term monitoring and the assessment of future climate impacts on fire regimes across regions, posing several advantages over burned area as a response variable. Our results leave the door open to the development a more complex modelling framework based on daily data from numerical climate model outputs based on the FWI system.

  19. The National Nonindigenous Aquatic Species Database

    USGS Publications Warehouse

    Neilson, Matthew E.; Fuller, Pamela L.

    2012-01-01

    The U.S. Geological Survey (USGS) Nonindigenous Aquatic Species (NAS) Program maintains a database that monitors, records, and analyzes sightings of nonindigenous aquatic plant and animal species throughout the United States. The program is based at the USGS Wetland and Aquatic Research Center in Gainesville, Florida.The initiative to maintain scientific information on nationwide occurrences of nonindigenous aquatic species began with the Aquatic Nuisance Species Task Force, created by Congress in 1990 to provide timely information to natural resource managers. Since then, the NAS database has been a clearinghouse of information for confirmed sightings of nonindigenous, also known as nonnative, aquatic species throughout the Nation. The database is used to produce email alerts, maps, summary graphs, publications, and other information products to support natural resource managers.

  20. Impacts of prescribed fire on Pinus rigida Mill. in upland forests of the Atlantic Coastal Plain.

    PubMed

    Carlo, Nicholas J; Renninger, Heidi J; Clark, Kenneth L; Schäfer, Karina V R

    2016-08-01

    A comparative analysis of the impacts of prescribed fire on three upland forest stands in the Northeastern Atlantic Plain, NJ, USA, was conducted. Effects of prescribed fire on water use and gas exchange of overstory pines were estimated via sap-flux rates and photosynthetic measurements on Pinus rigida Mill. Each study site had two sap-flux plots, one experiencing prescribed fire and one control (unburned) plot for comparison before and after the fire. We found that photosynthetic capacity in terms of Rubisco-limited carboxylation rate and intrinsic water-use efficiency was unaffected, while light compensation point and dark respiration rate were significantly lower in the burned vs control plots post-fire. Furthermore, quantum yield in pines in the pine-dominated stands was less affected than pines in the mixed oak/pine stand, as there was an increase in quantum yield in the oak/pine stand post-fire compared with the control (unburned) plot. We attribute this to an effect of forest type but not fire per se. Average daily sap-flux rates of the pine trees increased compared with control (unburned) plots in pine-dominated stands and decreased in the oak/pine stand compared with control (unburned) plots, potentially due to differences in fuel consumption and pre-fire sap-flux rates. Finally, when reference canopy stomatal conductance was analyzed, pines in the pine-dominated stands were more sensitive to changes in vapor pressure deficit (VPD), while stomatal responses of pines in the oak/pine stand were less affected by VPD. Therefore, prescribed fire affects physiological functioning and water use of pines, but the effects may be modulated by forest stand type and fuel consumption pattern, which suggests that these factors may need to be taken into account for forest management in fire-dominated systems. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Use of computer decision support in an antimicrobial stewardship program (ASP).

    PubMed

    Evans, R S; Olson, J A; Stenehjem, E; Buckel, W R; Thorell, E A; Howe, S; Wu, X; Jones, P S; Lloyd, J F

    2015-01-01

    Document information needs, gaps within the current electronic applications and reports, and workflow interruptions requiring manual information searches that decreased the ability of our antimicrobial stewardship program (ASP) at Intermountain Healthcare (IH) to prospectively audit and provide feedback to clinicians to improve antimicrobial use. A framework was used to provide access to patient information contained in the electronic medical record, the enterprise-wide data warehouse, the data-driven alert file and the enterprise-wide encounter file to generate alerts and reports via pagers, emails and through the Centers for Diseases and Control's National Healthcare Surveillance Network. Four new applications were developed and used by ASPs at Intermountain Medical Center (IMC) and Primary Children's Hospital (PCH) based on the design and input from the pharmacists and infectious diseases physicians and the new Center for Diseases Control and Prevention/National Healthcare Safety Network (NHSN) antibiotic utilization specifications. Data from IMC and PCH now show a general decrease in the use of drugs initially targeted by the ASP at both facilities. To be effective, ASPs need an enormous amount of "timely" information. Members of the ASP at IH report these new applications help them improve antibiotic use by allowing efficient, timely review and effective prioritization of patients receiving antimicrobials in order to optimize patient care.

  2. Assessing Disaster Preparedness among Latino Migrant and Seasonal Farmworkers in Eastern North Carolina

    PubMed Central

    Burke, Sloane; Bethel, Jeffrey W.; Foreman Britt, Amber

    2012-01-01

    Natural disasters including hurricanes, floods, earthquakes, tornadoes, and fires often involve substantial physical and mental impacts on affected populations and thus are public health priorities. Limited research shows that vulnerable populations such as the low-income, socially isolated migrant and seasonal farmworkers (MSFW) are particularly susceptible to the effects of natural disasters. This research project assessed the awareness, perceived risk, and practices regarding disaster preparedness and response resources and identified barriers to utilization of community and government services during or after a natural disaster among Latino MSFWs’ and their families. Qualitative (N = 21) focus groups (3) and quantitative (N = 57) survey methodology was implemented with Latino MSFWs temporarily residing in rural eastern North Carolina to assess perceived and actual risk for natural disasters. Hurricanes were a top concern among the sample population, many participants shared they lacked proper resources for an emergency (no emergency kit in the house, no evacuation plan, no home internet, a lack of knowledge of what should be included in an emergency kit, etc.). Transportation and language were found to be additional barriers. Emergency broadcasts in Spanish and text message alerts were identified by the population to be helpful for disaster alerts. FEMA, American Red Cross, local schools and the migrant clinic were trusted places for assistance and information. In summary, tailored materials, emergency alerts, text messages, and news coverage concerning disaster threats should be provided in the population’s native language and when feasible delivered in a culturally appropriate mechanism such as “charlas” (talks) and brochures. PMID:23202674

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  4. Environmental Assessment for Buckley Air Force Base Air Traffic Control Tower and Fire Station

    DTIC Science & Technology

    2003-05-01

    Guard Base, Arapahoe County, Colorado, Colorado National Heritage Program, Colorado State University , Ft. Collins, CO, July 2000. COANG, 2000d. Final... Westcliffe Publishers, Inc, Englewood, CO, 1995. Hoogland, 1995. Hoogland, John L. The Black-Tailed Prairie Dog- Social Life of a Burrowing Mammal. The... University of Chicago Press. Chicago, IL, 1995. Hranac, 2002. Email: Utilities Information, from Civ 460/CES/CEV to Civ 460/CES/CEVP dated 16

  5. Environment Agency England flood warning systems

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  6. Axonal Conduction Delays, Brain State, and Corticogeniculate Communication.

    PubMed

    Stoelzel, Carl R; Bereshpolova, Yulia; Alonso, Jose-Manuel; Swadlow, Harvey A

    2017-06-28

    Thalamocortical conduction times are short, but layer 6 corticothalamic axons display an enormous range of conduction times, some exceeding 40-50 ms. Here, we investigate (1) how axonal conduction times of corticogeniculate (CG) neurons are related to the visual information conveyed to the thalamus, and (2) how alert versus nonalert awake brain states affect visual processing across the spectrum of CG conduction times. In awake female Dutch-Belted rabbits, we found 58% of CG neurons to be visually responsive, and 42% to be unresponsive. All responsive CG neurons had simple, orientation-selective receptive fields, and generated sustained responses to stationary stimuli. CG axonal conduction times were strongly related to modulated firing rates (F1 values) generated by drifting grating stimuli, and their associated interspike interval distributions, suggesting a continuum of visual responsiveness spanning the spectrum of axonal conduction times. CG conduction times were also significantly related to visual response latency, contrast sensitivity (C-50 values), directional selectivity, and optimal stimulus velocity. Increasing alertness did not cause visually unresponsive CG neurons to become responsive and did not change the response linearity (F1/F0 ratios) of visually responsive CG neurons. However, for visually responsive CG neurons, increased alertness nearly doubled the modulated response amplitude to optimal visual stimulation (F1 values), significantly shortened response latency, and dramatically increased response reliability. These effects of alertness were uniform across the broad spectrum of CG axonal conduction times. SIGNIFICANCE STATEMENT Corticothalamic neurons of layer 6 send a dense feedback projection to thalamic nuclei that provide input to sensory neocortex. While sensory information reaches the cortex after brief thalamocortical axonal delays, corticothalamic axons can exhibit conduction delays of <2 ms to 40-50 ms. Here, in the corticogeniculate visual system of awake rabbits, we investigate the functional significance of this axonal diversity, and the effects of shifting alert/nonalert brain states on corticogeniculate processing. We show that axonal conduction times are strongly related to multiple visual response properties, suggesting a continuum of visual responsiveness spanning the spectrum of corticogeniculate axonal conduction times. We also show that transitions between awake brain states powerfully affect corticogeniculate processing, in some ways more strongly than in layer 4. Copyright © 2017 the authors 0270-6474/17/376342-17$15.00/0.

  7. Increased fire frequency promotes stronger spatial genetic structure and natural selection at regional and local scales in Pinus halepensis Mill.

    PubMed

    Budde, Katharina B; González-Martínez, Santiago C; Navascués, Miguel; Burgarella, Concetta; Mosca, Elena; Lorenzo, Zaida; Zabal-Aguirre, Mario; Vendramin, Giovanni G; Verdú, Miguel; Pausas, Juli G; Heuertz, Myriam

    2017-04-01

    The recurrence of wildfires is predicted to increase due to global climate change, resulting in severe impacts on biodiversity and ecosystem functioning. Recurrent fires can drive plant adaptation and reduce genetic diversity; however, the underlying population genetic processes have not been studied in detail. In this study, the neutral and adaptive evolutionary effects of contrasting fire regimes were examined in the keystone tree species Pinus halepensis Mill. (Aleppo pine), a fire-adapted conifer. The genetic diversity, demographic history and spatial genetic structure were assessed at local (within-population) and regional scales for populations exposed to different crown fire frequencies. Eight natural P. halepensis stands were sampled in the east of the Iberian Peninsula, five of them in a region exposed to frequent crown fires (HiFi) and three of them in an adjacent region with a low frequency of crown fires (LoFi). Samples were genotyped at nine neutral simple sequence repeats (SSRs) and at 251 single nucleotide polymorphisms (SNPs) from coding regions, some of them potentially important for fire adaptation. Fire regime had no effects on genetic diversity or demographic history. Three high-differentiation outlier SNPs were identified between HiFi and LoFi stands, suggesting fire-related selection at the regional scale. At the local scale, fine-scale spatial genetic structure (SGS) was overall weak as expected for a wind-pollinated and wind-dispersed tree species. HiFi stands displayed a stronger SGS than LoFi stands at SNPs, which probably reflected the simultaneous post-fire recruitment of co-dispersed related seeds. SNPs with exceptionally strong SGS, a proxy for microenvironmental selection, were only reliably identified under the HiFi regime. An increasing fire frequency as predicted due to global change can promote increased SGS with stronger family structures and alter natural selection in P. halepensis and in plants with similar life history traits. © The Author 2017. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  8. Volume 10, Issue 11-12© 2001 WILEY-VCH Verlag Berlin GmbH, Fed. Rep. of GermanySave Title to My Profile

    E-MailPrint

    Volume 10, Issue 11-12, Pages 887-984(November 2001)

    Original Paper

    Imaging of atomic orbitals with the Atomic Force Microscope - experiments and simulations

    NASA Astrophysics Data System (ADS)

    Giessibl, F. J.; Bielefeldt, H.; Hembacher, S.; Mannhart, J.

    2001-11-01

    Atomic force microscopy (AFM) is a mechanical profiling technique that allows to image surfaces with atomic resolution. Recent progress in reducing the noise of this technique has led to a resolution level where previously undetectable symmetries of the images of single atoms are observed. These symmetries are related to the nature of the interatomic forces. The Si(111)-(7 × 7) surface is studied by AFM with various tips and AFM images are simulated with chemical and electrostatic model forces. The calculation of images from the tip-sample forces is explained in detail and the implications of the imaging parameters are discussed. Because the structure of the Si(111)-(7 × 7) surface is known very well, the shape of the adatom images is used to determine the tip structure. The observability of atomic orbitals by AFM and scanning tunneling microscopy is discussed.

  9. An e-health system for the elderly (Butler Project): a pilot study on acceptance and satisfaction.

    PubMed

    Botella, Cristina; Etchemendy, Ernestina; Castilla, Diana; Baños, Rosa María; García-Palacios, Azucena; Quero, Soledad; Alcañiz, Mariano; Lozano, José Antonio

    2009-06-01

    The Butler Project is a technological e-health platform that uses the Internet to connect various users; it was designed to deliver health care to the elderly. The Butler platform has three levels of implementation: diagnosis (mood monitoring, alert system, management reports), therapy (training in inducing positive moods, memory work), and entertainment (e-mail, chat, video, photo albums, music, friend forums, accessibility to the Internet). The objective of this work is to describe the psychological aspects of the platform and to present data obtained from four users. Results show that after using the system, the participants increased their positive emotions and decreased their negative ones; in addition, they obtained high levels of satisfaction and experienced little difficulty in using the system.

  10. Biomedical information @ the speed of light: implementing desktop access to publishers' resources at the Paterson Institute for Cancer Research.

    PubMed

    Glover, S W

    2001-06-01

    Shortly after midnight every Thursday morning, a list server in Massachusetts delivers an electronic table of contents message to the Kostoris Medical Library at the Paterson Institute for Cancer Research in Manchester, UK. The messageins details of the latest edition of the New England Journal of Medicine, complete with hyperlinks to the full text of the content online. Publishers' electronic current awareness services have been integrated into the dissemination process of the Library service to enhance the speed of communication and access to full text content. As a means of promoting electronic journal use, a system of e-mail delivery coupled with fast Internet access has allowed a migration from paper-based current awareness alerting to a seamless online product.

  11. Web-based biobank system infrastructure monitoring using Python, Perl, and PHP.

    PubMed

    Norling, Martin; Kihara, Absolomon; Kemp, Steve

    2013-12-01

    The establishment and maintenance of biobanks is only as worthwhile as the security and logging of the biobank contents. We have designed a monitoring system that continuously measures temperature and gas content, records the movement of samples in and out of the biobank, and also records the opening and closing of the freezers-storing the results and images in a database. We have also incorporated an early warning feature that sends out alerts, via SMS and email, to responsible persons if any measurement is recorded outside the acceptable limits, guaranteeing the integrity of biobanked samples, as well as reagents used in sample analysis. A surveillance system like this increases the value for any biobank as the initial investment is small and the value of having trustworthy samples for future research is high.

  12. Saccule contribution to immediate early gene induction in the gerbil brainstem with posterior canal galvanic or hypergravity stimulation

    NASA Technical Reports Server (NTRS)

    Marshburn, T. H.; Kaufman, G. D.; Purcell, I. M.; Perachio, A. A.

    1997-01-01

    Immunolabeling patterns of the immediate early gene-related protein Fos in the gerbil brainstem were studied following stimulation of the sacculus by both hypergravity and galvanic stimulation. Head-restrained, alert animals were exposed to a prolonged (1 h) inertial vector of 2 G (19.6 m/s2) head acceleration directed in a dorso-ventral head axis to maximally stimulate the sacculus. Fos-defined immunoreactivity was quantified, and the results compared to a control group. The hypergravity stimulus produced Fos immunolabeling in the dorsomedial cell column (dmcc) of the inferior olive independently of other subnuclei. Similar dmcc labeling was induced by a 30 min galvanic stimulus of up to -100 microA applied through a stimulating electrode placed unilaterally on the bony labyrinth overlying the posterior canal (PC). The pattern of vestibular afferent firing activity induced by this galvanic stimulus was quantified in anesthetized gerbils by simultaneously recording from Scarpa's ganglion. Only saccular and PC afferent neurons exhibited increases in average firing rates of 200-300%, suggesting a pattern of current spread involving only PC and saccular afferent neurons at this level of stimulation. These results suggest that alteration in saccular afferent firing rates are sufficient to induce Fos-defined genomic activation of the dmcc, and lend further evidence to the existence of a functional vestibulo-olivary-cerebellar pathway of adaptation to novel gravito-inertial environments.

  13. Febrile Infection-Related Epilepsy Syndrome (FIRES): An Overview of Treatment and Recent Patents.

    PubMed

    Hon, Kam Lun E Lun; Leung, Alexander K C; Torres, Alcy R

    2018-05-08

    New-onset refractory status epilepticus (NORSE) refers to a clinical presentation in a patient without active epilepsy or other existing relevant neurological disorder, with new onset of refractory status epilepticus in the absence of a clear acute or active structural, metabolic, or toxic cause. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE that requires a febrile infection between 24 hours and 2 weeks prior to the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus, and with no restriction to the age of the patient. The literature on FIRES is scarce. This article reviews the pathophysiology, clinical features, and various treatment modalities in the treatment of FIRES. A Medline/Pubmed search was conducted using Clinical Queries with the key terms "febrile infection-related epilepsy syndrome", "FIRES", "new-onset refractory status epilepticus" and "NORSE". The search strategy included meta-analyses, randomized controlled trials, clinical trials, reviews and pertinent references. Patents were searched using the key term "FIRES", "NORSE" and "febrile epilepsy syndrome" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. FIRES almost invariably begins with a mild nonspecific febrile illness in an otherwise healthy individual. Twenty four hours to two weeks later, seizures begin and quickly become very frequent and worsen, becoming status epilepticus. Seizures can be simple motor, complex partial or secondary generalized. The exact etiology is no known. It is possible that the syndrome is caused by an inflammatory or autoimmune mechanism. Seizures in FIRES are notoriously very difficult to treat. Treatment modalities include, among others, various antiepileptic drugs, ketogenic diet, intravenous corticosteroids, intravenous immunoglobulin, and burst-suppression coma. Outcome is poor; most children are left with significant cognitive disability and refractory epilepsy. Recent patents for the management of FIRES are discussed. FIRES is a rare epilepsy syndrome of unclear etiology in which children, usually of school age, suddenly develop very frequent seizures after a mild febrile illness. Seizures in FIRES are typically recalcitrant and difficult to treat. The prognosis is poor. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Visual selective attention in amnestic mild cognitive impairment.

    PubMed

    McLaughlin, Paula M; Anderson, Nicole D; Rich, Jill B; Chertkow, Howard; Murtha, Susan J E

    2014-11-01

    Subtle deficits in visual selective attention have been found in amnestic mild cognitive impairment (aMCI). However, few studies have explored performance on visual search paradigms or the Simon task, which are known to be sensitive to disease severity in Alzheimer's patients. Furthermore, there is limited research investigating how deficiencies can be ameliorated with exogenous support (auditory cues). Sixteen individuals with aMCI and 14 control participants completed 3 experimental tasks that varied in demand and cue availability: visual search-alerting, visual search-orienting, and Simon task. Visual selective attention was influenced by aMCI, auditory cues, and task characteristics. Visual search abilities were relatively consistent across groups. The aMCI participants were impaired on the Simon task when working memory was required, but conflict resolution was similar to controls. Spatially informative orienting cues improved response times, whereas spatially neutral alerting cues did not influence performance. Finally, spatially informative auditory cues benefited the aMCI group more than controls in the visual search task, specifically at the largest array size where orienting demands were greatest. These findings suggest that individuals with aMCI have working memory deficits and subtle deficiencies in orienting attention and rely on exogenous information to guide attention. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    PubMed Central

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

    2016-01-01

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

  16. ForWarn: A Cross-Cutting Forest Resource Management and Decision Support System Providing the Capacity to Identify and Track Forest Disturbances Nationally

    NASA Astrophysics Data System (ADS)

    Hargrove, W. W.; Spruce, J.; Norman, S.; Christie, W.; Hoffman, F. M.

    2012-12-01

    The Eastern Forest Environmental Threat Assessment Center and Western Wildland Environmental Assessment Center of the USDA Forest Service have collaborated with NASA Stennis Space Center to develop ForWarn, a forest monitoring tool that uses MODIS satellite imagery to produce weekly snapshots of vegetation conditions across the lower 48 United States. Forest and natural resource managers can use ForWarn to rapidly detect, identify, and respond to unexpected changes in the nation's forests caused by insects, diseases, wildfires, severe weather, or other natural or human-caused events. ForWarn detects most types of forest disturbances, including insects, disease, wildfires, frost and ice damage, tornadoes, hurricanes, blowdowns, harvest, urbanization, and landslides. It also detects drought, flood, and temperature effects, and shows early and delayed seasonal vegetation development. Operating continuously since January 2010, results show ForWarn to be a robust and highly capable tool for detecting changes in forest conditions. ForWarn is the first national-scale system of its kind based on remote sensing developed specifically for forest disturbances. It has operated as a prototype since January 2010 and has provided useful information about the location and extent of disturbances detected during the 2011 growing season, including tornadoes, wildfires, and extreme drought. The ForWarn system had an official unveiling and rollout in March 2012, initiated by a joint NASA and USDA press release. The ForWarn home page has had 2,632 unique visitors since rollout in March 2012, with 39% returning visits. ForWarn was used to map tornado scars from the historic April 27, 2011 tornado outbreak, and detected timber damage within more than a dozen tornado tracks across northern Mississippi, Alabama, and Georgia. ForWarn is the result of an ongoing, substantive cooperation among four different government agencies: USDA, NASA, USGS, and DOE. Disturbance maps are available on the web through the ForWarn Change Assessment Viewer at http://forwarn.forestthreats.org/fcav. No user id or password is required, and there is no cost. The Assessment Viewer operates within any popular web browser using nearly any type of computer. It lets users pan, zoom, and scroll around within ForWarn maps, and also contains an up-to-date library of co-registered, near real-time ancillary maps from diverse sources that allows users to assess the nature of particular forest disturbances and ascribe their most-likely causes. Users can check the current week's U.S. Drought Monitor, USGS VegDRI maps, FHM Historical Aerial Disturbance Surveys, MODIS Cumulative Current Year Fire Detections, and many others. A "Share this map" feature lets users save the current map view and extent into a web URL, so that users can easily share what they are looking at inside the Assessment Viewer with others via an email, a document, or a web page. The ForWarn Rapid National Assessment Team examined more than 60 ForWarn forest disturbance events in 2011-2012, and issued over 30 alerts. We hope to automate forest disturbance alerts and supply them through various subscription services. Forest owners and managers would only be alerted to disturbances occurring near their own forest resources.

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

    PubMed

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

    2018-05-15

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

  18. INITIATE: An Intelligent Adaptive Alert Environment.

    PubMed

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

    2015-01-01

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

  19. Bulletin of Forest Fire risk in Albania- The experience of the Albania National Centre for forecast and Monitoring of Natural Risks

    NASA Astrophysics Data System (ADS)

    Berdufi, I.; Jaupaj, O.; Marku, M.; Deda, M.; Fiori, E.; D'Andrea, M.; Biondi, G.; Fioruci, P.; Massabò, M.; Zorba, P.; Gjonaj, M.

    2012-04-01

    In the territory of Albania usually every year around 1000 ha are affected by forest fires, from which about 500 ha are completely destroyed. The number of forest fires (nf), with the burning surface (bs) in years has been like this: during the years 1988-1998: nf / bs = 2.19, 1998-2001: nf / bs = 5.66, year 2002 -2005: nf / bs = 8.2, and during the years 2005-2006: nf / bs = 11.9, while economic losses in a year by forest fires is about 2 million of Euro. The increase in years of these figures and the last floods which happened in the last two years in Shkoder, led to an international cooperation, that between the Italian Civil Protection Department and the Albania General Directorate of Civil Emergency. The focus of this cooperation was the building capacity of the Albanian National System of Civil Protection in forecasting, monitoring and prevention forest fires and floods risks. As a result of this collaboration the "National Center for the Forecast and Monitoring of Natural Risks", was set up at the Institute of Geosciences, Energy, Water and Environment. The Center is the first of its kind in Albania. The mission of the Center is the prediction and monitoring of the forest fire and flood risk in the Albanian territory, as a tools for risk reduction and mitigation. The first step to achieve this strategy was the implementation of the forest fires risk forecast model "RISICO". RISICO was adapted for whole Albania territory by CIMA Research Foundation. The Center, in the summer season, issues a daily bulletin. The bulletin reports the potential risk scenarios related with the ignition and propagation of fires in Albania. The bulletin is broadcasted through email or fax within 12.00 AM of each working day. It highlights where and when severe risk conditions may occur within the next 48 hours

  20. Implementing an overdose education and naloxone distribution program in a health system.

    PubMed

    Devries, Jennifer; Rafie, Sally; Polston, Gregory

    To design and implement a health system-wide program increasing provision of take-home naloxone in patients at risk for opioid overdose, with the downstream aim of reducing fatalities. The program includes health care professional education and guidelines, development, and dissemination of patient education materials, electronic health record changes to promote naloxone prescriptions, and availability of naloxone in pharmacies. Academic health system, San Diego, California. University of California, San Diego Health (UCSDH), offers both inpatient and outpatient primary care and specialty services with 563 beds spanning 2 hospitals and 6 pharmacies. UCSDH is part of the University of California health system, and it serves as the county's safety net hospital. In January 2016, a multisite academic health system initiated a system-wide overdose education and naloxone distribution program to prevent opioid overdose and opioid overdose-related deaths. An interdisciplinary, interdepartmental team came together to develop and implement the program. To strengthen institutional support, naloxone prescribing guidelines were developed and approved for the health system. Education on naloxone for physicians, pharmacists, and nurses was provided through departmental trainings, bulletins, and e-mail notifications. Alerts in the electronic health record and preset naloxone orders facilitated co-prescribing of naloxone with opioid prescriptions. Electronic health record reports captured naloxone prescriptions ordered. Summary reports on the electronic health record measured naloxone reminder alerts and response rates. Since the start of the program, the health system has trained 252 physicians, pharmacists, and nurses in overdose education and take-home naloxone. There has been an increase in the number of prescriptions for naloxone from a baseline of 4.5 per month to an average of 46 per month during the 3 months following full implementation of the program including implementation of electronic health record alerts. Initiating and implementing an overdose education and naloxone distribution program is feasible in an academic health system. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  1. Zika virus infection: report of the first imported cases in a Paris travel centre.

    PubMed

    Sokal, Aurélien; D'Ortenzio, Eric; Houhou-Fidouh, Nadira; Brichler, Ségolène; Dorchies, Justine; Cabras, Ornella; Leparc-Goffart, Isabelle; Yazdanpanah, Yazdan; Matheron, Sophie

    2016-07-01

    We describe characteristics of 17 patients with a Zika virus (ZIKV) infection seen in a Travel Center in Paris during the 4 months following the WHO alert on ZIKV. Sixteen were imported cases, including 13 from the Caribbean. One was a women living in Paris infected through sexual transmission. One case was a pregnant woman. All cases were symptomatic with fever, fatigue and cutaneous rash in 15/17, 13/17, and 16/17, respectively. Leucopenia was observed in 6/17, thrombopenia in 2/17. Diagnosis was confirmed by ZIKV RT-PCR (plasma: 12/17; urine 15/17) or detection of ZIKV IgM (2/17). Two patients were hospitalized but all evolved well. © International Society of Travel Medicine, 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Automatic management system for dose parameters in interventional radiology and cardiology.

    PubMed

    Ten, J I; Fernandez, J M; Vaño, E

    2011-09-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions.

  3. Vision of a cyberinfrastructure for nonnative, invasive species management

    USGS Publications Warehouse

    2008-01-01

    Although the quantity of data on the location, status, and management of invasive species is ever increasing, invasive species data sets are often difficult to obtain and integrate. A cyberinfrastructure for such information could make these data available for Internet users. The data can be used to create regional watch lists, to send e-mail alerts when a new species enters a region, to construct models of species' current and future distributions, and to inform management. Although the exchange of environmental data over the Internet in the form of raster data is maturing, and the exchange of species occurrence data is developing quickly, there is room for improvement. In this article, we present a vision for a comprehensive invasive species cyberinfrastructure that is capable of accessing data effectively, creating models of invasive species spread, and distributing this information.

  4. Fire eater's lung: retrospective analysis of 123 cases reported to a National Poison Center.

    PubMed

    Franzen, Daniel; Kohler, Malcolm; Degrandi, Colette; Kullak-Ublick, Gerd A; Ceschi, Alessandro

    2014-01-01

    Fire eater's lung (FEL) is a distinct form of acute chemical toxic pneumonitis, which is caused by aspiration of flammable petrochemical derivatives used by street performers for 'fire eating'. The optimal management of this condition has not yet been determined. The aim of this study was to investigate patient characteristics, clinical features, treatment, and outcome of FEL. A single-center retrospective review of consecutive cases of FEL in children and adults reported to a national poison center (the Swiss Toxicological Information Center) between 1995 and 2012. 123 cases (83.7% males, mean age 21.9 years) were included. The most frequently reported symptom was cough (50.4%), followed by chest pain (45.5%), and fever (35.8%). Dyspnea was reported by 23.6%. Cough (p = 0.002) and chest pain (p = 0.02) were significantly more prevalent in subjects reporting to have aspirated the fuel compared to those who have swallowed it or who did not perceive poison exposure. A pulmonary infiltrate was detected in 83% of the cases in whom chest X-ray was performed. Overall, 22% were treated with an antibiotic agent for a mean duration of 10.4 days. Corticosteroids were administered in 4.9%. All showed complete recovery irrespective of the therapeutic management. The combination of intense pleuritic chest pain, cough, dyspnea, and fever, or any of these symptoms after 'fire eating' or erroneous swallowing of a petroleum distillate should alert the clinician to the diagnosis of FEL. Early antibiotic treatment of severe cases seems justified, considering that clinical, laboratory, and radiologic findings of FEL are overlapping with bacterial superinfection. Copyright © 2013 S. Karger AG, Basel.

  5. Thetford plastics fire, October 1991: the role of a preventive medical team in chemical incidents.

    PubMed Central

    Baxter, P J; Heap, B J; Rowland, M G; Murray, V S

    1995-01-01

    OBJECTIVES--To review the role of a medical team in the emergency management of a major polyvinyl chloride (PVC) fire in an urban area. METHODS--The district health authority's consultant in communicable disease control (CCDC) was requested to advise on the health impacts of a fire that consumed some 1000 tonnes of plastic, mainly PVC, over 72 hours and which emitted a large smoke plume that threatened the health of local residents and emergency workers alike, constituting one of the largest incidents the local emergency services had dealt with in recent years. A medical team was formed comprising the CCDC, a regional epidemiologist, an occupational physician, and a medical toxicologist. This paper is an account of this team's experience of advising on the medical management of the emergency without having any formally established role or previous training for the task. RESULTS--The main issues requiring the input of the medical team included: the possible products of combustion and their effects on health; the clinical management of those exposed; the alerting of local hospitals to the type of casualties to expect; the special health risks posed to emergency workers, especially the firemen; the need for evacuation of local residents; the risks of contamination of soil, water, and crops; the potential health impact of the plume; and the provision of expert and authoritative advice on the short and long term health implications to the public. Active surveillance systems, which included the local general practitioners and hospitals, were established and air monitoring instigated. The 46 casualties were restricted to emergency personnel who had inadvertently received exposure to the fire smoke: all recovered within 48 hours. Local residents were unharmed. CONCLUSION--The incident showed the need for preventive medical teams trained to fill a formal advisory and investigative role for chemical releases and fires, and which can play an integral part in emergency management. PMID:7489061

  6. Thetford plastics fire, October 1991: the role of a preventive medical team in chemical incidents.

    PubMed

    Baxter, P J; Heap, B J; Rowland, M G; Murray, V S

    1995-10-01

    To review the role of a medical team in the emergency management of a major polyvinyl chloride (PVC) fire in an urban area. The district health authority's consultant in communicable disease control (CCDC) was requested to advise on the health impacts of a fire that consumed some 1000 tonnes of plastic, mainly PVC, over 72 hours and which emitted a large smoke plume that threatened the health of local residents and emergency workers alike, constituting one of the largest incidents the local emergency services had dealt with in recent years. A medical team was formed comprising the CCDC, a regional epidemiologist, an occupational physician, and a medical toxicologist. This paper is an account of this team's experience of advising on the medical management of the emergency without having any formally established role or previous training for the task. The main issues requiring the input of the medical team included: the possible products of combustion and their effects on health; the clinical management of those exposed; the alerting of local hospitals to the type of casualties to expect; the special health risks posed to emergency workers, especially the firemen; the need for evacuation of local residents; the risks of contamination of soil, water, and crops; the potential health impact of the plume; and the provision of expert and authoritative advice on the short and long term health implications to the public. Active surveillance systems, which included the local general practitioners and hospitals, were established and air monitoring instigated. The 46 casualties were restricted to emergency personnel who had inadvertently received exposure to the fire smoke: all recovered within 48 hours. Local residents were unharmed. The incident showed the need for preventive medical teams trained to fill a formal advisory and investigative role for chemical releases and fires, and which can play an integral part in emergency management.

  7. The legal status of Uncertainty

    NASA Astrophysics Data System (ADS)

    Altamura, M.; Ferraris, L.; Miozzo, D.; Musso, L.; Siccardi, F.

    2011-03-01

    An exponential improvement of numerical weather prediction (NWP) models was observed during the last decade (Lynch, 2008). Civil Protection (CP) systems exploited Meteo services in order to redeploy their actions towards the prediction and prevention of events rather than towards an exclusively response-oriented mechanism1. Nevertheless, experience tells us that NWP models, even if assisted by real time observations, are far from being deterministic. Complications frequently emerge in medium to long range forecasting, which are subject to sudden modifications. On the other hand, short term forecasts, if seen through the lens of criminal trials2, are to the same extent, scarcely reliable (Molini et al., 2009). One particular episode related with wrong forecasts, in the Italian panorama, has deeply frightened CP operators as the NWP model in force missed a meteorological adversity which, in fact, caused death and dealt severe damage in the province of Vibo Valentia (2006). This event turned into a very discussed trial, lasting over three years, and intended against whom assumed the legal position of guardianship within the CP. A first set of data is now available showing that in concomitance with the trial of Vibo Valentia the number of alerts issued raised almost three folds. We sustain the hypothesis that the beginning of the process of overcriminalization (Husak, 2008) of CPs is currently increasing the number of false alerts with the consequent effect of weakening alert perception and response by the citizenship (Brezntiz, 1984). The common misunderstanding of such an issue, i.e. the inherent uncertainty in weather predictions, mainly by prosecutors and judges, and generally by whom deals with law and justice, is creating the basis for a defensive behaviour3 within CPs. This paper intends, thus, to analyse the social and legal relevance of uncertainty in the process of issuing meteo-hydrological alerts by CPs. Footnotes: 1 The Italian Civil Protection is working in this direction since 1992 (L. 225/92). An example of this effort is clearly given by the Prime Minister Decree (DPCM 20/12/2001 "Linee guida relative ai piani regionali per la programmazione delle attivita' di previsione, prevenzione e lotta attiva contro gli incendi boschivi - Guidelines for regional plans for the planning of prediction, prevention and forest fires fighting activities") that, already in 2001, emphasized "the most appropriate approach to pursue the preservation of forests is to promote and encourage prediction and prevention activities rather than giving priority to the emergency-phase focused on fire-fighting". 2 Supreme Court of the United States, In re Winship (No. 778), No. 778 argued: 20 January 1970, decided: 31 March 1970: Proof beyond a reasonable doubt, which is required by the Due Process Clause in criminal trials, is among the "essentials of due process and fair treatment" 3 In Kessler and McClellan (1996): "Defensive medicine is a potentially serious social problem: if fear of liability drives health care providers to administer treatments that do not have worthwhile medical benefits, then the current liability system may generate inefficiencies much larger than the costs of compensating malpractice claimants".

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

    PubMed Central

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

    1997-01-01

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

  9. Temporal effects of prescribed burning on terpene production in Mediterranean pines.

    PubMed

    Valor, Teresa; Ormeño, Elena; Casals, Pere

    2017-12-01

    Prescribed burning is used to reduce fuel hazard but underburning can damage standing trees. The effect of burning on needle terpene storage, a proxy for secondary metabolism, in fire-damaged pines is poorly understood despite the protection terpenes confer against biotic and abiotic stressors. We investigated variation in needle terpene storage after burning in three Mediterranean pine species featuring different adaptations to fire regimes. In two pure-stands of Pinus halepensis Mill. and two mixed-stands of Pinus sylvestris L. and Pinus nigra ssp. salzmanni (Dunal) Franco, we compared 24 h and 1 year post-burning concentrations with pre-burning concentrations in 20 trees per species, and evaluated the relative contribution of tree fire severity and physiological condition (δ13C and N concentration) on temporal terpene dynamics (for mono- sesqui- and diterpenes). Twenty-four hours post-burning, monoterpene concentrations were slightly higher in P. halepensis than at pre-burning, while values were similar in P. sylvestris. Differently, in the more fire-resistant P. nigra monoterpene concentrations were lower at 24 h, compared with pre-burning. One year post-burning, concentrations were always lower compared with pre- or 24 h post-burning, regardless of the terpene group. Mono- and sesquiterpene variations were negatively related to pre-burning δ13C, while diterpene variations were associated with fire-induced changes in needle δ13C and N concentration. At both post-burning times, mono- and diterpene concentrations increased significantly with crown scorch volume in all species. Differences in post-burning terpene contents as a function of the pine species' sensitivity to fire suggest that terpenic metabolites could have adaptive importance in fire-prone ecosystems in terms of flammability or defence against biotic agents post-burning. One year post-burning, our results suggest that in a context of fire-induced resource availability, pines likely prioritize primary rather than secondary metabolism. Overall, this study contributes to the assessment of the direct and indirect effects of fire on pine terpene storage, providing valuable information about their vulnerability to biotic and abiotic stressors throughout time. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    PubMed

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

    2017-09-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  13. Medication-related clinical decision support alert overrides in inpatients.

    PubMed

    Nanji, Karen C; Seger, Diane L; Slight, Sarah P; Amato, Mary G; Beeler, Patrick E; Her, Qoua L; Dalleur, Olivia; Eguale, Tewodros; Wong, Adrian; Silvers, Elizabeth R; Swerdloff, Michael; Hussain, Salman T; Maniam, Nivethietha; Fiskio, Julie M; Dykes, Patricia C; Bates, David W

    2018-05-01

    To define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers' reasons for overriding them and the appropriateness of those reasons. We conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons. Overall, 73.3% of patient allergy, drug-drug interaction, and duplicate drug alerts were overridden, though the rate of overrides varied by alert type (P < .0001). About 60% of overrides were appropriate, and that proportion also varied by alert type (P < .0001). Few overrides of renal- (2.2%) or age-based (26.4%) medication substitutions were appropriate, while most duplicate drug (98%), patient allergy (96.5%), and formulary substitution (82.5%) alerts were appropriate. Despite warnings of potential significant harm, certain categories of alert overrides were inappropriate >75% of the time. The vast majority of duplicate drug, patient allergy, and formulary substitution alerts were appropriate, suggesting that these categories of alerts might be good targets for refinement to reduce alert fatigue. Almost three-quarters of alerts were overridden, and 40% of the overrides were not appropriate. Future research should optimize alert types and frequencies to increase their clinical relevance, reducing alert fatigue so that important alerts are not inappropriately overridden.

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

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2017-01-01

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

  16. Physicians’ response to computerised alerts for psychotropic drugs in older persons: a multilevel analysis of the associated alert, patient and physician characteristics

    PubMed Central

    Tamblyn, Robyn; Reidel, Kristen; Patel, Vaishali

    2012-01-01

    Objective Computerised drug alerts are expected to reduce patients’ risk of adverse drug events. However, physicians over-ride most drug alerts, because they believe that the benefit exceeds the risk. The purpose of this study was to determine the drug alert, patient and physician characteristics associated with the: (1) occurrence of psychotropic drug alerts for elderly patients and the (2) response to these alerts by their primary care physicians. Setting Primary care, Quebec, Canada. Design Prospective cohort study. Participants Sixty-one physicians using an electronic prescribing and drug alert decision-support system in their practice, and 3413 elderly patients using psychotropic drugs. Primary and secondary measures Psychotropic drug class, alert severity, patient risk for fall injuries and physician experience, practice volume and computer use were evaluated in relationship to the likelihood of having: (1) a psychotropic drug alert, (2) the prescription revised in response to an alert. Cluster-adjusted alternating logistic regression was used to assess multilevel predictors of alert occurrence and response. Results In total 13 080 psychotropic drug alerts were generated in 8931 visits. Alerts were more likely to be generated for male patients at higher risk of fall-related injury and for physicians who established the highest alert threshold. In 9.9% of alerts seen, the prescription was revised. The highest revision rate was for antipsychotic alerts (22.6%). Physicians were more likely to revise prescriptions for severe alerts (OR 2.03; 95%CI 1.39 to 2.98), if patients had cognitive impairment (OR 1.95; 95%CI 1.13 to 3.36), and if they made more visits to their physician (OR 1.05 per 5 visits; 95%CI 1 to 1.09). Conclusions Physicians view and respond to a small proportion of alerts, mainly for higher-risk patients. To reduce the risk of psychotropic drug-related fall injuries, a new generation of evidence-based drug alerts should be developed. PMID:23024254

  17. Differential effects of phasic and tonic alerting on the efficiency of executive attention.

    PubMed

    Asanowicz, Dariusz; Marzecová, Anna

    2017-05-01

    The study examined how alerting and executive attention interact in a task involving conflict resolution. We proposed a tentative scenario in which an initial exogenous phasic alerting phase is followed by an endogenous tonic alerting phase, and hypothesized that these two processes may have distinct effects on conflict resolution. Phasic alerting was expected to increase the conflict, whereas tonic alerting was expected to decrease the conflict. Three experiments were conducted using different variants of the flanker task with visual alerting cues and varied cue-target intervals (SOA), to differentiate between effects of phasic alerting (short SOA) and tonic alerting (long SOA). The results showed that phasic alerting consistently decreased the efficiency of conflict resolution indexed by response time and accuracy, whereas tonic alerting increased the accuracy of conflict resolution, but at a cost in the speed of processing the conflict. The third experiment additionally showed that the effects of phasic alerting may be modulated by the psychophysical strength of alerting cues. Discussed are possible mechanisms that could account for the observed interactions between alerting and conflict resolution, as well as some discrepancies between the current and previous studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Influence of Shift Work on Manual Dexterity and Reaction Time in Tunisian Nurses.

    PubMed

    Merchaoui, Irtyah; Chaari, Neila; Bouhlel, Mohamed; Bouzgarrou, Lamia; Malchaire, Jacques; Akrout, Mohamed

    2017-01-01

    Major effects of shift schedule are related to sleep alertness and performance, but also to long term health outcomes. For nurses, these negative effects have consequences not only on the individual, but also on the workplace, as decreased alertness and reduced job performance could endanger human lives. The specific aim of our study is to assess the influence of shift schedule on nurses´ cognitive ability and rapidity of execution. Our survey is a cross sectional study which had been conducted for 15 months; it involved a sample of 293 participants representative of 1118 nurses working in two Tunisian university hospitals. It included an evaluation of the rapidity of execution performance through the manual dexterity test and the reaction time test. The study was completed by an assessment of the workability Index through a 7- item survey. No association was found between the groups of work schedules and the cognitive ability of execution speed. However, we found a significant decrease in cognitive performance in the nurses exceeding 10 years of job seniority for both schedules. We concluded to an impaired cognitive performance speed in the over 10-year seniority groups in both schedules. Recommendations should be focused on implementing periodic assessment of cognitive performance based on O'Connor finger dexterity test and time reaction test and on implementing effective preventive measures in hospitals after ten years of seniority at work. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

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

    PubMed

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

    2013-06-01

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

  20. An IDS Alerts Aggregation Algorithm Based on Rough Set Theory

    NASA Astrophysics Data System (ADS)

    Zhang, Ru; Guo, Tao; Liu, Jianyi

    2018-03-01

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

  1. Alertness and cognitive control: Toward a spatial grouping hypothesis.

    PubMed

    Schneider, Darryl W

    2018-05-01

    A puzzling interaction involving alertness and cognitive control is indicated by the finding of faster performance but larger congruency effects on alert trials (on which alerting cues are presented before the task stimuli) than on no-alert trials in selective attention tasks. In the present study, the author conducted four experiments to test hypotheses about the interaction. Manipulation of stimulus spacing revealed a difference in congruency effects between alert and no-alert trials for narrowly spaced stimuli but not for widely spaced stimuli, inconsistent with the hypothesis that increased alertness is associated with more diffuse attention. Manipulation of color grouping revealed similar differences in congruency effects between alert and no-alert trials for same-color and different-color groupings of targets and distractors, inconsistent with the general hypothesis that increased alertness is associated with more perceptual grouping. To explain the results, the author proposes that increased alertness is associated specifically with more spatial grouping of stimuli, possibly by modulating the threshold for parsing stimulus displays into distinct objects.

  2. Managing the Alert Process at NewYork-Presbyterian Hospital

    PubMed Central

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

    2005-01-01

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

  3. Technology and tuberculosis control: the OUT-TB Web experience.

    PubMed

    Guthrie, Jennifer L; Alexander, David C; Marchand-Austin, Alex; Lam, Karen; Whelan, Michael; Lee, Brenda; Furness, Colin; Rea, Elizabeth; Stuart, Rebecca; Lechner, Julia; Varia, Monali; McLean, Jennifer; Jamieson, Frances B

    2017-04-01

    Develop a tool to disseminate integrated laboratory, clinical, and demographic case data necessary for improved contact tracing and outbreak detection of tuberculosis (TB). In 2007, the Public Health Ontario Laboratories implemented a universal genotyping program to monitor the spread of TB strains within Ontario. Ontario Universal Typing of TB (OUT-TB) Web utilizes geographic information system (GIS) technology with a relational database platform, allowing TB control staff to visualize genotyping matches and microbiological data within the context of relevant epidemiological and demographic data. OUT-TB Web is currently available to the 8 health units responsible for >85% of Ontario's TB cases and is a valuable tool for TB case investigation. Users identified key features to implement for application enhancements, including an e-mail alert function, customizable heat maps for visualizing TB and drug-resistant cases, socioeconomic map layers, a dashboard providing TB surveillance metrics, and a feature for animating the geographic spread of strains over time. OUT-TB Web has proven to be an award-winning application and a useful tool. Developed and enhanced using regular user feedback, future versions will include additional data sources, enhanced map and line-list filter capabilities, and development of a mobile app. © 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

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

    PubMed

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

    2017-09-01

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

  5. Reducing online identity disclosure using warnings.

    PubMed

    Carpenter, Sandra; Zhu, Feng; Kolimi, Swapna

    2014-09-01

    In an experimental design, we tested whether written warnings can reduce the amount of identity information exposure online. A psychological attack on information privacy that has been shown to be effective in previous research was launched. This attack took advantage of the fact that people respond to certain types of requests in a relatively automatic, or mindless, fashion. The experiment manipulated the word that was used in the alert header: "warning", "caution", or "hazard". All warnings proved to be effective in reducing disclosure, but "hazard" proved to be most effective. Also warnings were more effective in reducing disclosure of driver's license numbers than email addresses. The discussion (a) provides tentative conclusions why these patterns were obtained, (b) suggests how to design warnings in cyber-environments, and (c) addresses future possibilities for research on this topic. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  6. Psychologist in a pocket: towards depression screening on mobile phones.

    PubMed

    Bitsch, Jó Ágila; Ramos, Roann; Ix, Tim; Ferrer-Cheng, Paula Glenda; Wehrle, Klaus

    2015-01-01

    Depression is the most prevalent clinical disorder and one of the main causes of disability. This makes early detection of depressive symptoms critical in its prevention and management. This paper presents and discusses the development of Psychologist in a Pocket (PiaP), a mental mHealth application for Android which screens and monitors for these symptoms, and-given the explicit permission of the user-alerts a trusted contact such as the mental health professional or a close friend, if it detects symptoms. All text inputted electronically-such as short message services, emails, social network posts-is analyzed based on keywords related to depression based on DSM-5 and ICD criteria as well as Beck's Cognitive Theory of Depression and the Self-Focus Model. Data evaluation and collection happen in the background, on-device, without requiring any user involvement. Currently, the application is in an early prototype phase entering initial clinical validation.

  7. From SARS to Avian Influenza Preparedness in Hong Kong.

    PubMed

    Wong, Andrew T Y; Chen, Hong; Liu, Shao-Haei; Hsu, Enoch K; Luk, Kristine S; Lai, Christopher K C; Chan, Regina F Y; Tsang, Owen T Y; Choi, K W; Kwan, Y W; Tong, Anna Y H; Cheng, Vincent C C; Tsang, Dominic N C

    2017-05-15

    The first human H5N1 case was diagnosed in Hong Kong in 1997. Since then, experience in effective preparedness strategies that target novel influenza viruses has expanded. Here, we report on avian influenza preparedness in public hospitals in Hong Kong to illustrate policies and practices associated with control of emerging infectious diseases. The Hong Kong government's risk-based preparedness plan for influenza pandemics includes 3 response levels for command, control, and coordination frameworks for territory-wide responses. The tiered levels of alert, serious, and emergency response enable early detection based on epidemiological exposure followed by initiation of a care bundle. Information technology, laboratory preparedness, clinical and public health management, and infection control preparedness provide a comprehensive and generalizable preparedness plan for emerging infectious diseases. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  8. Successful public-private partnerships: The NYPD shield model.

    PubMed

    Amadeo, Vincent; Iannone, Stephen

    2017-12-01

    This article will identify the challenges that post 9/11 law enforcement faces regarding privatepublic partnerships and describe in detail the NYPD Shield programme, created to combat those challenges. Recommendations made by the 911 Commission included the incorporation of the private sector into future homeland security strategies. One such strategy is NYPD Shield. This programme is a nationally recognized award-winning public-private partnership dedicated to providing counterterrorism training and information sharing with government agencies, non-government organizations, private businesses, and the community. Information is shared through several platforms that include a dedicated website, instruction of counterterrorism training curricula, e-mail alerts, intelligence assessments and the hosting of quarterly conferences. This article also details how the NYPD Shield is providing its successful template to other law enforcement agencies enabling them to initiate similar programmes in their respective jurisdictions, and in doing so joining a National Shield Network.

  9. First case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) in Hong Kong.

    PubMed

    Leung, Wai Shing; Chan, Man Chun; Chik, Shiu Hong; Tsang, Tak Yin

    2016-04-01

    Yellow fever is an important and potentially fatal infection in tropical regions of Africa, South America, eastern Panama in Central America and Trinidad in the Caribbean. Yellow fever vaccination is not only crucial to reduce the disease risk and mortality in individuals travelling to these areas, but also an important public health measure to prevent the spread of the disease. Despite generally considered as a safe vaccine, yellow fever vaccine can rarely be associated with severe adverse reactions including yellow fever vaccine-associated viscerotropic disease (YEL-AVD). Here, we report the first case of YEL-AVD in Hong Kong. Clinicians should alert to the possibility of YEL-AVD in vaccinees presenting with compatible symptoms after yellow fever vaccination, particularly in people at higher risk of adverse events. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  10. Prescription order risk factors for pediatric dosing alerts.

    PubMed

    Stultz, J S; Porter, K; Nahata, M C

    2015-02-01

    To determine dosing alert rates based on prescription order characteristics and identify prescription order risk factors for the occurrence of dosing alerts. A retrospective analysis of inpatient medication orders and dosing alerts occurring during October 2011 and January, April, and July 2012 at a pediatric institution. Prescription orders and alerts were categorized by: medication class, patient age, route of administration, and month of the year. There were 228,259 orders during the studied period, with 11,072 alerted orders (4.9%). The most frequently alerted medication class was the non-analgesic central nervous system agent class (14% of alerts). Age, route, medication class, and month all independently affected dosing alert rates. The alert rate was highest for immunosuppressive agents (54%), neonates (6.7%), and orders for rectal administration (9.5%). The alert rate was higher in adult patients receiving their care at a pediatric institution (5.7%) compared to children (4.7%), but after multivariate analysis, pediatric orders had higher odds for an alert (OR 1.1, 95% CI 1.05-1.16). Mercaptopurine had the highest alert rate when categorized by active ingredient (73.9%). Albuterol 2.5mg/mL continuous aerosol and heparin 1000 units in 0.9% sodium chloride injection solution were the unique medications with the highest alert rates (100.0% and 97.7%, respectively). Certain types of prescription orders have a higher risk for causing dosing alerts than others. Patient age, medication class, route of administration, and the month of year can affect dosing alert rates. Design and customization efforts should focus on these medications and prescription order characteristics that increase the risk for dosing alerts. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

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

    2017-11-01

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

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

    PubMed Central

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

    2011-01-01

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

  13. Provider management strategies of abnormal test result alerts: a cognitive task analysis.

    PubMed

    Hysong, Sylvia J; Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

    2010-01-01

    Electronic medical records (EMRs) facilitate abnormal test result communication through "alert" notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results.

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

    USGS Publications Warehouse

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

    2013-01-01

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

  15. Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation

    PubMed Central

    Russ, Alissa L; Zillich, Alan J; Melton, Brittany L; Russell, Scott A; Chen, Siying; Spina, Jeffrey R; Weiner, Michael; Johnson, Elizabette G; Daggy, Joanne K; McManus, M Sue; Hawsey, Jason M; Puleo, Anthony G; Doebbeling, Bradley N; Saleem, Jason J

    2014-01-01

    Objective To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors. Materials and methods We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug–allergy, drug–drug interaction, and drug–disease alerts based upon human factors principles. We assessed usability (learnability of redesign, efficiency, satisfaction, and usability errors), perceived workload, and prescribing errors. Results Although prescribers received no training on the design changes, prescribers were able to resolve redesigned alerts more efficiently (median (IQR): 56 (47) s) compared to the original alerts (85 (71) s; p=0.015). In addition, prescribers rated redesigned alerts significantly higher than original alerts across several dimensions of satisfaction. Redesigned alerts led to a modest but significant reduction in workload (p=0.042) and significantly reduced the number of prescribing errors per prescriber (median (range): 2 (1–5) compared to original alerts: 4 (1–7); p=0.024). Discussion Aspects of the redesigned alerts that likely contributed to better prescribing include design modifications that reduced usability-related errors, providing clinical data closer to the point of decision, and displaying alert text in a tabular format. Displaying alert text in a tabular format may help prescribers extract information quickly and thereby increase responsiveness to alerts. Conclusions This simulation study provides evidence that applying human factors design principles to medication alerts can improve usability and prescribing outcomes. PMID:24668841

  16. Applying human factors principles to alert design increases efficiency and reduces prescribing errors in a scenario-based simulation.

    PubMed

    Russ, Alissa L; Zillich, Alan J; Melton, Brittany L; Russell, Scott A; Chen, Siying; Spina, Jeffrey R; Weiner, Michael; Johnson, Elizabette G; Daggy, Joanne K; McManus, M Sue; Hawsey, Jason M; Puleo, Anthony G; Doebbeling, Bradley N; Saleem, Jason J

    2014-10-01

    To apply human factors engineering principles to improve alert interface design. We hypothesized that incorporating human factors principles into alerts would improve usability, reduce workload for prescribers, and reduce prescribing errors. We performed a scenario-based simulation study using a counterbalanced, crossover design with 20 Veterans Affairs prescribers to compare original versus redesigned alerts. We redesigned drug-allergy, drug-drug interaction, and drug-disease alerts based upon human factors principles. We assessed usability (learnability of redesign, efficiency, satisfaction, and usability errors), perceived workload, and prescribing errors. Although prescribers received no training on the design changes, prescribers were able to resolve redesigned alerts more efficiently (median (IQR): 56 (47) s) compared to the original alerts (85 (71) s; p=0.015). In addition, prescribers rated redesigned alerts significantly higher than original alerts across several dimensions of satisfaction. Redesigned alerts led to a modest but significant reduction in workload (p=0.042) and significantly reduced the number of prescribing errors per prescriber (median (range): 2 (1-5) compared to original alerts: 4 (1-7); p=0.024). Aspects of the redesigned alerts that likely contributed to better prescribing include design modifications that reduced usability-related errors, providing clinical data closer to the point of decision, and displaying alert text in a tabular format. Displaying alert text in a tabular format may help prescribers extract information quickly and thereby increase responsiveness to alerts. This simulation study provides evidence that applying human factors design principles to medication alerts can improve usability and prescribing outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Provider acceptance of an automated electronic alert for acute kidney injury

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2011-01-01

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

  19. Provider management strategies of abnormal test result alerts: a cognitive task analysis

    PubMed Central

    Sawhney, Mona K; Wilson, Lindsay; Sittig, Dean F; Espadas, Donna; Davis, Traber; Singh, Hardeep

    2010-01-01

    Objective Electronic medical records (EMRs) facilitate abnormal test result communication through “alert” notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. Design 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens. Results Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Conclusion Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results. PMID:20064805

  20. A Small Diameter Rosette for Sampling Ice Covered Waters

    NASA Astrophysics Data System (ADS)

    Chayes, D. N.; Smethie, W. M.; Perry, R. S.; Schlosser, P.; Friedrich, R.

    2011-12-01

    A gas tight, small diameter, lightweight rosette, supporting equipment and an effective operational protocol has been developed for aircraft supported sampling of sea water across the Lincoln Sea. The system incorporates a commercial off the shelf CTD electronics (SBE19+ sensor package and SBE33 deck unit) to provide real-time measurement data at the surface. We designed and developed modular water sample units and custom electronics to decode the bottle firing commands and close the sample bottles. For a typical station, we land a ski-equipped deHaviland Twin Otter (DHC-6) aircraft on a suitable piece of sea-ice, drill a 12" diameter hole through the ice next to the cargo door and set up a tent to provide a reasonable working environment over the hole. A small winch with 0.1" diameter single conductor cable is mounted in the aircraft by the cargo door and a tripod supports a sheave above the hole. The CTD module is connected to the end of the wire and the water sampling modules are stacked on top as the system is lowered. For most stations, three sample modules are used to provide 12 four (4) liter sample bottles. Data collected during the down-cast is used to formulate the sampling plan which is executed on the up-cast. The system is powered by a 3,700 Watt, 120VAC gasoline generator. After collection, the sample modules are stored in passively temperature stabilized ice chests during the flight back to the logistics facility at Alert where a broad range of samples are drawn and stored for future analysis. The transport mechanism has a good track record of maintaining water samples within about two degrees of the original collection temperature which minimizes out-gassing. The system has been successfully deployed during a field program each spring starting in 2004 along a transect between the north end of Ellesmere Island (Alert, Nunavut) and the North Pole. During the eight field programs we have taken 48 stations with twelve bottles at most stations (eight at some shallow stations) and with a miss-fire rate within two percent of those achieved with traditional over-the-side CTD/rosette systems.

  1. The effect of phasic auditory alerting on visual perception.

    PubMed

    Petersen, Anders; Petersen, Annemarie Hilkjær; Bundesen, Claus; Vangkilde, Signe; Habekost, Thomas

    2017-08-01

    Phasic alertness refers to a short-lived change in the preparatory state of the cognitive system following an alerting signal. In the present study, we examined the effect of phasic auditory alerting on distinct perceptual processes, unconfounded by motor components. We combined an alerting/no-alerting design with a pure accuracy-based single-letter recognition task. Computational modeling based on Bundesen's Theory of Visual Attention was used to examine the effect of phasic alertness on visual processing speed and threshold of conscious perception. Results show that phasic auditory alertness affects visual perception by increasing the visual processing speed and lowering the threshold of conscious perception (Experiment 1). By manipulating the intensity of the alerting cue, we further observed a positive relationship between alerting intensity and processing speed, which was not seen for the threshold of conscious perception (Experiment 2). This was replicated in a third experiment, in which pupil size was measured as a physiological marker of alertness. Results revealed that the increase in processing speed was accompanied by an increase in pupil size, substantiating the link between alertness and processing speed (Experiment 3). The implications of these results are discussed in relation to a newly developed mathematical model of the relationship between levels of alertness and the speed with which humans process visual information. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    PubMed

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

    2018-01-01

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

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

    PubMed

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

    2015-05-01

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

  4. Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy

    DTIC Science & Technology

    2012-03-01

    for the consumer at the mo- ment but will soon become a commoditized, basic requirement. For example, as the baby boomers grow older, mobile services...Commercial Mobile Alert Service (CMAS) Alerting Pipeline Taxonomy The WEA Project Team March 2012 SPECIAL REPORT CMU/SEI-2012-TR-019 CERT...report presents a taxonomy developed for the Commercial Mobile Alert Service (CMAS). The CMAS Alerting Pipeline Taxonomy is a hierarchical classification

  5. Wireless Emergency Alerts (WEA) Cybersecurity Risk Management Strategy for Alert Originators

    DTIC Science & Technology

    2014-03-01

    formerly known as the Commercial Mobile Alert Service ( CMAS ) RDT&E program, is a collaborative partnership that includes the cellular industry, the...Examples illustrate a STRIDE analysis of the generic mission 1 The CMAS Alerting Pipeline Taxonomy describes in detail a hierarchical classification...SEI-2013-SR-018 | 1 1 Introduction The Wireless Emergency Alerts (WEA) service, formerly known as the Commercial Mobile Alert Service ( CMAS ), is a

  6. A Novel Design for Drug-Drug Interaction Alerts Improves Prescribing Efficiency.

    PubMed

    Russ, Alissa L; Chen, Siying; Melton, Brittany L; Johnson, Elizabette G; Spina, Jeffrey R; Weiner, Michael; Zillich, Alan J

    2015-09-01

    Drug-drug interactions (DDIs) are common in clinical care and pose serious risks for patients. Electronic health records display DDI alerts that can influence prescribers, but the interface design of DDI alerts has largely been unstudied. In this study, the objective was to apply human factors engineering principles to alert design. It was hypothesized that redesigned DDI alerts would significantly improve prescribers' efficiency and reduce prescribing errors. In a counterbalanced, crossover study with prescribers, two DDI alert designs were evaluated. Department of Veterans Affairs (VA) prescribers were video recorded as they completed fictitious patient scenarios, which included DDI alerts of varying severity. Efficiency was measured from time-stamped recordings. Prescribing errors were evaluated against predefined criteria. Efficiency and prescribing errors were analyzed with the Wilcoxon signed-rank test. Other usability data were collected on the adequacy of alert content, prescribers' use of the DDI monograph, and alert navigation. Twenty prescribers completed patient scenarios for both designs. Prescribers resolved redesigned alerts in about half the time (redesign: 52 seconds versus original design: 97 seconds; p<.001). Prescribing errors were not significantly different between the two designs. Usability results indicate that DDI alerts might be enhanced by facilitating easier access to laboratory data and dosing information and by allowing prescribers to cancel either interacting medication directly from the alert. Results also suggest that neither design provided adequate information for decision making via the primary interface. Applying human factors principles to DDI alerts improved overall efficiency. Aspects of DDI alert design that could be further enhanced prior to implementation were also identified.

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

    PubMed

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

    2017-01-01

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

  8. 76 FR 80780 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

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

  9. Resin duct size and density as ecophysiological traits in fire scars of Pseudotsuga menziesii and Larix occidentalis.

    PubMed

    Arbellay, Estelle; Stoffel, Markus; Sutherland, Elaine K; Smith, Kevin T; Falk, Donald A

    2014-10-01

    Resin ducts (RDs) are features present in most conifer species as defence structures against pests and pathogens; however, little is known about RD expression in trees following fire injury. This study investigates changes in RD size and density in fire scars of Douglas fir (Pseudotsuga menziesii) and western larch (Larix occidentalis) as a means to evaluate the ecophysiological significance of traumatic resinosis for tree defence and survival. Transverse and tangential microsections were prepared for light microscopy and image analysis in order to analyse axial and radial RDs, respectively. Epithelial cells of RDs and fusiform rays associated with radial RDs were also examined. RDs were compared between normal xylem and wound xylem at four different section heights along the fire-injured stem. Following fire injury, P. menziesii axial RDs narrowed by 38-43 % in the first year after injury, and the magnitude of this change increased with stem height. Larix occidentalis axial RDs widened by 46-50 % in the second year after injury. Radial RDs were of equivalent size in P. menziesii, but widened by 162-214 % in L. occidentalis. Fusiform rays were larger following fire injury, by 4-14 % in P. menziesii and by 23-38 % in L. occidentalis. Furthermore, axial RD density increased in both species due to the formation of tangential rows of traumatic RDs, especially in the first and second years after injury. However, radial RD density did not change significantly. These results highlight traumatic resinosis as a species-specific response. Pseudotsuga menziesii produce RDs of equivalent or reduced size, whereas L. occidentalis produce wider RDs in both the axial and radial duct system, thereby increasing resin biosynthesis and accumulation within the whole tree. Larix occidentalis thus appears to allocate more energy to defence than P. menziesii. © The Author 2014. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Competitive outcomes between wood-decaying fungi are altered in burnt wood.

    PubMed

    Edman, Mattias; Eriksson, Anna-Maria

    2016-06-01

    Fire is an important disturbance agent in boreal forests where it creates a wide variety of charred and other types of heat-modified dead wood substrates, yet how these substrates affect fungal community structure and development within wood is poorly understood. We allowed six species of wood-decaying basidiomycetes to compete in pairs in wood-discs that were experimentally burnt before fungal inoculation. The outcomes of interactions in burnt wood differed from those in unburnt control wood for two species:Antrodia sinuosanever lost on burnt wood and won over its competitor in 67% of the trials compared to 40% losses and 20% wins on unburnt wood. In contrast, Ischnoderma benzoinumwon all interactions on unburnt wood compared to 33% on burnt wood. However, the responses differed depending on the identity of the competing species, suggesting an interaction between competitor and substrate type. The observed shift in competitive balance between fungal species probably results from chemical changes in burnt wood, but the underlying mechanism needs further investigation. Nevertheless, the results indicate that forest fires indirectly structure fungal communities by modifying dead wood, and highlight the importance of fire-affected dead wood substrates in boreal forests. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. NOAA Weather Wire Service

    Science.gov Websites

    & Imagery; includes NWS alerts and warnings No 6 Wireless Emergency Alerts (WEA) Mobile Phone Alerts & Warnings only No 7 Interactive NWS (iNWS) - NOTE 1 https://inws.ncep.noaa.gov/ Mobile Phone $$$$) Internet/ Mobile Phone Alerts and Warnings No 15 County or Local Emergency Management Telephone alert

  12. 75 FR 26196 - Publication of OIG Updated Special Fraud Alert on Telemarketing by Durable Medical Equipment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... Special Fraud Alert on Telemarketing by Durable Medical Equipment Suppliers AGENCY: Office of Inspector... Special Fraud Alert. Specifically, the Updated Special Fraud Alert addressed the statutory provision...) 205-0007. SUPPLEMENTARY INFORMATION: In our publication of the OIG Updated Special Fraud Alert on...

  13. Physician Perspectives of CYP2C19 and Clopidogrel Drug-Gene Interaction Active Clinical Decision Support Alerts

    PubMed Central

    Nishimura, Adam A.; Shirts, Brian H.; Salama, Joseph; Smith, Joe W.; Devine, Beth; Tarczy-Hornoch, Peter

    2015-01-01

    Objective To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness. Materials and Methods 52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction. Results Only 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts. Principal Conclusions Pharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways. PMID:26642939

  14. Physician perspectives of CYP2C19 and clopidogrel drug-gene interaction active clinical decision support alerts.

    PubMed

    Nishimura, Adam A; Shirts, Brian H; Salama, Joseph; Smith, Joe W; Devine, Beth; Tarczy-Hornoch, Peter

    2016-02-01

    To determine if physicians find clinical decision support alerts for pharmacogenomic drug-gene interactions useful and assess their perceptions of usability aspects that impact usefulness. 52 physicians participated in an online simulation and questionnaire involving a prototype alert for the clopidogrel and CYP2C19 drug-gene interaction. Only 4% of participants stated they would override the alert. 92% agreed that the alerts were useful. 87% found the visual interface appropriate, 91% felt the timing of the alert was appropriate and 75% were unfamiliar with the specific drug-gene interaction. 80% of providers preferred the ability to order the recommended medication within the alert. Qualitative responses suggested that supplementary information is important, but should be provided as external links, and that the utility of pharmacogenomic alerts depends on the broader ecosystem of alerts. Pharmacogenomic alerts would be welcomed by many physicians, can be built with minimalist design principles, and are appropriately placed at the end of the prescribing process. Since many physicians lack familiarity with pharmacogenomics but have limited time, information and educational resources within the alert should be carefully selected and presented in concise ways. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Contributors to Frequent Telehealth Alerts Including False Alerts for Patients with Heart Failure: A Mixed Methods Exploration

    PubMed Central

    Radhakrishna, K.; Bowles, K.; Zettek-Sumner, A.

    2013-01-01

    Summary Background Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients. Objective To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency. Materials and Methods A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses’ notes on follow-up actions to patients’ telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency. Results Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (p<0.05) of renal disorders, anxiety, and cardiac arrhythmias emerged as predictors of telehealth alerts through quantitative analysis (n = 168) using multiple regression. Inappropriate telehealth measurement technique by patients (54%) and home healthcare system inefficiencies (37%) contributed to most telehealth false alerts in the purposive qualitative sub-sample (n = 35) of patients with high telehealth alerts. Conclusion Encouraging patient engagement with the telehealth process, fostering a collaborative approach among all the clinicians involved with the telehealth intervention, tailoring telehealth alert thresholds to patient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management. PMID:24454576

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

    PubMed Central

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

    2018-01-01

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

  17. Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

    PubMed

    Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S

    2017-11-01

    Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

  18. Pilot evaluation of a method to assess prescribers' information processing of medication alerts.

    PubMed

    Russ, Alissa L; Melton, Brittany L; Daggy, Joanne K; Saleem, Jason J

    2017-02-01

    Prescribers commonly receive alerts during medication ordering. Prescribers work in a complex, time-pressured environment; to enhance the effectiveness of safety alerts, the effort needed to cognitively process these alerts should be minimized. Methods to evaluate the extent to which computerized alerts support prescribers' information processing are lacking. To develop a methodological protocol to assess the extent to which alerts support prescribers' information processing at-a-glance; specifically, the incorporation of information into their working memory. We hypothesized that the method would be feasible and that we would be able to detect a significant difference in prescribers' information processing with a revised alert display that incorporates warning design guidelines compared to the original alert display. A counterbalanced, within-subject study was conducted with 20 prescribers in a human-computer interaction laboratory. We tested a single alert that was displayed in two different ways. Prescribers were informed that an alert would appear for 10s. After the alert was shown, a white screen was displayed, and prescribers were asked to verbally describe what they saw; indicate how many total warnings; and describe anything else they remembered about the alert. We measured information processing via the accuracy of prescribers' free recall and their ability to identify that three warning messages were present. Two analysts independently evaluated participants' responses against a comprehensive catalog of alert elements and then discussed discrepancies until reaching consensus. This feasibility study demonstrated that the method seemed to be effective for evaluating prescribers' information processing of medication alert displays. With this method, we were able to detect significant differences in prescribers' recall of alert information. The proportion of total data elements that prescribers were able to accurately recall was significantly greater for the revised versus original alert display (p=0.006). With the revised display, more prescribers accurately reported that three warnings were shown (p=0.002). The methodological protocol was feasible for evaluating the alert display and yielded important findings on prescribers' information processing. Study methods supplement traditional usability evaluation methods and may be useful for evaluating information processing of other healthcare technologies. Published by Elsevier Inc.

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

    NASA Technical Reports Server (NTRS)

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

    2016-01-01

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

  20. An Evaluation of the British Columbia Asthma Monitoring System (BCAMS) and PM2.5 Exposure Metrics during the 2014 Forest Fire Season

    PubMed Central

    McLean, Kathleen E.; Yao, Jiayun; Henderson, Sarah B.

    2015-01-01

    The British Columbia Asthma Monitoring System (BCAMS) tracks forest fire smoke exposure and asthma-related health outcomes, identifying excursions beyond expected daily counts. Weekly reports during the wildfire season support public health and emergency management decision-making. We evaluated BCAMS by identifying excursions for asthma-related physician visits and dispensations of the reliever medication salbutamol sulfate and examining their corresponding smoke exposures. A disease outbreak detection algorithm identified excursions from 1 July to 31 August 2014. Measured, modeled, and forecasted concentrations of fine particulate matter (PM2.5) were used to assess exposure. We assigned PM2.5 levels to excursions by choosing the highest value within a seven day window centred on the excursion day. Smoky days were defined as those with PM2.5 levels ≥ 25 µg/m3. Most excursions (57%–71%) were assigned measured or modeled PM2.5 concentrations of 10 µg/m3 or higher. Of the smoky days, 55.8% and 69.8% were associated with at least one excursion for physician visits and salbutamol dispensations, respectively. BCAMS alerted most often when measures of smoke exposure were relatively high. Better performance might be realized by combining asthma-related outcome metrics in a bivariate model. PMID:26075727

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

    PubMed

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

    2017-09-01

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

  2. Operational experience of continuous air monitoring of smoke for ²³⁹Pu during a wildfire.

    PubMed

    Whicker, Jeffrey J; Baltz, David; Eisele, William F; Hart, Orval F; McNaughton, Michael W; Green, Andrew A

    2012-08-01

    Smoke from a wildfire in northern New Mexico that moved along the border of the Los Alamos National Laboratory (LANL) was monitored for ²³⁹Pu in the event that the fire might cross into LANL property containing locations with low, but greater than background, levels of ²³⁹Pu and other alpha-emitting radionuclides. Three Environmental Continuous Air Monitors (ECAMs) in operation at LANL at the time of the fire provided near real-time measurements of the ²³⁹Pu in the smoke. Sampling data from routine measurements of PM-10 and PM-2.5 concentrations in the city of Los Alamos showed that smoke in the air rose during the fire to several hundred μg m⁻³, which produced limited visibility (several hundred meters) and resulted in poor air quality alerts for about a week-long period. Previous studies have shown that airborne dust can significantly impair continuous air monitors, so the purpose of this study was to assess the performance of the ECAMs under smoky conditions, which is important for many emergency response scenarios. Additionally, ECAMs are not required to be tested in smoke by ANSI standards, so there is little to no published data on performance of any ECAM while sampling smoke. Results show that the deployed ECAMs had reduced flow as the filter clogged with fine particles, but the goodness-of-fit parameter of the peak shape fitting algorithms and the minimum detectable concentration and dose were not impacted until the flow was reduced by more than about 20%, and even then they were within tolerable limits. Overall, ECAM performance was not impacted during the fire even under heavy smoke conditions and fluctuating radon levels, though changing the filters to limit any reductions in flow to less than 20% would maintain optimal ECAM performance.

  3. Onboard Science and Applications Algorithm for Hyperspectral Data Reduction

    NASA Technical Reports Server (NTRS)

    Chien, Steve A.; Davies, Ashley G.; Silverman, Dorothy; Mandl, Daniel

    2012-01-01

    An onboard processing mission concept is under development for a possible Direct Broadcast capability for the HyspIRI mission, a Hyperspectral remote sensing mission under consideration for launch in the next decade. The concept would intelligently spectrally and spatially subsample the data as well as generate science products onboard to enable return of key rapid response science and applications information despite limited downlink bandwidth. This rapid data delivery concept focuses on wildfires and volcanoes as primary applications, but also has applications to vegetation, coastal flooding, dust, and snow/ice applications. Operationally, the HyspIRI team would define a set of spatial regions of interest where specific algorithms would be executed. For example, known coastal areas would have certain products or bands downlinked, ocean areas might have other bands downlinked, and during fire seasons other areas would be processed for active fire detections. Ground operations would automatically generate the mission plans specifying the highest priority tasks executable within onboard computation, setup, and data downlink constraints. The spectral bands of the TIR (thermal infrared) instrument can accurately detect the thermal signature of fires and send down alerts, as well as the thermal and VSWIR (visible to short-wave infrared) data corresponding to the active fires. Active volcanism also produces a distinctive thermal signature that can be detected onboard to enable spatial subsampling. Onboard algorithms and ground-based algorithms suitable for onboard deployment are mature. On HyspIRI, the algorithm would perform a table-driven temperature inversion from several spectral TIR bands, and then trigger downlink of the entire spectrum for each of the hot pixels identified. Ocean and coastal applications include sea surface temperature (using a small spectral subset of TIR data, but requiring considerable ancillary data), and ocean color applications to track biological activity such as harmful algal blooms. Measuring surface water extent to track flooding is another rapid response product leveraging VSWIR spectral information.

  4. Effect of Green Tea Phytochemicals on Mood and Cognition.

    PubMed

    Dietz, Christina; Dekker, Matthijs

    2017-01-01

    Green tea is traditionally known to induce mental clarity, cognitive function, physical activation and relaxation. Recently, a special green tea, matcha tea, is rapidly gaining popularity throughout the world and is frequently referred to as a mood- and brain food. Matcha tea consumption leads to much higher intake of green tea phytochemicals compared to regular green tea. Previous research on tea constituents caffeine, L-theanine, and epigallocatechin gallate (EGCG) repeatedly demonstrated benefits on mood and cognitive performance. These effects were observed when these phytochemicals were consumed separately and in combination. A review was conducted on 49 human intervention studies to summarize the research on acute psychoactive effects of caffeine, L-theanine, and EGCG on different dimensions of mood and cognitive performance. Caffeine was found to mainly improve performance on demanding long-duration cognitive tasks and self-reported alertness, arousal, and vigor. Significant effects already occurred at low doses of 40 mg. L-theanine alone improved self-reported relaxation, tension, and calmness starting at 200 mg. L-theanine and caffeine combined were found to particularly improve performance in attention-switching tasks and alertness, but to a lesser extent than caffeine alone. No conclusive evidence relating to effects induced by EGCG could be given since the amount of intervention studies was limited. These studies provided reliable evidence showing that L-theanine and caffeine have clear beneficial effects on sustained attention, memory, and suppression of distraction. Moreover, L-theanine was found to lead to relaxation by reducing caffeine induced arousal. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Using crowd sourcing to combat potentially illegal or dangerous UAV operations

    NASA Astrophysics Data System (ADS)

    Tapsall, Brooke T.

    2016-10-01

    The UAV (Unmanned Aerial Vehicles) industry is growing exponentially at a pace that policy makers, individual countries and law enforcement agencies are finding difficult to keep up. The UAV market is large, as such the amount of UAVs being operated in potentially dangerous situations is prevalent and rapidly increasing. Media is continually reporting `near-miss' incidents between UAVs and commercial aircraft, UAV breaching security in sensitive areas or invading public privacy. One major challenge for law enforcement agencies is gaining tangible evidence against potentially dangerous or illegal UAV operators due to the rapidity with which UAV operators are able to enter, fly and exit a scene before authorities can arrive or before they can be located. DroneALERT, an application available via the Airport-UAV.com website, allows users to capture potentially dangerous or illegal UAV activity using their mobile device as it the incident is occurring. A short online DroneALERT Incident Report (DIR) is produced, emailed to the user and the Airport-UAV.com custodians. The DIR can be used to aid authorities in their investigations. The DIR contains details such as images and videos, location, time, date of the incident, drone model, its distance and height. By analysing information from the DIR, photos or video, there is a high potential for law enforcement authorities to use this evidence to identify the type of UAV used, triangulate the location of the potential dangerous UAV and operator, create a timeline of events, potential areas of operator exit and to determine the legalities breached. All provides crucial evidence for identifying and prosecuting a UAV operator.

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

    PubMed Central

    2017-01-01

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

  7. The ICT monitoring system of the ASTRI SST-2M prototype proposed for the Cherenkov Telescope Array

    NASA Astrophysics Data System (ADS)

    Gianotti, F.; Bruno, P.; Tacchini, A.; Conforti, V.; Fioretti, V.; Tanci, C.; Grillo, A.; Leto, G.; Malaguti, G.; Trifoglio, M.

    2016-08-01

    In the framework of the international Cherenkov Telescope Array (CTA) observatory, the Italian National Institute for Astrophysics (INAF) has developed a dual mirror, small sized, telescope prototype (ASTRI SST-2M), installed in Italy at the INAF observing station located at Serra La Nave, Mt. Etna. The ASTRI SST-2M prototype is the basis of the ASTRI telescopes that will form the mini-array proposed to be installed at the CTA southern site during its preproduction phase. This contribution presents the solutions implemented to realize the monitoring system for the Information and Communication Technology (ICT) infrastructure of the ASTRI SST-2M prototype. The ASTRI ICT monitoring system has been implemented by integrating traditional tools used in computer centers, with specific custom tools which interface via Open Platform Communication Unified Architecture (OPC UA) to the Alma Common Software (ACS) that is used to operate the ASTRI SST-2M prototype. The traditional monitoring tools are based on Simple Network Management Protocol (SNMP) and commercial solutions and features embedded in the devices themselves. They generate alerts by email and SMS. The specific custom tools convert the SNMP protocol into the OPC UA protocol and implement an OPC UA server. The server interacts with an OPC UA client implemented in an ACS component that, through the ACS Notification Channel, sends monitor data and alerts to the central console of the ASTRI SST-2M prototype. The same approach has been proposed also for the monitoring of the CTA onsite ICT infrastructures.

  8. Complex monitoring and alert network for electromagnetic, infrasound, acoustic seismotectonic phenomena

    NASA Astrophysics Data System (ADS)

    -Emilian Toader, Victorin; Moldovan, Iren-Adelina; Constantin, Ionescu

    2014-05-01

    The Romanian seismicity recorded in 2013 three important events: the largest seismic "silence", the shortest sequence of two earthquakes greater than 4.8R in less than 14 days after the "Romanian National Institute for Earth Physics" (NIEP) developed a digital network, and a very high crustal activity in Galati area. We analyze the variations of the telluric currents and local magnetic field, variations of the atmospheric electrostatic field, infrasound, temperature, humidity, wind speed and direction, atmospheric pressure, variations in the earth crust with inclinometers and animal behavior. The general effect is the first high seismic energy discontinuity that could be a precursor factor. Since 1977 Romania did not register any important earthquake that would generate a sense of fear among the population. In parallel with the seismic network NIEP developed a magneto-telluric, bioseismic, VLF and acoustic network. A large frequency spectrum is covered for mechanical vibration, magnetic and electric field with ground and air sensors. Special software was designed for acquisition, analysis and real time alert using internet direct connection, web page, email and SMS. Many examples show the sensitivity of telluric current, infrasound, acoustic records (from air-ground), and the effect of tectonic stress on the magnetic field or ground deformation. The next update of the multidisciplinary monitoring network will include measurement of ionization, radon emission, sky color, solar radiation and extension of infrasound and VL/LF equipment. NOAA Space Weather satellites transmit solar activity magnetic field data, X ray flux, electron, and proton flux information useful for complex analysis.

  9. ISKANDARnet IOMOS: Near real-time equatorial space weather monitoring and alert system in Peninsular Malaysia

    NASA Astrophysics Data System (ADS)

    Musa, Tajul Ariffin; Leong, Shien Kwun; Abdullah, Khairul Anuar; Othman, Rusli

    2012-11-01

    This work proposes ISKANDARnet Ionospheric Outburst MOnitoring and alert System (IOMOS), along with Ionospheric Outburst Index (IOX) to develop an operational near real-time space weather service for Malaysia. The IOMOS is based on Global Positioning System (GPS) Network-based Real-Time Kinematic (NRTK) concept which is by nature for atmospheric (ionosphere and troposphere) modeling within the network coverage. The elegance of this solution lies in the fact that IOMOS utilize differential ionospheric residual from network of GPS baselines which incur no additional cost for operation. Users will be informed about the ionospheric perturbation through Short Message Service (SMS), email or Twitter®. This approach will ultimately beneficial for the navigation and satellite positioning communities, particularly during the coming Solar Cycle 24. In addition, a combination of local and global GPS network has been employed to study the equatorial ionosphere geomorphology and climatology in the Malaysian sector. Equatorial Total Electron Content (TEC) over Malaysia shows semi-annual, annual, and seasonal variations with maximum values appearing during equinoctial months and minimum during solstices months. The TEC value during vernal equinox is about 21% higher than autumnal equinox, and December solstice exceeds that at the June solstice by around 14%. It is also found that semi-annual variation is present at all levels of solar activity, whereas June solstice predominates December solstice during high solar activity for annual and seasonal variations. In near future, a near real-time TEC derivation system will be developed to support equatorial ionosphere modeling to enhance space weather service for Malaysia.

  10. Market study: Tactile paging system

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A market survey was conducted regarding the commercialization potential and key market factors relevant to a tactile paging system for deaf-blind people. The purpose of the tactile paging system is to communicate to the deaf-blind people in an institutional environment. The system consists of a main console and individual satellite wrist units. The console emits three signals by telemetry to the wrist com (receiving unit) which will measure approximately 2 x 4 x 3/4 inches and will be fastened to the wrist by a strap. The three vibration signals are fire alarm, time period indication, and a third signal which will alert the wearer of the wrist com to the fact that the pin on the top of the wrist is emitting a morse coded message. The Morse code message can be felt and recognized with the finger.

  11. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  12. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  13. 16 CFR 613.1 - Duration of active duty alerts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Duration of active duty alerts. 613.1 Section 613.1 Commercial Practices FEDERAL TRADE COMMISSION THE FAIR CREDIT REPORTING ACT DURATION OF ACTIVE DUTY ALERTS § 613.1 Duration of active duty alerts. The duration of an active duty alert shall be...

  14. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed Central

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

    1996-01-01

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

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

    PubMed

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

    2011-01-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2012-08-27

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

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

    PubMed Central

    2012-01-01

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

  20. Alert status of nuclear weapons

    NASA Astrophysics Data System (ADS)

    Kristensen, Hans M.

    2017-11-01

    Nuclear Alert Forces. Four nuclear-armed states deploy nuclear warheads on alert, ready to be used on relatively short notice: United States, Russia, France and Britain. Combined, the four countries deploy an estimated 1,869 nuclear alert warheads. Russia and the United States deploy 1,749 alert warheads combined, or 94% of all alert warheads. Despite some debate about possible need to increase readiness of nuclear forces (China, Pakistan), the five other nuclear-armed states (China, Pakistan, India, Israel and North Korea) are thought to store their warheads separate from launchers under normal circumstances. The overall number of alert warheads has remained relatively stable during the past five years.

  1. Geo-targeted Weather Alerts Coming to Millions of Mobile Devices

    NASA Astrophysics Data System (ADS)

    Gerber, M.

    2011-12-01

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

  2. Regulatory alerts for dietary supplements in Canada and the United States, 2005-13.

    PubMed

    Abe, Andrew M; Hein, Darren J; Gregory, Philip J

    2015-06-01

    Dietary supplement regulatory alerts published by the Food and Drug Administration (FDA) and Health Canada were evaluated and characterized. FDA MedWatch and Health Canada websites were reviewed to identify regulatory alerts regarding dietary supplements from January 1, 2005, through December 31, 2013. Alerts were analyzed to identify product characteristics that may be predictive of product quality issues and potential patient harm. A total of 1560 dietary supplement-related regulatory alerts were identified. Of those, 1287 (83%) were identified through Health Canada, and 273 (18%) were identified through FDA MedWatch. The country of origin of dietary supplements associated with regulatory alerts was not provided in most regulatory alerts; however, when their origin was provided, the United States was the most common. Dietary supplements intended for sexual enhancement were the subject of 33% of all regulatory alerts identified. Products purchased online were the most likely to be associated with a regulatory alert. Dietary supplements intended for sexual enhancement, weight loss, and bodybuilding or athletic performance appeared to pose the greatest risk for patient harm due to product contamination with a pharmaceutical such as a phosphodiesterase-5 inhibitor or sibutramine. Analysis of Canadian and U.S. regulatory alerts concerning dietary supplements revealed that more than 80% of the composite alerts were issued by Health Canada. The most common intended uses of supplements for which alerts were issued were sexual enhancement, weight loss, and bodybuilding or athletic performance. The most common reason for alerts was the presence of a pharmaceutical contaminant. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. See Also:Mechanics of Cohesive-frictional MaterialsCopyright © 2004 John Wiley & Sons, Ltd.Get Sample Copy

  4. Recommend to Your Librarian
  5. E-MailPrint
  1. How Regrouping Alerts in Computerized Physician Order Entry Layout Influences Physicians' Prescription Behavior: Results of a Crossover Randomized Trial.

    PubMed

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

    2016-06-02

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

  2. The Medical Duty Officer: An Attempt to Mitigate the Ambulance At-Hospital Interval

    PubMed Central

    Halliday, Megan H.; Bouland, Andrew J.; Lawner, Benjamin J.; Comer, Angela C.; Ramos, Daniel C.; Fletcher, Mark

    2016-01-01

    Introduction A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time. Methods The MDO was implemented on November 11, 2013. A senior EMS paramedic was assigned to the position and was placed in the fire communication bureau from 9 a.m. to 9 p.m., seven days a week. We defined the pre-intervention period as August 2013 – October 2013 and the post-intervention period as December 2013 – February 2014. We also compared the post-intervention period to the “seasonal match control” one year earlier to adjust for seasonal variation in EMS volume. The MDO was tasked with the prospective management of city EMS resources through intensive monitoring of unit availability and hospital ED traffic. The MDO could suggest alternative transport destinations in the event of ED crowding. We collected and analyzed data from BCFD computer-aided dispatch (CAD) system for the following: ambulance response times, ambulance at-hospital interval, hospital diversion and alert status, and “suppression wait time” (defined as the total time suppression units remained on scene until ambulance arrival). The data analysis used a pre/post intervention design to examine the MDO impact on the BCFD EMS system. Results There were a total of 15,567 EMS calls during the pre-intervention period, 13,921 in the post-intervention period and 14,699 in the seasonal match control period one year earlier. The average at-hospital time decreased by 1.35 minutes from pre- to post-intervention periods and 4.53 minutes from the pre- to seasonal match control, representing a statistically significant decrease in this interval. There was also a statistically significant decrease in hospital alert time (approximately 1,700 hour decrease pre- to post-intervention periods) and suppression wait time (less than one minute decrease from pre- to post- and pre- to seasonal match control periods). The decrease in ambulance response time was not statistically significant. Conclusion Proactive deployment of a designated MDO was associated with a small, contemporaneous reduction in at-hospital time within an urban EMS jurisdiction. This project emphasized the importance of better communication between EMS systems and area hospitals as well as uniform reporting of variables for future iterations of this and similar projects. PMID:27625737

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

    NASA Technical Reports Server (NTRS)

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

    1997-01-01

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

  4. Validation of a personal fluid loss monitor.

    PubMed

    Wickwire, J; Bishop, P A; Green, J M; Richardson, M T; Lomax, R G; Casaru, C; Jones, E; Curtner-Smith, M

    2008-02-01

    Dehydration raises heat injury risk and reduces performance [ , , ]. The purpose was to validate the Hydra-Alert Jr (Acumen). The Hydra-Alert was tested in two exercise/clothing conditions. Participants wore it while wearing exercise clothing and exercising at a self-selected intensity (n = 8). Others wore the Hydra-Alert while wearing a ballistic-vest and performing an industrial-protocol (n = 8). For each condition, the Hydra-Alert was tested on two occasions (T1 and T2). The Hydra-Alert was tested against nude weight loss for both conditions. The Hydra-Alert had low test-retest reliability for both conditions (average absolute value of the error between Hydra-Alert outputs of T1 and T2 = 0.08 +/- 0.08 percentage points). With exercise-clothing, the Hydra-Alert evidenced low-moderate correlations between percent nude weight loss and Hydra-Alert output at 20 min (r = 0.59-T1, p = 0.13; r = 0.12-T2, p = 0.78), at 40 min (r = 0.93-T1, p = 0.001; r = 0.63-T2, p = 0.10), and at approximately 2 % weight loss (r = 0.21-T1 and T2, p = 0.61 and 0.62, respectively). The correlation at 40 min during T1 fell during T2 suggesting the Hydra-Alert was inconsistent. When wearing a ballistic-vest, the Hydra-Alert had poor validity (T1: r = - 0.29 [p = 0.48] for weight loss vs. monitor; T2: r = 0.11 [p = 0.80]). At the higher levels of dehydration ( approximately 2 %), the Hydra-Alert error was so high as to render its readings of little value. In some cases, the Hydra-Alert could lead to a false level of security if dehydrated. Therefore, the Hydra-Alert is of little use for those who want to measure their fluid loss while exercising in the heat.

  5. Real-time data acquisition and alerts may reduce reaction time and improve perfusionist performance during cardiopulmonary bypass.

    PubMed

    Beck, J R; Fung, K; Lopez, H; Mongero, L B; Argenziano, M

    2015-01-01

    Delayed perfusionist identification and reaction to abnormal clinical situations has been reported to contribute to increased mortality and morbidity. The use of automated data acquisition and compliance safety alerts has been widely accepted in many industries and its use may improve operator performance. A study was conducted to evaluate the reaction time of perfusionists with and without the use of compliance alert. A compliance alert is a computer-generated pop-up banner on a pump-mounted computer screen to notify the user of clinical parameters outside of a predetermined range. A proctor monitored and recorded the time from an alert until the perfusionist recognized the parameter was outside the desired range. Group one included 10 cases utilizing compliance alerts. Group 2 included 10 cases with the primary perfusionist blinded to the compliance alerts. In Group 1, 97 compliance alerts were identified and, in group two, 86 alerts were identified. The average reaction time in the group using compliance alerts was 3.6 seconds. The average reaction time in the group not using the alerts was nearly ten times longer than the group using computer-assisted, real-time data feedback. Some believe that real-time computer data acquisition and feedback improves perfusionist performance and may allow clinicians to identify and rectify potentially dangerous situations. © The Author(s) 2014.

  6. Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital

    PubMed Central

    Engels, Melanie J.

    2015-01-01

    Background: High-alert medications pose a greater risk of causing significant harm to patients if used in error. The Joint Commission requires that hospitals define institution-specific high-alert medications and implement processes to ensure safe medication use. Method: Nursing, pharmacy, and prescribers were asked to voluntarily complete a 34-question survey to assess their knowledge, experience, and perceptions regarding high-alert medications in an academic hospital. Results: The majority of respondents identified the organization’s high-alert medications, the consequences of an error involving a high-alert medication, and the reversal agent. Most of the risk-reduction strategies within the institution were viewed as being effective by respondents. Forty-five percent of the respondents utilized a high-alert medication in the previous 24 hours. Only 14.2% had experienced an error with a high-alert medication in the previous 12 months, with 46% being near misses. The survey found the 5 rights for medication administration were not being utilized consistently. Respondents indicated that work experience or hospital orientation is the preferred learning experience for high-alert medications. Conclusions: This study assessed all disciplines involved in the medication use process. Perceptions about high-alert medications differ between disciplines. Ongoing discipline-specific education is required to ensure that individuals accept accountability in the medication use process and to close knowledge gaps on high-alert medications and risk-reduction strategies. PMID:26446747

  7. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  8. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  9. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  10. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  11. 47 CFR 10.310 - Federal alert gateway. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  12. AmberAlert / DPS / DHSEM / AAB

    Science.gov Websites

    cooperative public service alert to aid in the safe recovery of abducted children. The Alaska AMBER Alert children to aid in their safe return. AMBER Alert Hotline: 866-AKAMBER - (866-252-6237) State of Alaska

  13. Analysis of Alerting System Failures in Commercial Aviation Accidents

    NASA Technical Reports Server (NTRS)

    Mumaw, Randall J.

    2017-01-01

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

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

    PubMed

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

    2010-01-01

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

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

    PubMed Central

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

    2001-01-01

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

  16. Alerts Visualization and Clustering in Network-based Intrusion Detection

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

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

    2010-04-01

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

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

    PubMed

    Krall, M A; Sittig, D F

    2001-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  19. Determining Inappropriate Medication Alerts from "Inaccurate Warning" Overrides in the Intensive Care Unit.

    PubMed

    Rehr, Christine A; Wong, Adrian; Seger, Diane L; Bates, David W

    2018-04-01

     This article aims to understand provider behavior around the use of the override reason "Inaccurate warning," specifically whether it is an effective way of identifying unhelpful medication alerts.  We analyzed alert overrides that occurred in the intensive care units (ICUs) of a major academic medical center between June and November 2016, focused on the following high-significance alert types: dose, drug-allergy alerts, and drug-drug interactions (DDI). Override appropriateness was analyzed by two independent reviewers using predetermined criteria.  A total of 268 of 26,501 ICU overrides (1.0%) used the reason "Inaccurate warning," with 93 of these overrides associated with our included alert types. Sixty-one of these overrides (66%) were identified to be appropriate. Twenty-one of 30 (70%) dose alert overrides were appropriate. Forty of 48 drug-allergy alert overrides (83%) were appropriate, for reasons ranging from prior tolerance ( n  = 30) to inaccurate ingredient matches ( n  = 5). None of the 15 DDI overrides were appropriate.  The "Inaccurate warning" reason was selectively used by a small proportion of providers and overrides using this reason identified important opportunities to reduce excess alerts. Potential opportunities include improved evaluation of dosing mechanisms based on patient characteristics, inclusion of institutional dosing protocols to alert logic, and evaluation of a patient's prior tolerance to a medication that they have a documented allergy for. This resource is not yet routinely used for alert tailoring at our institution but may prove to be a valuable resource to evaluate available alerts. Schattauer GmbH Stuttgart.

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

    PubMed

    Wasser, Tobias D; Fox, Patrick K

    2013-01-01

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

  1. Evaluation of Helmet Mounted Display Alerting Symbology

    NASA Technical Reports Server (NTRS)

    DeMaio, Joe; Rutkowski, Michael (Technical Monitor)

    2000-01-01

    Proposed helicopter helmet mounted displays will be used to alert the pilot to a variety of conditions, from threats to equipment problems. The present research was performed under the NASA Safe All-weather Flight Operations Research (SAFOR) program supported by a joint Army/NASA research agreement. The purpose of the research was to examine ways to optimize the alerting effectiveness of helmet display symbology. The research used two approaches to increasing the effectiveness of alerts. One was to increase the ability of the alert to attract attention by using the entire display surface. The other was to include information about the required response in the alert itself. The investigation was conducted using the NASA Ames Research Center's six-degree-of-freedom vertical motion simulator (VMS) with a rotorcraft cockpit. Helmet display symbology was based on the AH-64's pilot night vision system (PNVS), cruise mode symbology. A standardized mission was developed, that consisted of 11 legs. The mission included four tasks, which allowed variation in the frequency of alerts. The general trend in the data points to a small benefit from both the full-screen alert and the partial information alert.

  2. An Analysis of EMS and ED Detection of Stroke.

    PubMed

    Medoro, Ian; Cone, David C

    2017-01-01

    Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases. Stroke alerts called by EMS prior to ED arrival were compared to stroke alerts called by ED physicians and nurses (for walk-in patients, and patients transported by EMS without EMS stroke alerts). Means ± SD, medians, unpaired t-tests (for continuous data), and two-tailed Fisher's exact tests (for categorical data) were used. Of 260 consecutive stroke alerts, 129 were EMS stroke alerts, and 131 were ED stroke alerts (70 called by physicians, 61 by nurses). The mean NIH Stroke Scale was higher in the EMS group (8.1 ± 7.6 vs. 3.0 ± 5.0, p < 0.0001). The positive predictive value of EMS stroke alerts was 0.60 (78/129), alerts by ED nurses was 0.25 (15/61), and alerts by ED physicians was 0.31 (22/70). The PPV for EMS was better than for nurses or physicians (both p < 0.001), and more patients in the EMS group had final diagnoses of stroke (62/129 vs. 24/131, p < 0.001). The positive likelihood ratio was 1.53 for EMS personnel, 0.45 for physicians, and 0.77 for nurses. The mean time to order the CT (8.5 ± 7.1 min vs. 23.1 ± 18.2 min, p < 0.0001) and the mean ED length of stay (248 ± 116 min vs. 283 ± 128 min, p = 0.022) were shorter for the EMS stroke alert group. More EMS stroke alert patients received tPA (16/129 vs. 6/131, p = 0.027). EMS stroke alerts have better diagnostic test performance than stroke alerts by ED staff, likely due to higher NIH Stroke Scale scores (more obvious presentations) and are associated with better process measures. The fairly low PPV suggests room for improvement in prehospital stroke protocols.

  3. 47 CFR 10.240 - Notification to new subscribers of non-participation in CMAS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  4. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  5. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  6. 47 CFR 10.410 - Prioritization.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  7. Commercial Motor Vehicle Driver Fatigue And Alertness Study Executive Summary

    DOT National Transportation Integrated Search

    1996-11-01

    THE DRIVER FATIGUE AND ALERTNESS STUDY (DFAS) WAS THE LARGEST AND MOST COMPREHENSIVE OVER-THE-ROAD STUDY EVER CONDUCTED ON DRIVER FATIGUE AND ALERTNESS IN NORTH AMERICA. IT PROVIDES EXTENSIVE INFORMATION ON THE ALERTNESS, DRIVING PERFORMANCE, AND PHY...

  8. 47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  9. 47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  10. 47 CFR 11.56 - Obligation to process CAP-formatted EAS messages.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  11. Development and Implementation of Sepsis Alert Systems.

    PubMed

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

    2016-06-01

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

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

    NASA Technical Reports Server (NTRS)

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

    2015-01-01

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

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

    PubMed Central

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

    2001-01-01

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

  14. Timing and Causality in the Generation of Learned Eyelid Responses

    PubMed Central

    Sánchez-Campusano, Raudel; Gruart, Agnès; Delgado-García, José M.

    2011-01-01

    The cerebellum-red nucleus-facial motoneuron (Mn) pathway has been reported as being involved in the proper timing of classically conditioned eyelid responses. This special type of associative learning serves as a model of event timing for studying the role of the cerebellum in dynamic motor control. Here, we have re-analyzed the firing activities of cerebellar posterior interpositus (IP) neurons and orbicularis oculi (OO) Mns in alert behaving cats during classical eyeblink conditioning, using a delay paradigm. The aim was to revisit the hypothesis that the IP neurons (IPns) can be considered a neuronal phase-modulating device supporting OO Mns firing with an emergent timing mechanism and an explicit correlation code during learned eyelid movements. Optimized experimental and computational tools allowed us to determine the different causal relationships (temporal order and correlation code) during and between trials. These intra- and inter-trial timing strategies expanding from sub-second range (millisecond timing) to longer-lasting ranges (interval timing) expanded the functional domain of cerebellar timing beyond motor control. Interestingly, the results supported the above-mentioned hypothesis. The causal inferences were influenced by the precise motor and pre-motor spike timing in the cause-effect interval, and, in addition, the timing of the learned responses depended on cerebellar–Mn network causality. Furthermore, the timing of CRs depended upon the probability of simulated causal conditions in the cause-effect interval and not the mere duration of the inter-stimulus interval. In this work, the close relation between timing and causality was verified. It could thus be concluded that the firing activities of IPns may be related more to the proper performance of ongoing CRs (i.e., the proper timing as a consequence of the pertinent causality) than to their generation and/or initiation. PMID:21941469

  15. Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers.

    PubMed

    Gregory, Megan E; Russo, Elise; Singh, Hardeep

    2017-07-05

    Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied. To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload. A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States. Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system. Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

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

    PubMed

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

    2002-12-01

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

  17. An Investigation of Drug-Drug Interaction Alert Overrides at a Pediatric Hospital.

    PubMed

    Humphrey, Kate; Jorina, Maria; Harper, Marvin; Dodson, Brenda; Kim, Seung-Yeon; Ozonoff, Al

    2018-05-01

    Drug-drug interactions (DDIs) can result in patient harm. DDI alerts are intended to help prevent harm; when the majority of alerts presented to providers are being overridden, their value is diminished. Our objective was to evaluate the overall rates of DDI alert overrides and how rates varied by specialty, clinician type, and patient complexity. A retrospective study of DDI alert overrides that occurred during 2012 and 2013 within the inpatient setting described at the medication-, hospital-, provider-, and patient encounter-specific levels was performed at an urban, quaternary-care, pediatric hospital. There were >41 000 DDI alerts presented to clinicians; ∼90% were overridden. The 5 DDI pairs that were most frequently presented and overridden included the following: potassium chloride-spironolactone, methadone-ondansetron, ketorolac-ibuprofen, cyclosporine-fluconazole, and potassium chloride-enalapril, each with an alert override rate of ≥0.89. Override rates across provider groups ranged between 0.84 and 0.97. In general, patients with high complexity had a higher frequency of alert overrides, but the rates of alert overrides for each DDI pairing did not differ significantly. High rates of DDI alert overrides occur across medications, provider groups, and patient encounters. Methods to decrease DDI alerts which are likely to be overridden exist, but it is also clear that more robust and intelligent tools are needed. Characteristics exist at the medication, hospital, provider, and patient levels that can be used to help specialize and enhance information transmission. Copyright © 2018 by the American Academy of Pediatrics.

  18. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  19. 77 FR 41331 - Commercial Mobile Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

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

  20. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  1. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  2. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  3. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  4. 47 CFR 80.1111 - Distress alerting.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES STATIONS IN THE... Safety Communications § 80.1111 Distress alerting. (a) The transmission of a distress alert indicates... distress message format, which is relayed through space stations. (b) The distress alert must be sent...

  5. Alert Triage v 0.1 beta

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

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

    2016-01-06

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

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

    NASA Astrophysics Data System (ADS)

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

    2017-12-01

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

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

    PubMed

    Pfeiffer, Yvonne; Schwappach, David

    2016-01-01

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

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

    PubMed

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

    2016-10-01

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

  9. Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

    PubMed Central

    Dalal, Anuj K; Sahni, V Anik; Lacson, Ronilda; Khorasani, Ramin

    2016-01-01

    Objective To assess whether integrating critical result management software—Alert Notification of Critical Results (ANCR)—with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). Materials and Methods This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts (“alerts”) within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Results Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Conclusions Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. PMID:26335982

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

    PubMed

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

    2014-11-01

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

  11. New connectors coming for enteral feeding tubes; marqibo and risk of errors; angeliq is not a birth control pill.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2014-07-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.

  12. Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy.

    PubMed

    Schreiber, Richard; Sittig, Dean F; Ash, Joan; Wright, Adam

    2017-09-01

    In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion. Although testing had shown that the laboratory system would cancel duplicate laboratory orders, it was thought that duplicate alerting in the new order entry system would prevent such events. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Operational Space Weather Products at IPS

    NASA Astrophysics Data System (ADS)

    Neudegg, D.; Steward, G.; Marshall, R.; Terkildsen, M.; Kennewell, J.; Patterson, G.; Panwar, R.

    2008-12-01

    IPS Radio and Space Services operates an extensive network (IPSNET) of monitoring stations and observatories within the Australasian and Antarctic regions to gather information on the space environment. This includes ionosondes, magnetometers, GPS-ISM, oblique HF sounding, riometers, and solar radio and optical telescopes. IPS exchanges this information with similar organisations world-wide. The Regional Warning Centre (RWC) is the Australian Space Forecast Centre (ASFC) and it utilizes this data to provide products and services to support customer operations. A wide range of customers use IPS services including; defence force and emergency services using HF radio communications and surveillance systems, organisations involved in geophysical exploration and pipeline cathodic protection, GPS users in aviation. Subscriptions to the alerts, warnings, forecasts and reports regarding the solar, geophysical and ionospheric conditions are distributed by email and Special Message Service (SMS). IPS also develops and markets widely used PC software prediction tools for HF radio skywave and surface wave (ASAPS/GWPS) and provides consultancy services for system planning.

  14. A Simple and Low-Cost Monitoring System to Investigate Environmental Conditions in a Biological Research Laboratory.

    PubMed

    Gurdita, Akshay; Vovko, Heather; Ungrin, Mark

    2016-01-01

    Basic equipment such as incubation and refrigeration systems plays a critical role in nearly all aspects of the traditional biological research laboratory. Their proper functioning is therefore essential to ensure reliable and repeatable experimental results. Despite this fact, in many academic laboratories little attention is paid to validating and monitoring their function, primarily due to the cost and/or technical complexity of available commercial solutions. We have therefore developed a simple and low-cost monitoring system that combines a "Raspberry Pi" single-board computer with USB-connected sensor interfaces to track and log parameters such as temperature and pressure, and send email alert messages as appropriate. The system is controlled by open-source software, and we have also generated scripts to automate software setup so that no background in programming is required to install and use it. We have applied it to investigate the behaviour of our own equipment, and present here the results along with the details of the monitoring system used to obtain them.

  15. Evaluation of the Harmful Algal Bloom Mapping System (HABMapS) and Bulletin

    NASA Technical Reports Server (NTRS)

    Hall, Callie; Zanoni, Vicki; Estep, Leland; Terrie, Gregory; D'Sa, Eurico; Pagnutti, Mary

    2004-01-01

    The National Oceanic and Atmospheric Administration (NOAA) Harmful Algal Bloom (HAB) Mapping System and Bulletin provide a Web-based geographic information system (GIS) and an e-mail alert system that allow the detection, monitoring, and tracking of HABs in the Gulf of Mexico. NASA Earth Science data that potentially support HABMapS/Bulletin requirements include ocean color, sea surface temperature (SST), salinity, wind fields, precipitation, water surface elevation, and ocean currents. Modeling contributions include ocean circulation, wave/currents, along-shore current regimes, and chlorophyll modeling (coupled to imagery). The most immediately useful NASA contributions appear to be the 1-km Moderate Resolution Imaging Spectrometer (MODIS) chlorophyll and SST products and the (presently used) SeaWinds wind vector data. MODIS pigment concentration and SST data are sufficiently mature to replace imagery currently used in NOAA HAB applications. The large file size of MODIS data is an impediment to NOAA use and modified processing schemes would aid in NOAA adoption of these products for operational HAB forecasting.

  16. ISMP Medication Error Report Analysis

    PubMed Central

    Cohen, Michael R.; Smetzer, Judy L.

    2017-01-01

    These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:28179735

  17. ISMP Medication Error Report Analysis

    PubMed Central

    Cohen, Michael R.; Smetzer, Judy L.

    2017-01-01

    These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your in-service training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications. PMID:29276260

  18. Communications between local health departments and the public during emergencies: the importance of standardized web sites.

    PubMed

    Fallon, L Fleming; Schmalzried, Hans D; Hasan, Nausheen

    2011-01-01

    Of the 2790 local health departments (LHDs) in the United States, Internet homepages were located for 1986. We reviewed each homepage to document the presence of 9 elements deemed to be critical for effective communications during emergency or disaster situations. LHD Web site homepages had a mean of 4.1 (±1.4) elements. Among the findings, this review revealed that 4 of 5 (80.5%) of the LHDs included the agency phone number, half (49.4%) provided links to emergency information, and about 1 in 5 (19.6%) listed an agency e-mail address. Fewer than 1 in 20 (4.3%) of the LHD homepages reviewed allowed visitors to sign up for automatic alerts or notifications. We suggest that these results be used as a starting point in developing a standardized template containing the 9 homepage elements. Such a template complements National Incident Management System protocols and can provide a recognizable source of consistent and reliable information for people during a public health emergency or disaster.

  19. Modeling and using a web-based and tutored portfolio to support certification of professional competence in transfusion medicine

    PubMed Central

    Staccini, Pascal; Rouger, Philippe

    2008-01-01

    In order to manage a nationwide assessment program leading to certification of professional competence in blood transfusion throughout France, the National Institute of Blood Transfusion (INTS) and the University of Nice-Sophia Antipolis designed and developed a structured and tutored web-based portfolio. The entire process of certification has been approved by the national healthcare agency (HAS). Eleven assessment programs have been written. The structure of this e-portfolio is based on a matrix of actions defined according to standards of practice. For each action, elements of proof are uploaded by the physician and peer-reviewed by an expert (a tutor) before validation. The electronic portfolio stores all the history of the actions performed by users. This tracking feature generates alerts which are e-mailed to users (physicians and tutors) according to a list of monitored events. After one year of design and development, the application is now being used routinely. PMID:18999167

  20. ISMP Medication Error Report Analysis

    PubMed Central

    Cohen, Michael R.; Smetzer, Judy L.

    2016-01-01

    These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:28057945

  1. ISMP Medication Error Report Analysis

    PubMed Central

    Cohen, Michael R.; Smetzer, Judy L.

    2016-01-01

    ABSTRACT These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural-safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were receivedthrough the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:27928183

  2. Bar Code Medication Administration Technology: Characterization of High-Alert Medication Triggers and Clinician Workarounds.

    PubMed

    Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L

    2011-02-01

    Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes must be continually analyzed and restructured to yield the intended full benefits of BCMA technology. © 2011 SAGE Publications.

  3. Identification of Patients Expected to Benefit from Electronic Alerts for Acute Kidney Injury.

    PubMed

    Biswas, Aditya; Parikh, Chirag R; Feldman, Harold I; Garg, Amit X; Latham, Stephen; Lin, Haiqun; Palevsky, Paul M; Ugwuowo, Ugochukwu; Wilson, F Perry

    2018-06-07

    Electronic alerts for heterogenous conditions such as AKI may not provide benefit for all eligible patients and can lead to alert fatigue, suggesting that personalized alert targeting may be useful. Uplift-based alert targeting may be superior to purely prognostic-targeting of interventions because uplift models assess marginal treatment effect rather than likelihood of outcome. This is a secondary analysis of a clinical trial of 2278 adult patients with AKI randomized to an automated, electronic alert system versus usual care. We used three uplift algorithms and one purely prognostic algorithm, trained in 70% of the data, and evaluated the effect of targeting alerts to patients with higher scores in the held-out 30% of the data. The performance of the targeting strategy was assessed as the interaction between the model prediction of likelihood to benefit from alerts and randomization status. The outcome of interest was maximum relative change in creatinine from the time of randomization to 3 days after randomization. The three uplift score algorithms all gave rise to a significant interaction term, suggesting that a strategy of targeting individuals with higher uplift scores would lead to a beneficial effect of AKI alerting, in contrast to the null effect seen in the overall study. The prognostic model did not successfully stratify patients with regards to benefit of the intervention. Among individuals in the high uplift group, alerting was associated with a median reduction in change in creatinine of -5.3% ( P =0.03). In the low uplift group, alerting was associated with a median increase in change in creatinine of +5.3% ( P =0.005). Older individuals, women, and those with a lower randomization creatinine were more likely to receive high uplift scores, suggesting that alerts may benefit those with more slowly developing AKI. Uplift modeling, which accounts for treatment effect, can successfully target electronic alerts for AKI to those most likely to benefit, whereas purely prognostic targeting cannot. Copyright © 2018 by the American Society of Nephrology.

  4. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 8 2014-01-01 2014-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. ...

  5. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. ...

  6. 78 FR 22270 - Special Fraud Alert: Physician-Owned Entities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ...] Special Fraud Alert: Physician-Owned Entities AGENCY: Office of Inspector General (OIG), HHS. ACTION... Physician-Owned Entities. Specifically, the Special Fraud Alert addressed physician-owned entities that... publication of the Special Fraud Alert on Physician-Owned Entities, an inadvertent error appeared in the DATES...

  7. 76 FR 62321 - Airworthiness Directives; Aviation Communication & Surveillance Systems (ACSS) Traffic Alert and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

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

  8. 77 FR 26701 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-07

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

  9. Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

    NASA Astrophysics Data System (ADS)

    Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

    Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

  10. Context-Sensitive Clinical Alert Packages Written in Arden Syntax.

    PubMed

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

    2017-01-01

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

  11. KSC-96pc1124

    NASA Image and Video Library

    1996-09-26

    KENNEDY SPACE CENTER, FLA. -- A KSC fire truck stands on alert as the STS-79 Space Shuttle Atlantis hurtles down Runway 15 of KSC's Shuttle Landing Facility, its drag chute billowing behind it. Atlantis touched down at 8:13:15 a.m. EDT, September 26. On board is U.S. astronaut Shannon W. Lucid, who has been living and working on the Russian Space Station Mir for about six months. Lucid has spent 188 days in space from launch aboard Atlantis in March to her return today, establishing a U.S. record for long-duration spaceflight as well as representing the longest spaceflight for a woman. Succeeding Lucid on Mir is U.S. astronaut John E. Blaha, who embarked to Mir with the STS-79 crew. The commander of Mission STS-79 is William F. Readdy; Terrence W. Wilcutt is the pilot, and the three mission specialists are Jay Apt, Thomas D. Akers and Carl E. Walz

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

    Kurt Derr; Milos Manic

    Location Based Services (LBS), context aware applications, and people and object tracking depend on the ability to locate mobile devices, also known as localization, in the wireless landscape. Localization enables a diverse set of applications that include, but are not limited to, vehicle guidance in an industrial environment, security monitoring, self-guided tours, personalized communications services, resource tracking, mobile commerce services, guiding emergency workers during fire emergencies, habitat monitoring, environmental surveillance, and receiving alerts. This paper presents a new neural network approach (LENSR) based on a competitive topological Counter Propagation Network (CPN) with k-nearest neighborhood vector mapping, for indoor location estimationmore » based on received signal strength. The advantage of this approach is both speed and accuracy. The tested accuracy of the algorithm was 90.6% within 1 meter and 96.4% within 1.5 meters. Several approaches for location estimation using WLAN technology were reviewed for comparison of results.« less

  13. Alert generation and cockpit presentation for an integrated microburst alerting system

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

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

  14. 12 CFR 1022.121 - Active duty alerts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Active duty alerts. 1022.121 Section 1022.121... Consumer Reporting Agencies Regarding Identity Theft § 1022.121 Active duty alerts. (a) Duration. The duration of an active duty alert shall be twelve months. (b) [Reserved] ...

  15. 76 FR 3064 - Travelers Information Stations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

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

  16. 77 FR 33661 - Review of the Emergency Alert System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

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

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

    PubMed

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

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

  18. Adherence to drug-drug interaction alerts in high-risk patients: a trial of context-enhanced alerting.

    PubMed

    Duke, Jon D; Li, Xiaochun; Dexter, Paul

    2013-05-01

    Drug-drug interaction (DDI) alerting is an important form of clinical decision support, yet physicians often fail to attend to critical DDI warnings due to alert fatigue. We previously described a model for highlighting patients at high risk of a DDI by enhancing alerts with relevant laboratory data. We sought to evaluate the effect of this model on alert adherence in high-risk patients. A 6-month randomized controlled trial involving 1029 outpatient physicians was performed. The target interactions were all DDIs known to cause hyperkalemia. Alerts in the intervention group were enhanced with the patient's most recent potassium and creatinine levels. The control group received unmodified alerts. High -risk patients were those with baseline potassium >5.0 mEq/l and/or creatinine ≥1.5 mg/dl (132 μmol/l). We found no significant difference in alert adherence in high-risk patients between the intervention group (15.3%) and the control group (16.8%) (p=0.71). Adherence in normal risk patients was significantly lower in the intervention group (14.6%) than in the control group (18.6%) (p<0.01). In neither group did physicians increase adherence in patients at high risk. Physicians adhere poorly to hyperkalemia-associated DDI alerts even in patients with risk factors for a clinically significant interaction, and the display of relevant laboratory data in these alerts did not improve adherence levels in the outpatient setting. Further research is necessary to determine optimal strategies for conveying patient-specific DDI risk.

  19. Alertness Modulates Conflict Adaptation and Feature Integration in an Opposite Way

    PubMed Central

    Chen, Jia; Huang, Xiting; Chen, Antao

    2013-01-01

    Previous studies show that the congruency sequence effect can result from both the conflict adaptation effect (CAE) and feature integration effect which can be observed as the repetition priming effect (RPE) and feature overlap effect (FOE) depending on different experimental conditions. Evidence from neuroimaging studies suggests that a close correlation exists between the neural mechanisms of alertness-related modulations and the congruency sequence effect. However, little is known about whether and how alertness mediates the congruency sequence effect. In Experiment 1, the Attentional Networks Test (ANT) and a modified flanker task were used to evaluate whether the alertness of the attentional functions had a correlation with the CAE and RPE. In Experimental 2, the ANT and another modified flanker task were used to investigate whether alertness of the attentional functions correlate with the CAE and FOE. In Experiment 1, through the correlative analysis, we found a significant positive correlation between alertness and the CAE, and a negative correlation between the alertness and the RPE. Moreover, a significant negative correlation existed between CAE and RPE. In Experiment 2, we found a marginally significant negative correlation between the CAE and the RPE, but the correlation between alertness and FOE, CAE and FOE was not significant. These results suggest that alertness can modulate conflict adaptation and feature integration in an opposite way. Participants at the high alerting level group may tend to use the top-down cognitive processing strategy, whereas participants at the low alerting level group tend to use the bottom-up processing strategy. PMID:24250824

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2007-01-01

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

  2. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  3. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  4. 47 CFR 11.56 - EAS Participants receive CAP-formatted alerts.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  5. 21 CFR 26.20 - Alert system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  6. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  7. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  8. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  9. 47 CFR 80.277 - Ship Security Alert System (SSAS).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  10. 75 FR 25842 - Notice of a Grant With the Public Broadcasting Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

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

  11. 75 FR 26269 - Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

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

  12. 78 FR 49292 - American Medical Alert Corporation, DBA Tunstall, Clovis, New Mexico; Amended Certification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-13

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-82,859] American Medical Alert... Assistance on July 18, 2013, applicable to workers of American Medical Alert Corporation, doing business as... follows: All workers of American Medical Alert Corporation, doing business as Tunstall, Clovis, New Mexico...

  13. 76 FR 28789 - Draft Alert Entitled “Preventing Occupational Respiratory Disease From Dampness in Office...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... NIOSH-238] Draft Alert Entitled ``Preventing Occupational Respiratory Disease From Dampness in Office...), announces the availability of a draft Alert entitled ``Preventing Occupational Respiratory Disease from.../niosh/docket/review/docket238/default.html . The purpose of this Alert is to provide workers and...

  14. 77 FR 28387 - Federal Advisory Committee Act; Communications Security, Reliability, and Interoperability Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

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

  15. Jetliner Alert Systems

    NASA Technical Reports Server (NTRS)

    1983-01-01

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

  16. Alert Exchange Process Protocol

    NASA Technical Reports Server (NTRS)

    Groen, Frank

    2015-01-01

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

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

    DTIC Science & Technology

    2016-03-11

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

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

    PubMed

    Muench, Frederick; Baumel, Amit

    2017-05-26

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

  19. Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options.

    PubMed

    Malhotra, Sameer; Cheriff, Adam D; Gossey, J Travis; Cole, Curtis L; Kaushal, Rainu; Ancker, Jessica S

    2016-09-01

    Increasing the use of generic medications could help control medical costs. However, educational interventions have limited impact on prescriber behavior, and e-prescribing alerts are associated with high override rates and alert fatigue. Our objective was to evaluate the effect of a less intrusive intervention, a redesign of an e-prescribing interface that provides default options intended to "nudge" prescribers towards prescribing generic drugs. This retrospective cohort study in an academic ambulatory multispecialty practice assessed the effects of customizing an e-prescribing interface to substitute generic equivalents for brand-name medications during order entry and allow a one-click override to order the brand-name medication. Among drugs with generic equivalents, the proportion of generic drugs prescribed more than doubled after the interface redesign, rising abruptly from 39.7% to 95.9% (a 56.2% increase; 95% confidence interval, 56.0-56.4%; P < .001). Before the redesign, generic drug prescribing rates varied by therapeutic class, with rates as low as 8.6% for genitourinary products and 15.7% for neuromuscular drugs. After the redesign, generic drug prescribing rates for all but four therapeutic classes were above 90%: endocrine drugs, neuromuscular drugs, nutritional products, and miscellaneous products. Changing the default option in an e-prescribing interface in an ambulatory care setting was followed by large and sustained increases in the proportion of generic drugs prescribed at the practice. Default options in health information technology exert a powerful effect on user behavior, an effect that can be leveraged to optimize decision making. © 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.

  20. Weather warnings predict fall-related injuries among older adults.

    PubMed

    Mondor, Luke; Charland, Katia; Verma, Aman; Buckeridge, David L

    2015-05-01

    weather predictions are a useful tool for informing public health planning and prevention strategies for non-injury health outcomes, but the association between winter weather warnings and fall-related injuries has not been assessed previously. to examine the association between fall-related injuries among older adults and government-issued winter weather warnings. using a dynamic cohort of individuals ≥65 years of age who lived in Montreal between 1998 and 2006, we identified all fall-related injuries from administrative data using a validated set of diagnostic and procedure codes. We compared rates of injuries on days with freezing rain or snowstorm warnings to rates observed on days without warnings. We also compared the incidence of injuries on winter days to non-winter days. All analyses were performed overall and stratified by age and sex. freezing rain alerts were associated with an increase in fall-related injuries (incidence rate ratio [IRR] = 1.20, 95% confidence interval [CI]: 1.08-1.32), particularly among males (IRR = 1.31, 95% CI: 1.10-1.56), and lower rates of injuries were associated with snowstorm alerts (IRR = 0.89, 95% CI: 0.80-0.99). The rate of fall-related injuries did not differ seasonally (IRR = 1.00, 95% CI: 0.97-1.03). official weather warnings are predictive of increases in fall-related injuries among older adults. Public health agencies should consider using these warnings to trigger initiation of injury prevention strategies in advance of inclement weather. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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