Evaluating impact of clinical guidelines using a realist evaluation framework.

PubMed

Reddy, Sandeep; Wakerman, John; Westhorp, Gill; Herring, Sally

2015-12-01

The Remote Primary Health Care Manuals (RPHCM) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote Australia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20-year history. These evaluations did not consider a theory-based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence-based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM. The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence-based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community-controlled clinics, in three regions of Australia. Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation. © 2015 John Wiley & Sons, Ltd.

Performance Evaluation of a SLA Negotiation Control Protocol for Grid Networks

NASA Astrophysics Data System (ADS)

Cergol, Igor; Mirchandani, Vinod; Verchere, Dominique

A framework for an autonomous negotiation control protocol for service delivery is crucial to enable the support of heterogeneous service level agreements (SLAs) that will exist in distributed environments. We have first given a gist of our augmented service negotiation protocol to support distinct service elements. The augmentations also encompass related composition of the services and negotiation with several service providers simultaneously. All the incorporated augmentations will enable to consolidate the service negotiation operations for telecom networks, which are evolving towards Grid networks. Furthermore, our autonomous negotiation protocol is based on a distributed multi-agent framework to create an open market for Grid services. Second, we have concisely presented key simulation results of our work in progress. The results exhibit the usefulness of our negotiation protocol for realistic scenarios that involves different background traffic loading, message sizes and traffic flow asymmetry between background and negotiation traffics.

Evaluation and development the routing protocol of a fully functional simulation environment for VANETs

NASA Astrophysics Data System (ADS)

Ali, Azhar Tareq; Warip, Mohd Nazri Mohd; Yaakob, Naimah; Abduljabbar, Waleed Khalid; Atta, Abdu Mohammed Ali

2017-11-01

Vehicular Ad-hoc Networks (VANETs) is an area of wireless technologies that is attracting a great deal of interest. There are still several areas of VANETS, such as security and routing protocols, medium access control, that lack large amounts of research. There is also a lack of freely available simulators that can quickly and accurately simulate VANETs. The main goal of this paper is to develop a freely available VANETS simulator and to evaluate popular mobile ad-hoc network routing protocols in several VANETS scenarios. The VANETS simulator consisted of a network simulator, traffic (mobility simulator) and used a client-server application to keep the two simulators in sync. The VANETS simulator also models buildings to create a more realistic wireless network environment. Ad-Hoc Distance Vector routing (AODV), Dynamic Source Routing (DSR) and Dynamic MANET On-demand (DYMO) were initially simulated in a city, country, and highway environment to provide an overall evaluation.

Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods

PubMed Central

2010-01-01

Background Schools are key settings for health promotion (HP) but the development of suitable approaches for evaluating HP in schools is still a major topic of discussion. This article presents a research protocol of a program developed to evaluate HP. After reviewing HP evaluation issues, the various possible approaches are analyzed and the importance of a realistic evaluation framework and a mixed methods (MM) design are demonstrated. Methods/Design The design is based on a systemic approach to evaluation, taking into account the mechanisms, context and outcomes, as defined in realistic evaluation, adjusted to our own French context using an MM approach. The characteristics of the design are illustrated through the evaluation of a nationwide HP program in French primary schools designed to enhance children's social, emotional and physical health by improving teachers' HP practices and promoting a healthy school environment. An embedded MM design is used in which a qualitative data set plays a supportive, secondary role in a study based primarily on a different quantitative data set. The way the qualitative and quantitative approaches are combined through the entire evaluation framework is detailed. Discussion This study is a contribution towards the development of suitable approaches for evaluating HP programs in schools. The systemic approach of the evaluation carried out in this research is appropriate since it takes account of the limitations of traditional evaluation approaches and considers suggestions made by the HP research community. PMID:20109202

A GIS-based protocol for the simulation and evaluation of realistic 3-D thinning scenarios in recreational forest management.

PubMed

Lin, Chinsu; Thomson, Gavin; Hung, Shih-Hsiang; Lin, Yu-Dung

2012-12-30

This study introduces a GIS-based protocol for the simulation and evaluation of thinning treatments in recreational forest management. The protocol was implemented in a research study based on an area of recreational forest in Alishan National Scenic Area, Taiwan. Ground survey data were mapped to a GIS database, to create a precise, yet flexible, GIS-based digital forest. The digital forest model was used to generate 18 different thinning scenario images and one image of the existing unthinned forest. A questionnaire was completed by 456 participants while simultaneously viewing the scenario images. The questionnaire was used to determine the scenic beauty preferences of the respondents. Statistical analysis of the data revealed that the respondents preferred low density, upper-storey thinning treatments and a dispersed retention pattern of the remaining trees. High density upper-storey treatments evoked a strongly negative reaction in the observers. The experiment demonstrated that the proposed protocol is suitable for selecting an appropriate thinning strategy for recreational forest and that the protocol has practical value in recreational forest management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Geotechnical Centrifuge Experiments to Evaluate Piping in Foundation Soils

DTIC Science & Technology

2014-05-01

verifiable results. These tests were successful in design , construction, and execution of a realistic simulation of internal erosion leading to failure...possible “scale effects,” “modeling of models” testing protocol should be included in the test program. Also, the model design should minimize the scale...recommendations for improving the centrifuge tests include the following: • Design improved system for reservoir control to provide definitive and

Probability Distributions over Cryptographic Protocols

DTIC Science & Technology

2009-06-01

Artificial Immune Algorithm . . . . . . . . . . . . . . . . . . . 9 3 Design Decisions 11 3.1 Common Ground...creation algorithm for unbounded distribution . . . . . . . 24 4.2 Message creation algorithm for unbounded naive distribution . . . . 24 4.3 Protocol...creation algorithm for intended-run distributions . . . . . . 26 4.4 Protocol and message creation algorithm for realistic distribution . . 32 ix THIS

Generating Virtual Patients by Multivariate and Discrete Re-Sampling Techniques.

PubMed

Teutonico, D; Musuamba, F; Maas, H J; Facius, A; Yang, S; Danhof, M; Della Pasqua, O

2015-10-01

Clinical Trial Simulations (CTS) are a valuable tool for decision-making during drug development. However, to obtain realistic simulation scenarios, the patients included in the CTS must be representative of the target population. This is particularly important when covariate effects exist that may affect the outcome of a trial. The objective of our investigation was to evaluate and compare CTS results using re-sampling from a population pool and multivariate distributions to simulate patient covariates. COPD was selected as paradigm disease for the purposes of our analysis, FEV1 was used as response measure and the effects of a hypothetical intervention were evaluated in different populations in order to assess the predictive performance of the two methods. Our results show that the multivariate distribution method produces realistic covariate correlations, comparable to the real population. Moreover, it allows simulation of patient characteristics beyond the limits of inclusion and exclusion criteria in historical protocols. Both methods, discrete resampling and multivariate distribution generate realistic pools of virtual patients. However the use of a multivariate distribution enable more flexible simulation scenarios since it is not necessarily bound to the existing covariate combinations in the available clinical data sets.

Protocol: realist synthesis of the impact of unemployment insurance policies on poverty and health.

PubMed

Molnar, Agnes; O'Campo, Patricia; Ng, Edwin; Mitchell, Christiane; Muntaner, Carles; Renahy, Emilie; St John, Alexander; Shankardass, Ketan

2015-02-01

Unemployment insurance is an important social protection policy that buffers unemployed workers against poverty and poor health. Most unemployment insurance studies focus on whether increases in unemployment insurance generosity are predictive of poverty and health outcomes. Less work has used theory-driven approaches to understand and explain how and why unemployment insurance works, for whom, and under what circumstances. Given this, we present a realist synthesis protocol that seeks to unpack how contextual influences trigger relevant mechanisms to generate poverty and health outcomes. In this protocol, we conceptualize unemployment insurance as a key social protection policy; provide a supporting rationale on the need for a realist synthesis; and describe our process on identifying context-mechanism-outcome pattern configurations. Six methodological steps are described: initial theory development, search strategy; selection and appraisal of documents; data extraction; analysis and synthesis process; and presentation and dissemination of revised theory. Our forthcoming realist synthesis will be the first to build and test theory on the intended and unintended outcomes of unemployment insurance policies. Anticipated findings will allow policymakers to move beyond 'black box' approaches to consider 'mechanism-based' explanations that explicate the logic on how and why unemployment insurance matters. Copyright © 2014 Elsevier Ltd. All rights reserved.

Searching for the mechanisms of change: a protocol for a realist review of batterer treatment programmes

PubMed Central

Cheff, Rebecca; Finn, Debbie; Davloor, Whitney; O'Campo, Patricia

2016-01-01

Introduction Conflicting results reported by evaluations of typical batterer intervention programmes leave many judicial officials and policymakers uncertain about the best way to respond to domestic violence, and whether to recommend and fund these programmes. Traditional evaluations and systematic reviews tend to focus predominantly on whether the programmes ‘worked’ (eg, reduced recidivism) often at the exclusion of understanding for whom they may or may not have worked, under what circumstances, and why. Methods and analysis We are undertaking a realist review of the batterer treatment programme literature with the aim of addressing this gap. Keeping with the goals of realist review, our primary aims are to identify the theory that underlies these programmes, highlight the mechanisms that trigger changes in participant behaviour and finally explain why these programmes help some individuals reduce their use of violence and under what conditions they are effective or not effective. We begin by describing the process of perpetrator treatment, and by proposing an initial theoretical model of behaviour change that will be tested by our review. We then describe the criteria for inclusion of an evaluation into the review, the search strategy we will use to identify the studies, and the plan for data extraction and analysis. Ethics and dissemination The results of this review will be written up using the RAMESES Guidelines for Realist Synthesis, and disseminated through peer-reviewed publications aimed at the practitioner community as well as presented at community forums, and at violence against women conferences. Ethics approval was not needed. PMID:27053268

Demonstrating a Realistic IP Mission Prototype

NASA Technical Reports Server (NTRS)

Rash, James; Ferrer, Arturo B.; Goodman, Nancy; Ghazi-Tehrani, Samira; Polk, Joe; Johnson, Lorin; Menke, Greg; Miller, Bill; Criscuolo, Ed; Hogie, Keith

2003-01-01

Flight software and hardware and realistic space communications environments were elements of recent demonstrations of the Internet Protocol (IP) mission concept in the lab. The Operating Missions as Nodes on the Internet (OMNI) Project and the Flight Software Branch at NASA/GSFC collaborated to build the prototype of a representative space mission that employed unmodified off-the-shelf Internet protocols and technologies for end-to-end communications between the spacecraft/instruments and the ground system/users. The realistic elements used in the prototype included an RF communications link simulator and components of the TRIANA mission flight software and ground support system. A web-enabled camera connected to the spacecraft computer via an Ethernet LAN represented an on-board instrument creating image data. In addition to the protocols at the link layer (HDLC), transport layer (UDP, TCP), and network (IP) layer, a reliable file delivery protocol (MDP) at the application layer enabled reliable data delivery both to and from the spacecraft. The standard Network Time Protocol (NTP) performed on-board clock synchronization with a ground time standard. The demonstrations of the prototype mission illustrated some of the advantages of using Internet standards and technologies for space missions, but also helped identify issues that must be addressed. These issues include applicability to embedded real-time systems on flight-qualified hardware, range of applicability of TCP, and liability for and maintenance of commercial off-the-shelf (COTS) products. The NASA Earth Science Technology Office (ESTO) funded the collaboration to build and demonstrate the prototype IP mission.

Calculation of 3D genome structures for comparison of chromosome conformation capture experiments with microscopy: An evaluation of single-cell Hi-C protocols.

PubMed

Lando, David; Stevens, Tim J; Basu, Srinjan; Laue, Ernest D

2018-01-01

Single-cell chromosome conformation capture approaches are revealing the extent of cell-to-cell variability in the organization and packaging of genomes. These single-cell methods, unlike their multi-cell counterparts, allow straightforward computation of realistic chromosome conformations that may be compared and combined with other, independent, techniques to study 3D structure. Here we discuss how single-cell Hi-C and subsequent 3D genome structure determination allows comparison with data from microscopy. We then carry out a systematic evaluation of recently published single-cell Hi-C datasets to establish a computational approach for the evaluation of single-cell Hi-C protocols. We show that the calculation of genome structures provides a useful tool for assessing the quality of single-cell Hi-C data because it requires a self-consistent network of interactions, relating to the underlying 3D conformation, with few errors, as well as sufficient longer-range cis- and trans-chromosomal contacts.

Protocol for fermionic positive-operator-valued measures

NASA Astrophysics Data System (ADS)

Arvidsson-Shukur, D. R. M.; Lepage, H. V.; Owen, E. T.; Ferrus, T.; Barnes, C. H. W.

2017-11-01

In this paper we present a protocol for the implementation of a positive-operator-valued measure (POVM) on massive fermionic qubits. We present methods for implementing nondispersive qubit transport, spin rotations, and spin polarizing beam-splitter operations. Our scheme attains linear opticslike control of the spatial extent of the qubits by considering ground-state electrons trapped in the minima of surface acoustic waves in semiconductor heterostructures. Furthermore, we numerically simulate a high-fidelity POVM that carries out Procrustean entanglement distillation in the framework of our scheme, using experimentally realistic potentials. Our protocol can be applied not only to pure ensembles with particle pairs of known identical entanglement, but also to realistic ensembles of particle pairs with a distribution of entanglement entropies. This paper provides an experimentally realizable design for future quantum technologies.

Realist Evaluation of the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care (EURIPIDES) in England: study protocol.

PubMed

Weich, Scott; Fenton, Sarah-Jane Hannah; Bhui, Kamaldeep; Staniszewska, Sophie; Madan, Jason; Larkin, Michael; Newton, Elizabeth; Crepaz-Keay, David; Canaway, Alastair; Croft, Charlotte; Griffiths, Frances

2018-06-14

Inpatient mental healthcare continues to be an area of high risk and where patients report negative experiences. To ensure the patient voice is heard, National Health Service (NHS) Trusts are required to collect feedback from patients routinely. We do not know what kinds of feedback are most important or what management processes are needed to translate this into effective action plans. Further, we do not know if this makes any difference to the patients themselves. This study seeks to explore which of the many different approaches to collecting and using patient experience data are the most useful for supporting improvements in inpatient mental healthcare. The overarching aim of the study is to arrive at recommendations for best practice in the collection and use of patient experience data in NHS England adult inpatient mental health settings. We present the protocol for Realist Evaluation of the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care study (EURIPIDES). The study is composed of five work packages (WPs), including a systematic review of patient experiences (WP1); a telephone survey to assist the selection of case sites (WP2); six indepth case studies involving interviews with service users, carers and staff to enable a realist evaluation of the use of patient experience to improve quality in adult inpatient mental health services (WP3); an economic evaluation of patient experience feedback activity (WP5); and a consensus conference (WP4). We discuss the methodological rationale for the five WPs. This study has received approval from West Midlands/South Birmingham NHS Research Ethics Committee. The outcome of the consensus conference meeting (WP4) will form the basis of the outputs to be disseminated to NHS providers. Dissemination will also take place through publications and presentations at relevant conferences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Performance analysis of wireless sensor networks in geophysical sensing applications

NASA Astrophysics Data System (ADS)

Uligere Narasimhamurthy, Adithya

Performance is an important criteria to consider before switching from a wired network to a wireless sensing network. Performance is especially important in geophysical sensing where the quality of the sensing system is measured by the precision of the acquired signal. Can a wireless sensing network maintain the same reliability and quality metrics that a wired system provides? Our work focuses on evaluating the wireless GeoMote sensor motes that were developed by previous computer science graduate students at Mines. Specifically, we conducted a set of experiments, namely WalkAway and Linear Array experiments, to characterize the performance of the wireless motes. The motes were also equipped with the Sticking Heartbeat Aperture Resynchronization Protocol (SHARP), a time synchronization protocol developed by a previous computer science graduate student at Mines. This protocol should automatically synchronize the mote's internal clocks and reduce time synchronization errors. We also collected passive data to evaluate the response of GeoMotes to various frequency components associated with the seismic waves. With the data collected from these experiments, we evaluated the performance of the SHARP protocol and compared the performance of our GeoMote wireless system against the industry standard wired seismograph system (Geometric-Geode). Using arrival time analysis and seismic velocity calculations, we set out to answer the following question. Can our wireless sensing system (GeoMotes) perform similarly to a traditional wired system in a realistic scenario?

All-optical nanomechanical heat engine.

PubMed

Dechant, Andreas; Kiesel, Nikolai; Lutz, Eric

2015-05-08

We propose and theoretically investigate a nanomechanical heat engine. We show how a levitated nanoparticle in an optical trap inside a cavity can be used to realize a Stirling cycle in the underdamped regime. The all-optical approach enables fast and flexible control of all thermodynamical parameters and the efficient optimization of the performance of the engine. We develop a systematic optimization procedure to determine optimal driving protocols. Further, we perform numerical simulations with realistic parameters and evaluate the maximum power and the corresponding efficiency.

All-Optical Nanomechanical Heat Engine

NASA Astrophysics Data System (ADS)

Dechant, Andreas; Kiesel, Nikolai; Lutz, Eric

2015-05-01

We propose and theoretically investigate a nanomechanical heat engine. We show how a levitated nanoparticle in an optical trap inside a cavity can be used to realize a Stirling cycle in the underdamped regime. The all-optical approach enables fast and flexible control of all thermodynamical parameters and the efficient optimization of the performance of the engine. We develop a systematic optimization procedure to determine optimal driving protocols. Further, we perform numerical simulations with realistic parameters and evaluate the maximum power and the corresponding efficiency.

A novel dynamic mechanical testing technique for reverse shoulder replacements.

PubMed

Dabirrahmani, Danè; Bokor, Desmond; Appleyard, Richard

2014-04-01

In vitro mechanical testing of orthopedic implants provides information regarding their mechanical performance under simulated biomechanical conditions. Current in vitro component stability testing methods for reverse shoulder implants are based on anatomical shoulder designs, which do not capture the dynamic nature of these loads. With glenoid component loosening as one of the most prevalent modes of failure in reverse shoulder replacements, it is important to establish a testing protocol with a more realistic loading regime. This paper introduces a novel method of mechanically testing reverse shoulder implants, using more realistic load magnitudes and vectors, than is currently practiced. Using a custom made jig setup within an Instron mechanical testing system, it is possible to simulate the change in magnitude and direction of the joint load during arm abduction. This method is a step towards a more realistic testing protocol for measuring reverse shoulder implant stability.

Searching for the mechanisms of change: a protocol for a realist review of batterer treatment programmes.

PubMed

Velonis, Alisa J; Cheff, Rebecca; Finn, Debbie; Davloor, Whitney; O'Campo, Patricia

2016-04-06

Conflicting results reported by evaluations of typical batterer intervention programmes leave many judicial officials and policymakers uncertain about the best way to respond to domestic violence, and whether to recommend and fund these programmes. Traditional evaluations and systematic reviews tend to focus predominantly on whether the programmes 'worked' (eg, reduced recidivism) often at the exclusion of understanding for whom they may or may not have worked, under what circumstances, and why. We are undertaking a realist review of the batterer treatment programme literature with the aim of addressing this gap. Keeping with the goals of realist review, our primary aims are to identify the theory that underlies these programmes, highlight the mechanisms that trigger changes in participant behaviour and finally explain why these programmes help some individuals reduce their use of violence and under what conditions they are effective or not effective. We begin by describing the process of perpetrator treatment, and by proposing an initial theoretical model of behaviour change that will be tested by our review. We then describe the criteria for inclusion of an evaluation into the review, the search strategy we will use to identify the studies, and the plan for data extraction and analysis. The results of this review will be written up using the RAMESES Guidelines for Realist Synthesis, and disseminated through peer-reviewed publications aimed at the practitioner community as well as presented at community forums, and at violence against women conferences. Ethics approval was not needed. 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/

Transdisciplinary research for impact: protocol for a realist evaluation of the relationship between transdisciplinary research collaboration and knowledge translation

PubMed Central

Archibald, Mandy M; Harvey, Gillian; Kitson, Alison L

2018-01-01

Introduction Transdisciplinary teams are increasingly regarded as integral to conducting effective research. Similarly, knowledge translation is often seen as a solution to improving the relevance and benefits of health research. Yet, whether, how, for whom and under which circumstances transdisciplinary research influences knowledge translation is undertheorised, which limits its potential impact. The proposed research aims to identify the contexts and mechanisms by which transdisciplinary research contributes to developing shared understandings and behaviours of knowledge translation between team members. Methods and analysis Using a longitudinal case-study design approach to realist evaluation, we outline a study protocol examining whether, how, if and for whom transdisciplinary collaboration can impact knowledge translation understandings and behaviours within a 5-year transdisciplinary Centre of Research Excellence. Data are being collected between February 2017 and December 2020 over four rounds of theory development, refinement and testing using interviews, observation, document review and visual elicitation as data sources. Ethics and dissemination The Health Research Ethics Committee of the University of Adelaide approved this study. Findings will be communicated with team members at scheduled intervals throughout the study verbally and by means of creative reflective approaches (eg, arts elicitation, journalling). This research will be used to help support optimal team functioning by identifying strategies to support knowledge sharing and communication within and beyond the team to facilitate attainment of research objectives. Academic dissemination will occur through publication and presentations. PMID:29627820

Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling

PubMed Central

Meads, C; Nyssen, O P; Wong, G; Steed, L; Bourke, L; Ross, C A; Hayman, S; Field, V; Lord, J; Greenhalgh, T; Taylor, S J C

2014-01-01

Introduction Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis. Methods Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case. PMID:24549165

Protocol for an HTA report: Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic modelling.

PubMed

Meads, C; Nyssen, O P; Wong, G; Steed, L; Bourke, L; Ross, C A; Hayman, S; Field, V; Lord, J; Greenhalgh, T; Taylor, S J C

2014-02-18

Long-term medical conditions (LTCs) cause reduced health-related quality of life and considerable health service expenditure. Writing therapy has potential to improve physical and mental health in people with LTCs, but its effectiveness is not established. This project aims to establish the clinical and cost-effectiveness of therapeutic writing in LTCs by systematic review and economic evaluation, and to evaluate context and mechanisms by which it might work, through realist synthesis. Included are any comparative study of therapeutic writing compared with no writing, waiting list, attention control or placebo writing in patients with any diagnosed LTCs that report at least one of the following: relevant clinical outcomes; quality of life; health service use; psychological, behavioural or social functioning; adherence or adverse events. Searches will be conducted in the main medical databases including MEDLINE, EMBASE, PsycINFO, The Cochrane Library and Science Citation Index. For the realist review, further purposive and iterative searches through snowballing techniques will be undertaken. Inclusions, data extraction and quality assessment will be in duplicate with disagreements resolved through discussion. Quality assessment will include using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data synthesis will be narrative and tabular with meta-analysis where appropriate. De novo economic modelling will be attempted in one clinical area if sufficient evidence is available and performed according to the National Institute for Health and Care Excellence (NICE) reference case.

Using realist evaluation to assess primary healthcare teams' responses to intimate partner violence in Spain.

PubMed

Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel; Marchal, Bruno; Vives-Cases, Carmen

2015-01-01

Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. There were several key mechanisms -the teams' self-efficacy, perceived preparation, women-centred care-, and contextual factors -an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care- that should be considered to develop adequate primary health-care responses to violence. The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Optimal continuous variable quantum teleportation protocol for realistic settings

NASA Astrophysics Data System (ADS)

Luiz, F. S.; Rigolin, Gustavo

2015-03-01

We show the optimal setup that allows Alice to teleport coherent states | α > to Bob giving the greatest fidelity (efficiency) when one takes into account two realistic assumptions. The first one is the fact that in any actual implementation of the continuous variable teleportation protocol (CVTP) Alice and Bob necessarily share non-maximally entangled states (two-mode finitely squeezed states). The second one assumes that Alice's pool of possible coherent states to be teleported to Bob does not cover the whole complex plane (| α | < ∞). The optimal strategy is achieved by tuning three parameters in the original CVTP, namely, Alice's beam splitter transmittance and Bob's displacements in position and momentum implemented on the teleported state. These slight changes in the protocol are currently easy to be implemented and, as we show, give considerable gain in performance for a variety of possible pool of input states with Alice.

Realistic noise-tolerant randomness amplification using finite number of devices.

PubMed

Brandão, Fernando G S L; Ramanathan, Ravishankar; Grudka, Andrzej; Horodecki, Karol; Horodecki, Michał; Horodecki, Paweł; Szarek, Tomasz; Wojewódka, Hanna

2016-04-21

Randomness is a fundamental concept, with implications from security of modern data systems, to fundamental laws of nature and even the philosophy of science. Randomness is called certified if it describes events that cannot be pre-determined by an external adversary. It is known that weak certified randomness can be amplified to nearly ideal randomness using quantum-mechanical systems. However, so far, it was unclear whether randomness amplification is a realistic task, as the existing proposals either do not tolerate noise or require an unbounded number of different devices. Here we provide an error-tolerant protocol using a finite number of devices for amplifying arbitrary weak randomness into nearly perfect random bits, which are secure against a no-signalling adversary. The correctness of the protocol is assessed by violating a Bell inequality, with the degree of violation determining the noise tolerance threshold. An experimental realization of the protocol is within reach of current technology.

Realistic noise-tolerant randomness amplification using finite number of devices

NASA Astrophysics Data System (ADS)

Brandão, Fernando G. S. L.; Ramanathan, Ravishankar; Grudka, Andrzej; Horodecki, Karol; Horodecki, Michał; Horodecki, Paweł; Szarek, Tomasz; Wojewódka, Hanna

2016-04-01

Randomness is a fundamental concept, with implications from security of modern data systems, to fundamental laws of nature and even the philosophy of science. Randomness is called certified if it describes events that cannot be pre-determined by an external adversary. It is known that weak certified randomness can be amplified to nearly ideal randomness using quantum-mechanical systems. However, so far, it was unclear whether randomness amplification is a realistic task, as the existing proposals either do not tolerate noise or require an unbounded number of different devices. Here we provide an error-tolerant protocol using a finite number of devices for amplifying arbitrary weak randomness into nearly perfect random bits, which are secure against a no-signalling adversary. The correctness of the protocol is assessed by violating a Bell inequality, with the degree of violation determining the noise tolerance threshold. An experimental realization of the protocol is within reach of current technology.

Experimental study on all-fiber-based unidimensional continuous-variable quantum key distribution

NASA Astrophysics Data System (ADS)

Wang, Xuyang; Liu, Wenyuan; Wang, Pu; Li, Yongmin

2017-06-01

We experimentally demonstrated an all-fiber-based unidimensional continuous-variable quantum key distribution (CV QKD) protocol and analyzed its security under collective attack in realistic conditions. A pulsed balanced homodyne detector, which could not be accessed by eavesdroppers, with phase-insensitive efficiency and electronic noise, was considered. Furthermore, a modulation method and an improved relative phase-locking technique with one amplitude modulator and one phase modulator were designed. The relative phase could be locked precisely with a standard deviation of 0.5° and a mean of almost zero. Secret key bit rates of 5.4 kbps and 700 bps were achieved for transmission fiber lengths of 30 and 50 km, respectively. The protocol, which simplified the CV QKD system and reduced the cost, displayed a performance comparable to that of a symmetrical counterpart under realistic conditions. It is expected that the developed protocol can facilitate the practical application of the CV QKD.

Realistic noise-tolerant randomness amplification using finite number of devices

PubMed Central

Brandão, Fernando G. S. L.; Ramanathan, Ravishankar; Grudka, Andrzej; Horodecki, Karol; Horodecki, Michał; Horodecki, Paweł; Szarek, Tomasz; Wojewódka, Hanna

2016-01-01

Randomness is a fundamental concept, with implications from security of modern data systems, to fundamental laws of nature and even the philosophy of science. Randomness is called certified if it describes events that cannot be pre-determined by an external adversary. It is known that weak certified randomness can be amplified to nearly ideal randomness using quantum-mechanical systems. However, so far, it was unclear whether randomness amplification is a realistic task, as the existing proposals either do not tolerate noise or require an unbounded number of different devices. Here we provide an error-tolerant protocol using a finite number of devices for amplifying arbitrary weak randomness into nearly perfect random bits, which are secure against a no-signalling adversary. The correctness of the protocol is assessed by violating a Bell inequality, with the degree of violation determining the noise tolerance threshold. An experimental realization of the protocol is within reach of current technology. PMID:27098302

A performance study of WebDav access to storages within the Belle II collaboration

NASA Astrophysics Data System (ADS)

Pardi, S.; Russo, G.

2017-10-01

WebDav and HTTP are becoming popular protocols for data access in the High Energy Physics community. The most used Grid and Cloud storage solutions provide such kind of interfaces, in this scenario tuning and performance evaluation became crucial aspects to promote the adoption of these protocols within the Belle II community. In this work, we present the results of a large-scale test activity, made with the goal to evaluate performances and reliability of the WebDav protocol, and study a possible adoption for the user analysis. More specifically, we considered a pilot infrastructure composed by a set of storage elements configured with the WebDav interface, hosted at the Belle II sites. The performance tests include a comparison with xrootd and gridftp. As reference tests we used a set of analysis jobs running under the Belle II software framework, accessing the input data with the ROOT I/O library, in order to simulate as much as possible a realistic user activity. The final analysis shows the possibility to achieve promising performances with WebDav on different storage systems, and gives an interesting feedback, for Belle II community and for other high energy physics experiments.

Electronic dental records: start taking the steps.

PubMed

Bergoff, Jana

2011-01-01

Converting paper patient records charts into their electronic counterparts (EDRs) not only has many advantages, but also could become a legal requirement in the future. Several steps key to a successful transition includes assessing the needs of the dental team and what they require as a part of the implementation Existing software and hardware must be evaluated for continued use and expansion. Proper protocols for information transfer must be established to ensure complete records while maintaining HIPAA regulations regarding patient privacy. Reduce anxiety by setting realistic dead-lines and using trusted back-up methods.

Multi-party Quantum Key Agreement without Entanglement

NASA Astrophysics Data System (ADS)

Cai, Bin-Bin; Guo, Gong-De; Lin, Song

2017-04-01

A new efficient quantum key agreement protocol without entanglement is proposed. In this protocol, each user encodes his secret key into the traveling particles by performing one of four rotation operations that one cannot perfectly distinguish. In the end, all users can simultaneously obtain the final shared key. The security of the presented protocol against some common attacks is discussed. It is shown that this protocol can effectively protect the privacy of each user and satisfy the requirement of fairness in theory. Moreover, the quantum carriers and the encoding operations used in the protocol can be achieved in realistic physical devices. Therefore, the presented protocol is feasible with current technology.

Security of a discretely signaled continuous variable quantum key distribution protocol for high rate systems.

PubMed

Zhang, Zheshen; Voss, Paul L

2009-07-06

We propose a continuous variable based quantum key distribution protocol that makes use of discretely signaled coherent light and reverse error reconciliation. We present a rigorous security proof against collective attacks with realistic lossy, noisy quantum channels, imperfect detector efficiency, and detector electronic noise. This protocol is promising for convenient, high-speed operation at link distances up to 50 km with the use of post-selection.

Optimization of Nonambulant Mass Casualty Decontamination Protocols as Part of an Initial or Specialist Operational Response to Chemical Incidents.

PubMed

Chilcott, Robert P; Mitchell, Hannah; Matar, Hazem

2018-05-30

The UK's Initial Operational Response (IOR) is a new process for improving the survival of multiple casualties following a chemical, biological, radiological or nuclear incident. Whilst the introduction of IOR represents a patient-focused response for ambulant casualties, there is currently no provision for disrobe and dry decontamination of nonambulant casualties. Moreover, the current specialist operational response (SOR) protocol for nonambulant casualty decontamination (also referred to as "clinical decontamination") has not been subject to rigorous evaluation or development. Therefore, the aim of this study was to confirm the effectiveness of putatively optimized dry (IOR) and wet (SOR) protocols for nonambulant decontamination in human volunteers. Dry and wet decontamination protocols were objectively evaluated using human volunteers. Decontamination effectiveness was quantified by liquid chromatography-mass spectrometry analysis of the recovery of a chemical warfare agent simulant (methylsalicylate) from skin and hair of volunteers, with whole-body fluorescence imaging to quantify the skin distribution of residual simulant. Both the dry and wet decontamination processes were rapid (3 and 4 min, respectively) and were effective in removing simulant from the hair and skin of volunteers, with no observable adverse effects related to skin surface spreading of contaminant. Further studies are required to assess the combined effectiveness of dry and wet decontamination under more realistic conditions and to develop appropriate operational procedures that ensure the safety of first responders.

Transdisciplinary research for impact: protocol for a realist evaluation of the relationship between transdisciplinary research collaboration and knowledge translation.

PubMed

Archibald, Mandy M; Lawless, Michael; Harvey, Gillian; Kitson, Alison L

2018-04-07

Transdisciplinary teams are increasingly regarded as integral to conducting effective research. Similarly, knowledge translation is often seen as a solution to improving the relevance and benefits of health research. Yet, whether, how, for whom and under which circumstances transdisciplinary research influences knowledge translation is undertheorised, which limits its potential impact. The proposed research aims to identify the contexts and mechanisms by which transdisciplinary research contributes to developing shared understandings and behaviours of knowledge translation between team members. Using a longitudinal case-study design approach to realist evaluation, we outline a study protocol examining whether, how, if and for whom transdisciplinary collaboration can impact knowledge translation understandings and behaviours within a 5-year transdisciplinary Centre of Research Excellence. Data are being collected between February 2017 and December 2020 over four rounds of theory development, refinement and testing using interviews, observation, document review and visual elicitation as data sources. The Health Research Ethics Committee of the University of Adelaide approved this study. Findings will be communicated with team members at scheduled intervals throughout the study verbally and by means of creative reflective approaches (eg, arts elicitation, journalling). This research will be used to help support optimal team functioning by identifying strategies to support knowledge sharing and communication within and beyond the team to facilitate attainment of research objectives. Academic dissemination will occur through publication and presentations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The three stages of building and testing mid-level theories in a realist RCT: a theoretical and methodological case-example.

PubMed

Jamal, Farah; Fletcher, Adam; Shackleton, Nichola; Elbourne, Diana; Viner, Russell; Bonell, Chris

2015-10-15

Randomised controlled trials (RCTs) of social interventions are often criticised as failing to open the 'black box' whereby they only address questions about 'what works' without explaining the underlying processes of implementation and mechanisms of action, and how these vary by contextual characteristics of person and place. Realist RCTs are proposed as an approach to evaluation science that addresses these gaps while preserving the strengths of RCTs in providing evidence with strong internal validity in estimating effects. In the context of growing interest in designing and conducting realist trials, there is an urgent need to offer a worked example to provide guidance on how such an approach might be practically taken forward. The aim of this paper is to outline a three-staged theoretical and methodological process of undertaking a realist RCT using the example of the evaluation of a whole-school restorative intervention aiming to reduce aggression and bullying in English secondary schools. First, informed by the findings of our initial pilot trial and sociological theory, we elaborate our theory of change and specific a priori hypotheses about how intervention mechanisms interact with context to produce outcomes. Second, we describe how we will use emerging findings from the integral process evaluation within the RCT to refine, and add to, these a priori hypotheses before the collection of quantitative, follow-up data. Third, we will test our hypotheses using a combination of process and outcome data via quantitative analyses of effect mediation (examining mechanisms) and moderation (examining contextual contingencies). The results are then used to refine and further develop the theory of change. The aim of the realist RCT approach is thus not merely to assess whether the intervention is effective or not, but to develop empirically informed mid-range theory through a three-stage process. There are important implications for those involved with reporting and reviewing RCTs, including the use of new, iterative protocols. Current Controlled Trials ISRCTN10751359 (Registered 11 March 2014).

Security of Continuous-Variable Quantum Key Distribution via a Gaussian de Finetti Reduction

NASA Astrophysics Data System (ADS)

Leverrier, Anthony

2017-05-01

Establishing the security of continuous-variable quantum key distribution against general attacks in a realistic finite-size regime is an outstanding open problem in the field of theoretical quantum cryptography if we restrict our attention to protocols that rely on the exchange of coherent states. Indeed, techniques based on the uncertainty principle are not known to work for such protocols, and the usual tools based on de Finetti reductions only provide security for unrealistically large block lengths. We address this problem here by considering a new type of Gaussian de Finetti reduction, that exploits the invariance of some continuous-variable protocols under the action of the unitary group U (n ) (instead of the symmetric group Sn as in usual de Finetti theorems), and by introducing generalized S U (2 ,2 ) coherent states. Crucially, combined with an energy test, this allows us to truncate the Hilbert space globally instead as at the single-mode level as in previous approaches that failed to provide security in realistic conditions. Our reduction shows that it is sufficient to prove the security of these protocols against Gaussian collective attacks in order to obtain security against general attacks, thereby confirming rigorously the widely held belief that Gaussian attacks are indeed optimal against such protocols.

Security of Continuous-Variable Quantum Key Distribution via a Gaussian de Finetti Reduction.

PubMed

Leverrier, Anthony

2017-05-19

Establishing the security of continuous-variable quantum key distribution against general attacks in a realistic finite-size regime is an outstanding open problem in the field of theoretical quantum cryptography if we restrict our attention to protocols that rely on the exchange of coherent states. Indeed, techniques based on the uncertainty principle are not known to work for such protocols, and the usual tools based on de Finetti reductions only provide security for unrealistically large block lengths. We address this problem here by considering a new type of Gaussian de Finetti reduction, that exploits the invariance of some continuous-variable protocols under the action of the unitary group U(n) (instead of the symmetric group S_{n} as in usual de Finetti theorems), and by introducing generalized SU(2,2) coherent states. Crucially, combined with an energy test, this allows us to truncate the Hilbert space globally instead as at the single-mode level as in previous approaches that failed to provide security in realistic conditions. Our reduction shows that it is sufficient to prove the security of these protocols against Gaussian collective attacks in order to obtain security against general attacks, thereby confirming rigorously the widely held belief that Gaussian attacks are indeed optimal against such protocols.

Evaluation of a navigation system for dental implantation as a tool to train novice dental practitioners.

PubMed

Casap, Nardy; Nadel, Sahar; Tarazi, Eyal; Weiss, Ervin I

2011-10-01

This study evaluated the benefits of a virtual reality navigation system for teaching the surgical stage of dental implantation to final-year dental students. The study aimed to assess the students' performance in dental implantation assignments by comparing freehand protocols with virtual reality navigation. Forty final-year dentistry students without previous experience in dental implantation surgery were given an implantation assignment comprising 3 tasks. Marking, drilling, and widening of implant holes were executed by a freehand protocol on the 2 mandibular sides by 1 group and by virtual reality navigation on 1 side and contralaterally with the freehand protocol by the other group. Subjective and objective assessments of the students' performance were graded. Marking with the navigation system was more accurate than with the standard protocol. The 2 groups performed similarly in the 2-mm drilling on the 2 mandibular sides. Widening of the 2 mesial holes to 3 mm was significantly better with the second execution in the standard protocol group, but not in the navigation group. The navigation group's second-site freehand drilling of the molar was significantly worse than the first. The execution of all assignments was significantly faster in the freehand group than in the navigation group (60.75 vs 77.25 minutes, P = .02). Self-assessment only partly matched the objective measurements and was more realistic in the standard protocol group. Despite the improved performance with the navigation system, the added value of training in dental implantation surgery with virtual reality navigation was minimal. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Highly Realistic Training for Navy Corpsmen: A Follow-up Assessment

DTIC Science & Technology

2017-10-12

Highly Realistic Training for Navy Corpsmen: A Follow-Up Assessment Naval Health Research Center Stephanie Booth-Kewley, PhD Renée G...protection of human subjects in research (Protocol NHRC.2013.0019). Naval Health Research Center 140 Sylvester Road San Diego, California 92106...CAPT Marshall R. Monteville, Ph.D., MSC, USN Date Commanding Officer Naval Health Research Center San Diego 140 Sylvester Rd. San Diego, CA

SU-F-R-40: Robustness Test of Computed Tomography Textures of Lung Tissues to Varying Scanning Protocols Using a Realistic Phantom Environment

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

Lee, S; Markel, D; Hegyi, G

2016-06-15

Purpose: The reliability of computed tomography (CT) textures is an important element of radiomics analysis. This study investigates the dependency of lung CT textures on different breathing phases and changes in CT image acquisition protocols in a realistic phantom setting. Methods: We investigated 11 CT texture features for radiation-induced lung disease from 3 categories (first-order, grey level co-ocurrence matrix (GLCM), and Law’s filter). A biomechanical swine lung phantom was scanned at two breathing phases (inhale/exhale) and two scanning protocols set for PET/CT and diagnostic CT scanning. Lung volumes acquired from the CT images were divided into 2-dimensional sub-regions with amore » grid spacing of 31 mm. The distribution of the evaluated texture features from these sub-regions were compared between the two scanning protocols and two breathing phases. The significance of each factor on feature values were tested at 95% significance level using analysis of covariance (ANCOVA) model with interaction terms included. Robustness of a feature to a scanning factor was defined as non-significant dependence on the factor. Results: Three GLCM textures (variance, sum entropy, difference entropy) were robust to breathing changes. Two GLCM (variance, sum entropy) and 3 Law’s filter textures (S5L5, E5L5, W5L5) were robust to scanner changes. Moreover, the two GLCM textures (variance, sum entropy) were consistent across all 4 scanning conditions. First-order features, especially Hounsfield unit intensity features, presented the most drastic variation up to 39%. Conclusion: Amongst the studied features, GLCM and Law’s filter texture features were more robust than first-order features. However, the majority of the features were modified by either breathing phase or scanner changes, suggesting a need for calibration when retrospectively comparing scans obtained at different conditions. Further investigation is necessary to identify the sensitivity of individual image acquisition parameters.« less

Evaluation of a realtime, remote monitoring telemedicine system using the Bluetooth protocol and a mobile phone network.

PubMed

Jasemian, Yousef; Arendt-Nielsen, Lars

2005-01-01

A generic, realtime wireless telemedicine system has been developed that uses the Bluetooth protocol and the general packet radio service for mobile phones. The system was tested on 10 healthy volunteers, by continuous monitoring of their electrocardiograms (ECGs). Under realistic conditions, the system had 96.5% uptime, a data throughput of 3.3 kbit/s, a mean packet error rate of 8.5x10(-3) packet/s and a mean packet loss rate of 8.2x10(-3) packet/s. During 24 h testing, the total average downtime was 66 min and 90% of the periods of downtime were of only 1-3 min duration. Less than 10% of the ECGs were of unacceptable quality. Thus, the generic telemedicine system showed high reliability and performance, and the design may provide a foundation for realtime monitoring in clinical practice, for example in cardiology.

in silico Surveillance: evaluating outbreak detection with simulation models

PubMed Central

2013-01-01

Background Detecting outbreaks is a crucial task for public health officials, yet gaps remain in the systematic evaluation of outbreak detection protocols. The authors’ objectives were to design, implement, and test a flexible methodology for generating detailed synthetic surveillance data that provides realistic geographical and temporal clustering of cases and use to evaluate outbreak detection protocols. Methods A detailed representation of the Boston area was constructed, based on data about individuals, locations, and activity patterns. Influenza-like illness (ILI) transmission was simulated, producing 100 years of in silico ILI data. Six different surveillance systems were designed and developed using gathered cases from the simulated disease data. Performance was measured by inserting test outbreaks into the surveillance streams and analyzing the likelihood and timeliness of detection. Results Detection of outbreaks varied from 21% to 95%. Increased coverage did not linearly improve detection probability for all surveillance systems. Relaxing the decision threshold for signaling outbreaks greatly increased false-positives, improved outbreak detection slightly, and led to earlier outbreak detection. Conclusions Geographical distribution can be more important than coverage level. Detailed simulations of infectious disease transmission can be configured to represent nearly any conceivable scenario. They are a powerful tool for evaluating the performance of surveillance systems and methods used for outbreak detection. PMID:23343523

A mixed methods protocol to evaluate the effect and cost-effectiveness of an Integrated electronic Diagnosis Approach (IeDA) for the management of childhood illnesses at primary health facilities in Burkina Faso.

PubMed

Blanchet, Karl; Lewis, James J; Pozo-Martin, Francisco; Satouro, Arsene; Somda, Serge; Ilboudo, Patrick; Sarrassat, Sophie; Cousens, Simon

2016-08-04

Burkina Faso introduced the Integrated Management of Childhood Illnesses (IMCI) strategy in 2003. However, an evaluation conducted in 2013 found that only 28 % of children were assessed for three danger signs as recommended by IMCI, and only 15 % of children were correctly classified. About 30 % of children were correctly prescribed with an antibiotic for suspected pneumonia or oral rehydration salts (ORS) for diarrhoea, and 40 % were correctly referred. Recent advances in information and communication technologies (ICT) and use of electronic clinical protocols hold the potential to transform healthcare delivery in low-income countries. However, no evidence is available on the effect of ICT on adherence to IMCI. This paper describes the research protocol of a mixed methods study that aims to measure the effect of the Integrated electronic Diagnosis Approach innovation (an electronic IMCI protocol provided to nurses) in two regions of Burkina Faso. The study combines a stepped-wedge trial, a realistic evaluation and an economic study in order to capture the effect of the innovation after its introduction on the level of adherence, cost and acceptability. The main challenge is to interconnect the three substudies. In integrating outcome, process and cost data, we focus on three key questions: (i) How does the effectiveness and the cost of the intervention vary by type of health worker and type of health centre? (ii) What is the impact of changes in the content, coverage and quality of the IeDA intervention on adherence and cost-effectiveness? (iii) What mechanisms of change (including costs) might explain the relationship between the IeDA intervention and adherence? Clinicaltrials.gov, NCT02341469 .

Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol

PubMed Central

Talbot, Lise R; Gaboury, Isabelle

2017-01-01

Background Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. Methods and analysis Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. Ethics and dissemination This research project has received approval from the Comité d’éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences. PMID:28237962

Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol.

PubMed

Bergeron, Dave A; Talbot, Lise R; Gaboury, Isabelle

2017-02-24

Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. This research project has received approval from the Comité d'éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences. 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/.

Simple protocols for oblivious transfer and secure identification in the noisy-quantum-storage model

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

Schaffner, Christian

2010-09-15

We present simple protocols for oblivious transfer and password-based identification which are secure against general attacks in the noisy-quantum-storage model as defined in R. Koenig, S. Wehner, and J. Wullschleger [e-print arXiv:0906.1030]. We argue that a technical tool from Koenig et al. suffices to prove security of the known protocols. Whereas the more involved protocol for oblivious transfer from Koenig et al. requires less noise in storage to achieve security, our ''canonical'' protocols have the advantage of being simpler to implement and the security error is easier control. Therefore, our protocols yield higher OT rates for many realistic noise parameters.more » Furthermore, a proof of security of a direct protocol for password-based identification against general noisy-quantum-storage attacks is given.« less

An eCK-Secure Authenticated Key Exchange Protocol without Random Oracles

NASA Astrophysics Data System (ADS)

Moriyama, Daisuke; Okamoto, Tatsuaki

This paper presents a (PKI-based) two-pass authenticated key exchange (AKE) protocol that is secure in the extended Canetti-Krawczyk (eCK) security model. The security of the proposed protocol is proven without random oracles (under three assumptions), and relies on no implementation techniques such as a trick by LaMacchia, Lauter and Mityagin (so-called the NAXOS trick). Since an AKE protocol that is eCK-secure under a NAXOS-like implementation trick will be no more eCK-secure if some realistic information leakage occurs through side-channel attacks, it has been an important open problem how to realize an eCK-secure AKE protocol without using the NAXOS tricks (and without random oracles).

Method for decreasing CT simulation time of complex phantoms and systems through separation of material specific projection data

NASA Astrophysics Data System (ADS)

Divel, Sarah E.; Christensen, Soren; Wintermark, Max; Lansberg, Maarten G.; Pelc, Norbert J.

2017-03-01

Computer simulation is a powerful tool in CT; however, long simulation times of complex phantoms and systems, especially when modeling many physical aspects (e.g., spectrum, finite detector and source size), hinder the ability to realistically and efficiently evaluate and optimize CT techniques. Long simulation times primarily result from the tracing of hundreds of line integrals through each of the hundreds of geometrical shapes defined within the phantom. However, when the goal is to perform dynamic simulations or test many scan protocols using a particular phantom, traditional simulation methods inefficiently and repeatedly calculate line integrals through the same set of structures although only a few parameters change in each new case. In this work, we have developed a new simulation framework that overcomes such inefficiencies by dividing the phantom into material specific regions with the same time attenuation profiles, acquiring and storing monoenergetic projections of the regions, and subsequently scaling and combining the projections to create equivalent polyenergetic sinograms. The simulation framework is especially efficient for the validation and optimization of CT perfusion which requires analysis of many stroke cases and testing hundreds of scan protocols on a realistic and complex numerical brain phantom. Using this updated framework to conduct a 31-time point simulation with 80 mm of z-coverage of a brain phantom on two 16-core Linux serves, we have reduced the simulation time from 62 hours to under 2.6 hours, a 95% reduction.

Cryptography in the Bounded-Quantum-Storage Model

NASA Astrophysics Data System (ADS)

Schaffner, Christian

2007-09-01

This thesis initiates the study of cryptographic protocols in the bounded-quantum-storage model. On the practical side, simple protocols for Rabin Oblivious Transfer, 1-2 Oblivious Transfer and Bit Commitment are presented. No quantum memory is required for honest players, whereas the protocols can only be broken by an adversary controlling a large amount of quantum memory. The protocols are efficient, non-interactive and can be implemented with today's technology. On the theoretical side, new entropic uncertainty relations involving min-entropy are established and used to prove the security of protocols according to new strong security definitions. For instance, in the realistic setting of Quantum Key Distribution (QKD) against quantum-memory-bounded eavesdroppers, the uncertainty relation allows to prove the security of QKD protocols while tolerating considerably higher error rates compared to the standard model with unbounded adversaries.

Understanding how appraisal of doctors produces its effects: a realist review protocol

PubMed Central

Brennan, Nicola; Bryce, Marie; Pearson, Mark; Wong, Geoff; Cooper, Chris; Archer, Julian

2014-01-01

Introduction UK doctors are now required to participate in revalidation to maintain their licence to practise. Appraisal is a fundamental component of revalidation. However, objective evidence of appraisal changing doctors’ behaviour and directly resulting in improved patient care is limited. In particular, it is not clear how the process of appraisal is supposed to change doctors’ behaviour and improve clinical performance. The aim of this research is to understand how and why appraisal of doctors is supposed to produce its effect. Methods and analysis Realist review is a theory-driven interpretive approach to evidence synthesis. It applies realist logic of inquiry to produce an explanatory analysis of an intervention that is, what works, for whom, in what circumstances, in what respects. Using a realist review approach, an initial programme theory of appraisal will be developed by consulting with key stakeholders in doctors’ appraisal in expert panels (ethical approval is not required), and by searching the literature to identify relevant existing theories. The search strategy will have a number of phases including a combination of: (1) electronic database searching, for example, EMBASE, MEDLINE, the Cochrane Library, ASSIA, (2) ‘cited by’ articles search, (3) citation searching, (4) contacting authors and (5) grey literature searching. The search for evidence will be iteratively extended and refocused as the review progresses. Studies will be included based on their ability to provide data that enable testing of the programme theory. Data extraction will be conducted, for example, by note taking and annotation at different review stages as is consistent with the realist approach. The evidence will be synthesised using realist logic to interrogate the final programme theory of the impact of appraisal on doctors’ performance. The synthesis results will be written up according to RAMESES guidelines and disseminated through peer-reviewed publication and presentations. Trial registration number The protocol is registered with PROSPERO 2014:CRD42014007092. PMID:24958211

Faked state attacks on realistic round robin DPS quantum key distribution systems and countermeasure

NASA Astrophysics Data System (ADS)

Iwakoshi, T.

2015-05-01

In May 2014, a new quantum key distribution protocol named "Round Robin Differential-Phase-Shift Quantum Key Distribution (RR DPS QKD)" was proposed. It has a special feature that the key consumption via privacy amplification is a small constant because RR DPS QKD guarantees its security by information causality, not by information-disturbance trade-off. Therefore, the authors claimed that RR DPS QKD systems does not need to monitor the disturbance by an attacker in the quantum channel. However, this study shows that a modified Faked-State Attack (or so-called bright illumination attack) can hack a RR DPS QKD system almost perfectly if it is implemented with realistic detectors even information-causality guarantees the security of RR DPS QKD protocol. Therefore, this study also proposes a possible Measurement-Device-Independent RR DPS QKD system to avoid the modified Faked-State Attack.

Optimized spatio-temporal descriptors for real-time fall detection: comparison of support vector machine and Adaboost-based classification

NASA Astrophysics Data System (ADS)

Charfi, Imen; Miteran, Johel; Dubois, Julien; Atri, Mohamed; Tourki, Rached

2013-10-01

We propose a supervised approach to detect falls in a home environment using an optimized descriptor adapted to real-time tasks. We introduce a realistic dataset of 222 videos, a new metric allowing evaluation of fall detection performance in a video stream, and an automatically optimized set of spatio-temporal descriptors which fed a supervised classifier. We build the initial spatio-temporal descriptor named STHF using several combinations of transformations of geometrical features (height and width of human body bounding box, the user's trajectory with her/his orientation, projection histograms, and moments of orders 0, 1, and 2). We study the combinations of usual transformations of the features (Fourier transform, wavelet transform, first and second derivatives), and we show experimentally that it is possible to achieve high performance using support vector machine and Adaboost classifiers. Automatic feature selection allows to show that the best tradeoff between classification performance and processing time is obtained by combining the original low-level features with their first derivative. Hence, we evaluate the robustness of the fall detection regarding location changes. We propose a realistic and pragmatic protocol that enables performance to be improved by updating the training in the current location with normal activities records.

The Traffic Adaptive Data Dissemination (TrAD) Protocol for both Urban and Highway Scenarios.

PubMed

Tian, Bin; Hou, Kun Mean; Zhou, Haiying

2016-06-21

The worldwide economic cost of road crashes and injuries is estimated to be US$518 billion per year and the annual congestion cost in France is estimated to be €5.9 billion. Vehicular Ad hoc Networks (VANETs) are one solution to improve transport features such as traffic safety, traffic jam and infotainment on wheels, where a great number of event-driven messages need to be disseminated in a timely way in a region of interest. In comparison with traditional wireless networks, VANETs have to consider the highly dynamic network topology and lossy links due to node mobility. Inter-Vehicle Communication (IVC) protocols are the keystone of VANETs. According to our survey, most of the proposed IVC protocols focus on either highway or urban scenarios, but not on both. Furthermore, too few protocols, considering both scenarios, can achieve high performance. In this paper, an infrastructure-less Traffic Adaptive data Dissemination (TrAD) protocol which takes into account road traffic and network traffic status for both highway and urban scenarios will be presented. TrAD has double broadcast suppression techniques and is designed to adapt efficiently to the irregular road topology. The performance of the TrAD protocol was evaluated quantitatively by means of realistic simulations taking into account different real road maps, traffic routes and vehicular densities. The obtained simulation results show that TrAD is more efficient in terms of packet delivery ratio, number of transmissions and delay in comparison with the performance of three well-known reference protocols. Moreover, TrAD can also tolerate a reasonable degree of GPS drift and still achieve efficient data dissemination.

The Traffic Adaptive Data Dissemination (TrAD) Protocol for both Urban and Highway Scenarios

PubMed Central

Tian, Bin; Hou, Kun Mean; Zhou, Haiying

2016-01-01

The worldwide economic cost of road crashes and injuries is estimated to be US$518 billion per year and the annual congestion cost in France is estimated to be €5.9 billion. Vehicular Ad hoc Networks (VANETs) are one solution to improve transport features such as traffic safety, traffic jam and infotainment on wheels, where a great number of event-driven messages need to be disseminated in a timely way in a region of interest. In comparison with traditional wireless networks, VANETs have to consider the highly dynamic network topology and lossy links due to node mobility. Inter-Vehicle Communication (IVC) protocols are the keystone of VANETs. According to our survey, most of the proposed IVC protocols focus on either highway or urban scenarios, but not on both. Furthermore, too few protocols, considering both scenarios, can achieve high performance. In this paper, an infrastructure-less Traffic Adaptive data Dissemination (TrAD) protocol which takes into account road traffic and network traffic status for both highway and urban scenarios will be presented. TrAD has double broadcast suppression techniques and is designed to adapt efficiently to the irregular road topology. The performance of the TrAD protocol was evaluated quantitatively by means of realistic simulations taking into account different real road maps, traffic routes and vehicular densities. The obtained simulation results show that TrAD is more efficient in terms of packet delivery ratio, number of transmissions and delay in comparison with the performance of three well-known reference protocols. Moreover, TrAD can also tolerate a reasonable degree of GPS drift and still achieve efficient data dissemination. PMID:27338393

Realist complex intervention science: Applying realist principles across all phases of the Medical Research Council framework for developing and evaluating complex interventions

PubMed Central

Fletcher, Adam; Jamal, Farah; Moore, Graham; Evans, Rhiannon E.; Murphy, Simon; Bonell, Chris

2016-01-01

The integration of realist evaluation principles within randomised controlled trials (‘realist RCTs’) enables evaluations of complex interventions to answer questions about what works, for whom and under what circumstances. This allows evaluators to better develop and refine mid-level programme theories. However, this is only one phase in the process of developing and evaluating complex interventions. We describe and exemplify how social scientists can integrate realist principles across all phases of the Medical Research Council framework. Intervention development, modelling, and feasibility and pilot studies need to theorise the contextual conditions necessary for intervention mechanisms to be activated. Where interventions are scaled up and translated into routine practice, realist principles also have much to offer in facilitating knowledge about longer-term sustainability, benefits and harms. Integrating a realist approach across all phases of complex intervention science is vital for considering the feasibility and likely effects of interventions for different localities and population subgroups. PMID:27478401

Study protocol: realist evaluation of effectiveness and sustainability of a community health workers programme in improving maternal and child health in Nigeria.

PubMed

Mirzoev, Tolib; Etiaba, Enyi; Ebenso, Bassey; Uzochukwu, Benjamin; Manzano, Ana; Onwujekwe, Obinna; Huss, Reinhard; Ezumah, Nkoli; Hicks, Joseph P; Newell, James; Ensor, Timothy

2016-06-07

Achievement of improved maternal and child health (MCH) outcomes continues to be an issue of international priority, particularly for sub-Saharan African countries such as Nigeria. Evidence suggests that the use of Community Health Workers (CHWs) can be effective in broadening access to, and coverage of, health services and improving MCH outcomes in such countries. In this paper, we report the methodology for a 5-year study which aims to evaluate the context, processes, outcomes and longer-term sustainability of a Nigerian CHW scheme. Evaluation of complex interventions requires a comprehensive understanding of intervention context, mechanisms and outcomes. The multidisciplinary and mixed-method realist approach will facilitate such evaluation. A favourable policy environment within which the study is conducted will ensure the successful uptake of results into policy and practice. A realist evaluation provides an overall methodological framework for this multidisciplinary and mixed methods research, which will be undertaken in Anambra state. The study will draw upon health economics, social sciences and statistics. The study comprises three steps: (1) initial theory development; (2) theory validation and (3) theory refinement and development of lessons learned. Specific methods for data collection will include in-depth interviews and focus group discussions with purposefully identified key stakeholders (managers, service providers and service users), document reviews, analyses of quantitative data from the CHW programme and health information system, and a small-scale survey. The impact of the programme on key output and outcome indicators will be assessed through an interrupted time-series analysis (ITS) of monthly quantitative data from health information system and programme reports. Ethics approvals for this study were obtained from the University of Leeds and the University of Nigeria. This study will provide a timely and important contribution to health systems strengthening specifically within Anambra state in southeast Nigeria but also more widely across Nigeria. This paper should be of interest to researchers who are interested in adapting and applying robust methodologies for assessing complex health system interventions. The paper will also be useful to policymakers and practitioners who are interested in commissioning and engaging in such complex evaluations to inform policies and practices.

Characterization of tissue-simulating phantom materials for ultrasound-guided needle procedures

NASA Astrophysics Data System (ADS)

Buchanan, Susan; Moore, John; Lammers, Deanna; Baxter, John; Peters, Terry

2012-02-01

Needle biopsies are standard protocols that are commonly performed under ultrasound (US) guidance or computed tomography (CT)1. Vascular access such as central line insertions, and many spinal needle therapies also rely on US guidance. Phantoms for these procedures are crucial as both training tools for clinicians and research tools for developing new guidance systems. Realistic imaging properties and material longevity are critical qualities for needle guidance phantoms. However, current commercially available phantoms for use with US guidance have many limitations, the most detrimental of which include harsh needle tracks obfuscating US images and a membrane comparable to human skin that does not allow seepage of inner media. To overcome these difficulties, we tested a variety of readily available media and membranes to evaluate optimal materials to fit our current needs. It was concluded that liquid hand soap was the best medium, as it instantly left no needle tracks, had an acceptable depth of US penetration and portrayed realistic imaging conditions, while because of its low leakage, low cost, acceptable durability and transparency, the optimal membrane was 10 gauge vinyl.

Distributional assumptions in food and feed commodities- development of fit-for-purpose sampling protocols.

PubMed

Paoletti, Claudia; Esbensen, Kim H

2015-01-01

Material heterogeneity influences the effectiveness of sampling procedures. Most sampling guidelines used for assessment of food and/or feed commodities are based on classical statistical distribution requirements, the normal, binomial, and Poisson distributions-and almost universally rely on the assumption of randomness. However, this is unrealistic. The scientific food and feed community recognizes a strong preponderance of non random distribution within commodity lots, which should be a more realistic prerequisite for definition of effective sampling protocols. Nevertheless, these heterogeneity issues are overlooked as the prime focus is often placed only on financial, time, equipment, and personnel constraints instead of mandating acquisition of documented representative samples under realistic heterogeneity conditions. This study shows how the principles promulgated in the Theory of Sampling (TOS) and practically tested over 60 years provide an effective framework for dealing with the complete set of adverse aspects of both compositional and distributional heterogeneity (material sampling errors), as well as with the errors incurred by the sampling process itself. The results of an empirical European Union study on genetically modified soybean heterogeneity, Kernel Lot Distribution Assessment are summarized, as they have a strong bearing on the issue of proper sampling protocol development. TOS principles apply universally in the food and feed realm and must therefore be considered the only basis for development of valid sampling protocols free from distributional constraints.

Exploitation of realistic computational anthropomorphic phantoms for the optimization of nuclear imaging acquisition and processing protocols.

PubMed

Loudos, George K; Papadimitroulas, Panagiotis G; Kagadis, George C

2014-01-01

Monte Carlo (MC) simulations play a crucial role in nuclear medical imaging since they can provide the ground truth for clinical acquisitions, by integrating and quantifing all physical parameters that affect image quality. The last decade a number of realistic computational anthropomorphic models have been developed to serve imaging, as well as other biomedical engineering applications. The combination of MC techniques with realistic computational phantoms can provide a powerful tool for pre and post processing in imaging, data analysis and dosimetry. This work aims to create a global database for simulated Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) exams and the methodology, as well as the first elements are presented. Simulations are performed using the well validated GATE opensource toolkit, standard anthropomorphic phantoms and activity distribution of various radiopharmaceuticals, derived from literature. The resulting images, projections and sinograms of each study are provided in the database and can be further exploited to evaluate processing and reconstruction algorithms. Patient studies using different characteristics are included in the database and different computational phantoms were tested for the same acquisitions. These include the XCAT, Zubal and the Virtual Family, which some of which are used for the first time in nuclear imaging. The created database will be freely available and our current work is towards its extension by simulating additional clinical pathologies.

Continuous-variable quantum key distribution in uniform fast-fading channels

NASA Astrophysics Data System (ADS)

Papanastasiou, Panagiotis; Weedbrook, Christian; Pirandola, Stefano

2018-03-01

We investigate the performance of several continuous-variable quantum key distribution protocols in the presence of uniform fading channels. These are lossy channels whose transmissivity changes according to a uniform probability distribution. We assume the worst-case scenario where an eavesdropper induces a fast-fading process, where she chooses the instantaneous transmissivity while the remote parties may only detect the mean statistical effect. We analyze coherent-state protocols in various configurations, including the one-way switching protocol in reverse reconciliation, the measurement-device-independent protocol in the symmetric configuration, and its extension to a three-party network. We show that, regardless of the advantage given to the eavesdropper (control of the fading), these protocols can still achieve high rates under realistic attacks, within reasonable values for the variance of the probability distribution associated with the fading process.

Development of a program theory for shared decision-making: a realist review protocol.

PubMed

Groot, Gary; Waldron, Tamara; Carr, Tracey; McMullen, Linda; Bandura, Lori-Ann; Neufeld, Shelley-May; Duncan, Vicky

2017-06-17

The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions. In this protocol, we outline a study that will explore: "In which situations, how, why, and for whom does SDM between patients and health care providers contribute to improved decision making?" A seven step iterative process will be described including preliminary theory development, establishment of a search strategy, selection and appraisal of literature, data extraction, analysis and synthesis of extracted results from literature, and formation of a revised program theory with the input of patients, physicians, nurse navigators, and policy makers from a stakeholder session. The goal of the realist review will be to identify and refine a program theory for SDM through the identification of mechanisms which shape the characteristics of when, how, and why SDM will, and will not, work. PROSPERO CRD42017062609.

Collective attacks and unconditional security in continuous variable quantum key distribution.

PubMed

Grosshans, Frédéric

2005-01-21

We present here an information theoretic study of Gaussian collective attacks on the continuous variable key distribution protocols based on Gaussian modulation of coherent states. These attacks, overlooked in previous security studies, give a finite advantage to the eavesdropper in the experimentally relevant lossy channel, but are not powerful enough to reduce the range of the reverse reconciliation protocols. Secret key rates are given for the ideal case where Bob performs optimal collective measurements, as well as for the realistic cases where he performs homodyne or heterodyne measurements. We also apply the generic security proof of Christiandl et al. to obtain unconditionally secure rates for these protocols.

Process evaluation of a primary healthcare validation study of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people: study protocol.

PubMed

Farnbach, Sara; Evans, John; Eades, Anne-Marie; Gee, Graham; Fernando, Jamie; Hammond, Belinda; Simms, Matty; DeMasi, Karrina; Hackett, Maree

2017-11-03

Process evaluations are conducted alongside research projects to identify the context, impact and consequences of research, determine whether it was conducted per protocol and to understand how, why and for whom an intervention is effective. We present a process evaluation protocol for the Getting it Right research project, which aims to determine validity of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people. In this process evaluation, we aim to: (1) explore the context, impact and consequences of conducting Getting It Right, (2) explore primary healthcare staff and community representatives' experiences with the research project, (3) determine if it was conducted per protocol and (4) explore experiences with the depression screening tool, including perceptions about how it could be implemented into practice (if found to be valid). We also describe the partnerships established to conduct this process evaluation and how the national Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research is met. Realist and grounded theory approaches are used. Qualitative data include semistructured interviews with primary healthcare staff and community representatives involved with Getting it Right. Iterative data collection and analysis will inform a coding framework. Interviews will continue until saturation of themes is reached, or all participants are considered. Data will be triangulated against administrative data and patient feedback. An Aboriginal and Torres Strait Islander Advisory Group guides this research. Researchers will be blinded from validation data outcomes for as long as is feasible. The University of Sydney Human Research Ethics Committee, Aboriginal Health and Medical Research Council of New South Wales and six state ethics committees have approved this research. Findings will be submitted to academic journals and presented at conferences. ACTRN12614000705684. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

XCAT/DRASIM: a realistic CT/human-model simulation package

NASA Astrophysics Data System (ADS)

Fung, George S. K.; Stierstorfer, Karl; Segars, W. Paul; Taguchi, Katsuyuki; Flohr, Thomas G.; Tsui, Benjamin M. W.

2011-03-01

The aim of this research is to develop a complete CT/human-model simulation package by integrating the 4D eXtended CArdiac-Torso (XCAT) phantom, a computer generated NURBS surface based phantom that provides a realistic model of human anatomy and respiratory and cardiac motions, and the DRASIM (Siemens Healthcare) CT-data simulation program. Unlike other CT simulation tools which are based on simple mathematical primitives or voxelized phantoms, this new simulation package has the advantages of utilizing a realistic model of human anatomy and physiological motions without voxelization and with accurate modeling of the characteristics of clinical Siemens CT systems. First, we incorporated the 4D XCAT anatomy and motion models into DRASIM by implementing a new library which consists of functions to read-in the NURBS surfaces of anatomical objects and their overlapping order and material properties in the XCAT phantom. Second, we incorporated an efficient ray-tracing algorithm for line integral calculation in DRASIM by computing the intersection points of the rays cast from the x-ray source to the detector elements through the NURBS surfaces of the multiple XCAT anatomical objects along the ray paths. Third, we evaluated the integrated simulation package by performing a number of sample simulations of multiple x-ray projections from different views followed by image reconstruction. The initial simulation results were found to be promising by qualitative evaluation. In conclusion, we have developed a unique CT/human-model simulation package which has great potential as a tool in the design and optimization of CT scanners, and the development of scanning protocols and image reconstruction methods for improving CT image quality and reducing radiation dose.

Quantum key distribution with finite resources: Secret key rates via Renyi entropies

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

Abruzzo, Silvestre; Kampermann, Hermann; Mertz, Markus

A realistic quantum key distribution (QKD) protocol necessarily deals with finite resources, such as the number of signals exchanged by the two parties. We derive a bound on the secret key rate which is expressed as an optimization problem over Renyi entropies. Under the assumption of collective attacks by an eavesdropper, a computable estimate of our bound for the six-state protocol is provided. This bound leads to improved key rates in comparison to previous results.

Realist theory construction for a mixed method multilevel study of neighbourhood context and postnatal depression.

PubMed

Eastwood, John G; Kemp, Lynn A; Jalaludin, Bin B

2016-01-01

We have recently described a protocol for a study that aims to build a theory of neighbourhood context and postnatal depression. That protocol proposed a critical realist Explanatory Theory Building Method comprising of an: (1) emergent phase, (2) construction phase, and (3) confirmatory phase. A concurrent triangulated mixed method multilevel cross-sectional study design was described. The protocol also described in detail the Theory Construction Phase which will be presented here. The Theory Construction Phase will include: (1) defining stratified levels; (2) analytic resolution; (3) abductive reasoning; (4) comparative analysis (triangulation); (5) retroduction; (6) postulate and proposition development; (7) comparison and assessment of theories; and (8) conceptual frameworks and model development. The stratified levels of analysis in this study were predominantly social and psychological. The abductive analysis used the theoretical frames of: Stress Process; Social Isolation; Social Exclusion; Social Services; Social Capital, Acculturation Theory and Global-economic level mechanisms. Realist propositions are presented for each analysis of triangulated data. Inference to best explanation is used to assess and compare theories. A conceptual framework of maternal depression, stress and context is presented that includes examples of mechanisms at psychological, social, cultural and global-economic levels. Stress was identified as a necessary mechanism that has the tendency to cause several outcomes including depression, anxiety, and health harming behaviours. The conceptual framework subsequently included conditional mechanisms identified through the retroduction including the stressors of isolation and expectations and buffers of social support and trust. The meta-theory of critical realism is used here to generate and construct social epidemiological theory using stratified ontology and both abductive and retroductive analysis. The findings will be applied to the development of a middle range theory and subsequent programme theory for local perinatal child and family interventions.

Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study

PubMed Central

Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke JAH; Schoonhoven, Lisette; Koopmans, Raymond TCM; Laurant, Miranda GH

2017-01-01

Introduction In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. Methods and analysis This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context–mechanism–outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. Ethics and dissemination The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. PMID:28600370

Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study.

PubMed

Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke J A H; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H

2017-06-08

In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol

PubMed Central

Mukumbang, Ferdinand C; Van Belle, Sara; Marchal, Bruno; Van Wyk, Brian

2016-01-01

Introduction Suboptimal retention in care and poor treatment adherence are key challenges to antiretroviral therapy (ART) in sub-Saharan Africa. Community-based approaches to HIV service delivery are recommended to improve patient retention in care and ART adherence. The implementation of the adherence clubs in the Western Cape province of South Africa was with variable success in terms of implementation and outcomes. The need for operational guidelines for its implementation has been identified. Therefore, understanding the contexts and mechanisms for successful implementation of the adherence clubs is crucial to inform the roll-out to the rest of South Africa. The protocol outlines an evaluation of adherence club intervention in selected primary healthcare facilities in the metropolitan area of the Western Cape Province, using the realist approach. Methods and analysis In the first phase, an exploratory study design will be used. Document review and key informant interviews will be used to elicit the programme theory. In phase two, a multiple case study design will be used to describe the adherence clubs in five contrastive sites. Semistructured interviews will be conducted with purposively selected programme implementers and members of the clubs to assess the context and mechanisms of the adherence clubs. For the programme's primary outcomes, a longitudinal retrospective cohort analysis will be conducted using routine patient data. Data analysis will involve classifying emerging themes using the context-mechanism-outcome (CMO) configuration, and refining the primary CMO configurations to conjectured CMO configurations. Finally, we will compare the conjectured CMO configurations from the cases with the initial programme theory. The final CMOs obtained will be translated into middle range theories. Ethics and dissemination The study will be conducted according to the principles of the declaration of Helsinki (1964). Ethics clearance was obtained from the University of the Western Cape. Dissemination will be done through publications and curation. PMID:27044575

Two-dimensional distributed-phase-reference protocol for quantum key distribution

NASA Astrophysics Data System (ADS)

Bacco, Davide; Christensen, Jesper Bjerge; Castaneda, Mario A. Usuga; Ding, Yunhong; Forchhammer, Søren; Rottwitt, Karsten; Oxenløwe, Leif Katsuo

2016-12-01

Quantum key distribution (QKD) and quantum communication enable the secure exchange of information between remote parties. Currently, the distributed-phase-reference (DPR) protocols, which are based on weak coherent pulses, are among the most practical solutions for long-range QKD. During the last 10 years, long-distance fiber-based DPR systems have been successfully demonstrated, although fundamental obstacles such as intrinsic channel losses limit their performance. Here, we introduce the first two-dimensional DPR-QKD protocol in which information is encoded in the time and phase of weak coherent pulses. The ability of extracting two bits of information per detection event, enables a higher secret key rate in specific realistic network scenarios. Moreover, despite the use of more dimensions, the proposed protocol remains simple, practical, and fully integrable.

Two-dimensional distributed-phase-reference protocol for quantum key distribution.

PubMed

Bacco, Davide; Christensen, Jesper Bjerge; Castaneda, Mario A Usuga; Ding, Yunhong; Forchhammer, Søren; Rottwitt, Karsten; Oxenløwe, Leif Katsuo

2016-12-22

Quantum key distribution (QKD) and quantum communication enable the secure exchange of information between remote parties. Currently, the distributed-phase-reference (DPR) protocols, which are based on weak coherent pulses, are among the most practical solutions for long-range QKD. During the last 10 years, long-distance fiber-based DPR systems have been successfully demonstrated, although fundamental obstacles such as intrinsic channel losses limit their performance. Here, we introduce the first two-dimensional DPR-QKD protocol in which information is encoded in the time and phase of weak coherent pulses. The ability of extracting two bits of information per detection event, enables a higher secret key rate in specific realistic network scenarios. Moreover, despite the use of more dimensions, the proposed protocol remains simple, practical, and fully integrable.

Two-dimensional distributed-phase-reference protocol for quantum key distribution

PubMed Central

Bacco, Davide; Christensen, Jesper Bjerge; Castaneda, Mario A. Usuga; Ding, Yunhong; Forchhammer, Søren; Rottwitt, Karsten; Oxenløwe, Leif Katsuo

2016-01-01

Quantum key distribution (QKD) and quantum communication enable the secure exchange of information between remote parties. Currently, the distributed-phase-reference (DPR) protocols, which are based on weak coherent pulses, are among the most practical solutions for long-range QKD. During the last 10 years, long-distance fiber-based DPR systems have been successfully demonstrated, although fundamental obstacles such as intrinsic channel losses limit their performance. Here, we introduce the first two-dimensional DPR-QKD protocol in which information is encoded in the time and phase of weak coherent pulses. The ability of extracting two bits of information per detection event, enables a higher secret key rate in specific realistic network scenarios. Moreover, despite the use of more dimensions, the proposed protocol remains simple, practical, and fully integrable. PMID:28004821

Understanding how appraisal of doctors produces its effects: a realist review protocol.

PubMed

Brennan, Nicola; Bryce, Marie; Pearson, Mark; Wong, Geoff; Cooper, Chris; Archer, Julian

2014-06-23

UK doctors are now required to participate in revalidation to maintain their licence to practise. Appraisal is a fundamental component of revalidation. However, objective evidence of appraisal changing doctors' behaviour and directly resulting in improved patient care is limited. In particular, it is not clear how the process of appraisal is supposed to change doctors' behaviour and improve clinical performance. The aim of this research is to understand how and why appraisal of doctors is supposed to produce its effect. Realist review is a theory-driven interpretive approach to evidence synthesis. It applies realist logic of inquiry to produce an explanatory analysis of an intervention that is, what works, for whom, in what circumstances, in what respects. Using a realist review approach, an initial programme theory of appraisal will be developed by consulting with key stakeholders in doctors' appraisal in expert panels (ethical approval is not required), and by searching the literature to identify relevant existing theories. The search strategy will have a number of phases including a combination of: (1) electronic database searching, for example, EMBASE, MEDLINE, the Cochrane Library, ASSIA, (2) 'cited by' articles search, (3) citation searching, (4) contacting authors and (5) grey literature searching. The search for evidence will be iteratively extended and refocused as the review progresses. Studies will be included based on their ability to provide data that enable testing of the programme theory. Data extraction will be conducted, for example, by note taking and annotation at different review stages as is consistent with the realist approach. The evidence will be synthesised using realist logic to interrogate the final programme theory of the impact of appraisal on doctors' performance. The synthesis results will be written up according to RAMESES guidelines and disseminated through peer-reviewed publication and presentations. The protocol is registered with PROSPERO 2014:CRD42014007092. 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.

Protocol-based care: the standardisation of decision-making?

PubMed

Rycroft-Malone, Jo; Fontenla, Marina; Seers, Kate; Bick, Debra

2009-05-01

To explore how protocol-based care affects clinical decision-making. In the context of evidence-based practice, protocol-based care is a mechanism for facilitating the standardisation of care and streamlining decision-making through rationalising the information with which to make judgements and ultimately decisions. However, whether protocol-based care does, in the reality of practice, standardise decision-making is unknown. This paper reports on a study that explored the impact of protocol-based care on nurses' decision-making. Theoretically informed by realistic evaluation and the promoting action on research implementation in health services framework, a case study design using ethnographic methods was used. Two sites were purposively sampled; a diabetic and endocrine unit and a cardiac medical unit. Within each site, data collection included observation, postobservation semi-structured interviews with staff and patients, field notes, feedback sessions and document review. Data were inductively and thematically analysed. Decisions made by nurses in both sites were varied according to many different and interacting factors. While several standardised care approaches were available for use, in reality, a variety of information sources informed decision-making. The primary approach to knowledge exchange and acquisition was person-to-person; decision-making was a social activity. Rarely were standardised care approaches obviously referred to; nurses described following a mental flowchart, not necessarily linked to a particular guideline or protocol. When standardised care approaches were used, it was reported that they were used flexibly and particularised. While the logic of protocol-based care is algorithmic, in the reality of clinical practice, other sources of information supported nurses' decision-making process. This has significant implications for the political goal of standardisation. The successful implementation and judicious use of tools such as protocols and guidelines will likely be dependant on approaches that facilitate the development of nurses' decision-making processes in parallel to paying attention to the influence of context.

Understanding how and why audits work: protocol for a realist review of audit programmes to improve hospital care.

PubMed

Hut-Mossel, Lisanne; Welker, Gera; Ahaus, Kees; Gans, Rijk

2017-06-14

Many types of audits are commonly used in hospital care to promote quality improvements. However, the evidence on the effectiveness of audits is mixed. The objectives of this proposed realist review are (1) to understand how and why audits might, or might not, work in terms of delivering the intended outcome of improved quality of hospital care and (2) to examine under what circumstances audits could potentially be effective. This protocol will provide the rationale for using a realist review approach and outline the method. This review will be conducted using an iterative four-stage approach. The first and second steps have already been executed. The first step was to develop an initial programme theory based on the literature that explains how audits are supposed to work. Second, a systematic literature search was conducted using relevant databases. Third, data will be extracted and coded for concepts relating to context, outcomes and their interrelatedness. Finally, the data will be synthesised in a five-step process: (1) organising the extracted data into evidence tables, (2) theming, (3) formulating chains of inference from the identified themes, (4) linking the chains of inference and formulating CMO configurations and (5) refining the initial programme theory. The reporting of the review will follow the 'Realist and Meta-Review Evidence Synthesis: Evolving Standards' (RAMESES) publication standards. This review does not require formal ethical approval. A better understanding of how and why these audits work, and how context impacts their effectiveness, will inform stakeholders in deciding how to tailor and implement audits within their local context. We will use a range of dissemination strategies to ensure that findings from this realist review are broadly disseminated to academic and non-academic audiences. CRD42016039882. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

EVA Human Health and Performance Benchmarking Study Overview and Development of a Microgravity Protocol

NASA Technical Reports Server (NTRS)

Norcross, Jason; Jarvis, Sarah; Bekdash, Omar; Cupples, Scott; Abercromby, Andrew

2017-01-01

The primary objective of this study is to develop a protocol to reliably characterize human health and performance metrics for individuals working inside various EVA suits under realistic spaceflight conditions. Expected results and methodologies developed during this study will provide the baseline benchmarking data and protocols with which future EVA suits and suit configurations (e.g., varied pressure, mass, center of gravity [CG]) and different test subject populations (e.g., deconditioned crewmembers) may be reliably assessed and compared. Results may also be used, in conjunction with subsequent testing, to inform fitness-for-duty standards, as well as design requirements and operations concepts for future EVA suits and other exploration systems.

Experiences with ATM in a multivendor pilot system at Forschungszentrum Julich

NASA Astrophysics Data System (ADS)

Kleines, H.; Ziemons, K.; Zwoll, K.

1998-08-01

The ATM technology for high speed serial transmission provides a new quality of communication by introducing novel features in a LAN environment, especially support of real time communication, of both LAN and WAN communication and of multimedia streams. In order to evaluate ATM for future DAQ systems and remote control systems as well as for a high speed picture archiving and communications system for medical images, Forschungszentrum Julich has build up a pilot system for the evaluation of ATM and standard low cost multimedia systems. It is a heterogeneous multivendor system containing a variety of switches and desktop solutions, employing different protocol options of ATM. The tests conducted in the pilot system revealed major difficulties regarding stability, interoperability and performance. The paper presents motivations, layout and results of the pilot system. Discussion of results concentrates on performance issues relevant for realistic applications, e.g., connection to a RAID system via NFS over ATM.

Safety assessment of ultra-wideband antennas for microwave breast imaging.

PubMed

De Santis, Valerio; Sill, Jeff M; Bourqui, Jeremie; Fear, Elise C

2012-04-01

This article deals with the safety assessment of several ultra-wideband (UWB) antenna designs for use in prototype microwave breast imaging systems. First, the performances of the antennas are validated by comparison of measured and simulated data collected for a simple test case. An efficient approach to estimating the specific energy absorption (SA) is introduced and validated. Next, SA produced by the UWB antennas inside more realistic breast models is computed. In particular, the power levels and pulse repetition periods adopted for the SA evaluation follow the measurement protocol employed by a tissue sensing adaptive radar (TSAR) prototype system. Results indicate that the SA for the antennas examined is below limits prescribed in standards for exposure of the general population; however, the difficulties inherent in applying such standards to UWB exposures are discussed. The results also suggest that effective tools for the rapid evaluation of new sensors have been developed. © 2011 Wiley Periodicals, Inc.

Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India

PubMed Central

Liu, Hueiming; Lindley, Richard; Alim, Mohammed; Felix, Cynthia; Gandhi, Dorcas B C; Verma, Shweta J; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Ramamurthy, Ramaprabhu Krishnappa; Pandian, Jeyaraj D; Walker, Marion; Forster, Anne; Anderson, Craig S; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree L; Maulik, Pallab K; Harvey, Lisa A; Jan, Stephen

2016-01-01

Introduction We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. Methods and analysis The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation. Ethics and dissemination The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation. Trial registration number CTRI/2013/04/003557. PMID:27633636

Space Link Extension Protocol Emulation for High-Throughput, High-Latency Network Connections

NASA Technical Reports Server (NTRS)

Tchorowski, Nicole; Murawski, Robert

2014-01-01

New space missions require higher data rates and new protocols to meet these requirements. These high data rate space communication links push the limitations of not only the space communication links, but of the ground communication networks and protocols which forward user data to remote ground stations (GS) for transmission. The Consultative Committee for Space Data Systems, (CCSDS) Space Link Extension (SLE) standard protocol is one protocol that has been proposed for use by the NASA Space Network (SN) Ground Segment Sustainment (SGSS) program. New protocol implementations must be carefully tested to ensure that they provide the required functionality, especially because of the remote nature of spacecraft. The SLE protocol standard has been tested in the NASA Glenn Research Center's SCENIC Emulation Lab in order to observe its operation under realistic network delay conditions. More specifically, the delay between then NASA Integrated Services Network (NISN) and spacecraft has been emulated. The round trip time (RTT) delay for the continental NISN network has been shown to be up to 120ms; as such the SLE protocol was tested with network delays ranging from 0ms to 200ms. Both a base network condition and an SLE connection were tested with these RTT delays, and the reaction of both network tests to the delay conditions were recorded. Throughput for both of these links was set at 1.2Gbps. The results will show that, in the presence of realistic network delay, the SLE link throughput is significantly reduced while the base network throughput however remained at the 1.2Gbps specification. The decrease in SLE throughput has been attributed to the implementation's use of blocking calls. The decrease in throughput is not acceptable for high data rate links, as the link requires constant data a flow in order for spacecraft and ground radios to stay synchronized, unless significant data is queued a the ground station. In cases where queuing the data is not an option, such as during real time transmissions, the SLE implementation cannot support high data rate communication.

Towards explaining the health impacts of residential energy efficiency interventions - A realist review. Part 1: Pathways.

PubMed

Willand, Nicola; Ridley, Ian; Maller, Cecily

2015-05-01

This paper is Part 1 of a realist review that tries to explain the impacts of residential energy efficiency interventions (REEIs) on householder health. According to recent systematic reviews residential energy efficiency interventions may benefit health. It is argued that home energy improvement are complex interventions and that a better understanding of the latent mechanisms and contextual issues that may shape the outcome of interventions is needed for effective intervention design. This realist review synthesises the results of 28 energy efficiency improvement programmes. This first part provides a review of the explanatory factors of the three key pathways, namely warmth in the home, affordability of fuel and psycho-social factors, and the pitfall of inadequate indoor air quality. The review revealed that REEIs improved winter warmth and lowered relative humidity with benefits for cardiovascular and respiratory health. In addition, residential energy efficiency improvements consolidated the meaning of the home as a safe haven, strengthened the householder's perceived autonomy and enhanced social status. Although satisfaction with the home proved to be an important explanation for positive mental health outcomes, financial considerations seemed to have played a secondary role. Evidence for negative impacts was rare but the risk should not be dismissed. Comprehensive refurbishments were not necessarily more effective than thermal retrofits or upgrades. A common protocol for the quantitative and qualitative evaluation of interventions would facilitate the synthesis of future studies. Householder and contextual influences are addressed in Part 2. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effective health care for older people resident in care homes: the optimal study protocol for realist review

PubMed Central

2014-01-01

Background Care homes in the UK rely on general practice for access to specialist medical and nursing care as well as referral to therapists and secondary care. Service delivery to care homes is highly variable in both quantity and quality. This variability is also evident in the commissioning and organisation of care home-specific services that range from the payment of incentives to general practitioners (GPs) to visit care homes, to the creation of care home specialist teams and outreach services run by geriatricians. No primary studies or systematic reviews have robustly evaluated the impact of these different approaches on organisation and resident-level outcomes. Our aim is to identify factors which may explain the perceived or demonstrated effectiveness of programmes to improve health-related outcomes in older people living in care homes. Methods/Design A realist review approach will be used to develop a theoretical understanding of what works when, why and in what circumstances. Elements of service models of interest include those that focus on assessment and management of residents’ health, those that use strategies to encourage closer working between visiting health care providers and care home staff, and those that address system-wide issues about access to assessment and treatment. These will include studies on continence, dignity, and speech and language assessment as well as interventions to promote person centred dementia care, improve strength and mobility, and nutrition. The impact of these interventions and their different mechanisms will be considered in relation to five key outcomes: residents’ medication use, use of out of hours’ services, hospital admissions (including use of Accident and Emergency) and length of hospital stay, costs and user satisfaction. An iterative three-stage approach will be undertaken that is stakeholder-driven and optimises the knowledge and networks of the research team. Discussion This realist review will explore why and for whom different approaches to providing health care to residents in care homes improves access to health care in the five areas of interest. It will inform commissioning decisions and be the basis for further research. This systematic review protocol is registered on the PROSPERO database reference number: CRD42014009112. PMID:24887325

Security of Distributed-Phase-Reference Quantum Key Distribution

NASA Astrophysics Data System (ADS)

Moroder, Tobias; Curty, Marcos; Lim, Charles Ci Wen; Thinh, Le Phuc; Zbinden, Hugo; Gisin, Nicolas

2012-12-01

Distributed-phase-reference quantum key distribution stands out for its easy implementation with present day technology. For many years, a full security proof of these schemes in a realistic setting has been elusive. We solve this long-standing problem and present a generic method to prove the security of such protocols against general attacks. To illustrate our result, we provide lower bounds on the key generation rate of a variant of the coherent-one-way quantum key distribution protocol. In contrast to standard predictions, it appears to scale quadratically with the system transmittance.

MO-AB-BRA-09: Temporally Realistic Manipulation a 4D Biomechanical Lung Phantom for Evaluation of Simultaneous Registration and Segmentation

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

Markel, D; Levesque, I R.; Larkin, J

Purpose: To produce multi-modality compatible, realistic datasets for the joint evaluation of segmentation and registration with a reliable ground truth using a 4D biomechanical lung phantom. The further development of a computer controlled air flow system for recreation of real patient breathing patterns is incorporated for additional evaluation of motion prediction algorithms. Methods: A pair of preserved porcine lungs was pneumatically manipulated using an in-house computer controlled respirator. The respirator consisted of a set of bellows actuated by a 186 W computer controlled industrial motor. Patient breathing traces were recorded using a respiratory bellows belt during CT simulation and inputmore » into a control program incorporating a proportional-integral-derivative (PID) feedback controller in LabVIEW. Mock tumors were created using dual compartment vacuum sealed sea sponges. 65% iohexol,a gadolinium-based contrast agent and 18F-FDG were used to produce contrast and thus determine a segmentation ground truth. The intensity distributions of the compartments were then digitally matched for the final dataset. A bifurcation tracking pipeline provided a registration ground truth using the bronchi of the lung. The lungs were scanned using a GE Discovery-ST PET/CT scanner and a Phillips Panorama 0.23T MRI using a T1 weighted 3D fast field echo (FFE) protocol. Results: The standard deviation of the error between the patient breathing trace and the encoder feedback from the respirator was found to be ±4.2%. Bifurcation tracking error using CT (0.97×0.97×3.27 mm{sup 3} resolution) was found to be sub-voxel up to 7.8 cm displacement for human lungs and less than 1.32 voxel widths in any axis up to 2.3 cm for the porcine lungs. Conclusion: An MRI/PET/CT compatible anatomically and temporally realistic swine lung phantom was developed for the evaluation of simultaneous registration and segmentation algorithms. With the addition of custom software and mock tumors, the entire package offers ground truths for benchmarking performance with high fidelity.« less

The Behavior of TCP and Its Extensions in Space

NASA Technical Reports Server (NTRS)

Wang, Ruhai; Horan, Stephen

2001-01-01

The performance of Transmission Control Protocol (TCP) in space has been examined from the observations of simulation and experimental tests for several years at National Aeronautics and Space Administration (NASA), Department of Defense (DoD) and universities. At New Mexico State University (NMSU), we have been concentrating on studying the performance of two protocol suites: the file transfer protocol (ftp) running over Transmission Control Protocol/Internet Protocol (TCP/IP) stack and the file protocol (fp) running over the Space Communications Protocol Standards (SCPS)-Transport Protocol (TP) developed under the Consultative Committee for Space Data Systems (CCSDS) standards process. SCPS-TP is considered to be TCP's extensions for space communications. This dissertation experimentally studies the behavior of TCP and SCPS-TP by running the protocol suites over both the Space-to-Ground Link Simulator (SGLS) test-bed and realistic satellite link. The study concentrates on comparing protocol behavior by plotting the averaged file transfer times for different experimental configurations and analyzing them using Statistical Analysis System (SAS) based procedures. The effects of different link delays and various Bit-Error-Rates (BERS) on each protocol performance are also studied and linear regression models are built for experiments over SGLS test-bed to reflect the relationships between the file transfer time and various transmission conditions.

Distilling entanglement with noisy operations

NASA Astrophysics Data System (ADS)

Chang, Jinho; Bae, Joonwoo; Kwon, Younghun

Entanglement distillation is a fundamental task in quantum information processing. It not only extracts entanglement out of corrupted systems but also leads to protecting systems of interest against intervention with environment. In this work, we consider a realistic scenario of entanglement distillation where noisy quantum operations are applied. In particular, the two-way distillation protocol that tolerates the highest error rate is considered. We show that among all types of noise there are only four equivalence classes according to the distillability condition. Since the four classes are connected by local unitary transformations, our results can be used to improve entanglement distillability in practice when entanglement distillation is performed in a realistic setting.

Protocol: developing a conceptual framework of patient mediated knowledge translation, systematic review using a realist approach.

PubMed

Gagliardi, Anna R; Légaré, France; Brouwers, Melissa C; Webster, Fiona; Wiljer, David; Badley, Elizabeth; Straus, Sharon

2011-03-22

Patient involvement in healthcare represents the means by which to achieve a healthcare system that is responsive to patient needs and values. Characterization and evaluation of strategies for involving patients in their healthcare may benefit from a knowledge translation (KT) approach. The purpose of this knowledge synthesis is to develop a conceptual framework for patient-mediated KT interventions. A preliminary conceptual framework for patient-mediated KT interventions was compiled to describe intended purpose, recipients, delivery context, intervention, and outcomes. A realist review will be conducted in consultation with stakeholders from the arthritis and cancer fields to explore how these interventions work, for whom, and in what contexts. To identify patient-mediated KT interventions in these fields, we will search MEDLINE, the Cochrane Library, and EMBASE from 1995 to 2010; scan references of all eligible studies; and examine five years of tables of contents for journals likely to publish quantitative or qualitative studies that focus on developing, implementing, or evaluating patient-mediated KT interventions. Screening and data collection will be performed independently by two individuals. The conceptual framework of patient-mediated KT options and outcomes could be used by healthcare providers, managers, educationalists, patient advocates, and policy makers to guide program planning, service delivery, and quality improvement and by us and other researchers to evaluate existing interventions or develop new interventions. By raising awareness of options for involving patients in improving their own care, outcomes based on using a KT approach may lead to greater patient-centred care delivery and improved healthcare outcomes.

Protocol: developing a conceptual framework of patient mediated knowledge translation, systematic review using a realist approach

PubMed Central

2011-01-01

Background Patient involvement in healthcare represents the means by which to achieve a healthcare system that is responsive to patient needs and values. Characterization and evaluation of strategies for involving patients in their healthcare may benefit from a knowledge translation (KT) approach. The purpose of this knowledge synthesis is to develop a conceptual framework for patient-mediated KT interventions. Methods A preliminary conceptual framework for patient-mediated KT interventions was compiled to describe intended purpose, recipients, delivery context, intervention, and outcomes. A realist review will be conducted in consultation with stakeholders from the arthritis and cancer fields to explore how these interventions work, for whom, and in what contexts. To identify patient-mediated KT interventions in these fields, we will search MEDLINE, the Cochrane Library, and EMBASE from 1995 to 2010; scan references of all eligible studies; and examine five years of tables of contents for journals likely to publish quantitative or qualitative studies that focus on developing, implementing, or evaluating patient-mediated KT interventions. Screening and data collection will be performed independently by two individuals. Conclusions The conceptual framework of patient-mediated KT options and outcomes could be used by healthcare providers, managers, educationalists, patient advocates, and policy makers to guide program planning, service delivery, and quality improvement and by us and other researchers to evaluate existing interventions or develop new interventions. By raising awareness of options for involving patients in improving their own care, outcomes based on using a KT approach may lead to greater patient-centred care delivery and improved healthcare outcomes. PMID:21426573

One-sided measurement-device-independent quantum key distribution

NASA Astrophysics Data System (ADS)

Cao, Wen-Fei; Zhen, Yi-Zheng; Zheng, Yu-Lin; Li, Li; Chen, Zeng-Bing; Liu, Nai-Le; Chen, Kai

2018-01-01

Measurement-device-independent quantum key distribution (MDI-QKD) protocol was proposed to remove all the detector side channel attacks, while its security relies on the trusted encoding systems. Here we propose a one-sided MDI-QKD (1SMDI-QKD) protocol, which enjoys detection loophole-free advantage, and at the same time weakens the state preparation assumption in MDI-QKD. The 1SMDI-QKD can be regarded as a modified MDI-QKD, in which Bob's encoding system is trusted, while Alice's is uncharacterized. For the practical implementation, we also provide a scheme by utilizing coherent light source with an analytical two decoy state estimation method. Simulation with realistic experimental parameters shows that the protocol has a promising performance, and thus can be applied to practical QKD applications.

Realism and resources: Towards more explanatory economic evaluation

PubMed Central

Anderson, Rob; Hardwick, Rebecca

2016-01-01

To be successfully and sustainably adopted, policy-makers, service managers and practitioners want public programmes to be affordable and cost-effective, as well as effective. While the realist evaluation question is often summarised as what works for whom, under what circumstances, we believe the approach can be as salient to answering questions about resource use, costs and cost-effectiveness – the traditional domain of economic evaluation methods. This paper first describes the key similarities and differences between economic evaluation and realist evaluation. It summarises what health economists see as the challenges of evaluating complex interventions, and their suggested solutions. We then use examples of programme theory from a recent realist review of shared care for chronic conditions to illustrate two ways in which realist evaluations might better capture the resource requirements and resource consequences of programmes, and thereby produce explanations of how they are linked to outcomes (i.e. explanations of cost-effectiveness). PMID:27478402

The Simulation of Read-time Scalable Coherent Interface

NASA Technical Reports Server (NTRS)

Li, Qiang; Grant, Terry; Grover, Radhika S.

1997-01-01

Scalable Coherent Interface (SCI, IEEE/ANSI Std 1596-1992) (SCI1, SCI2) is a high performance interconnect for shared memory multiprocessor systems. In this project we investigate an SCI Real Time Protocols (RTSCI1) using Directed Flow Control Symbols. We studied the issues of efficient generation of control symbols, and created a simulation model of the protocol on a ring-based SCI system. This report presents the results of the study. The project has been implemented using SES/Workbench. The details that follow encompass aspects of both SCI and Flow Control Protocols, as well as the effect of realistic client/server processing delay. The report is organized as follows. Section 2 provides a description of the simulation model. Section 3 describes the protocol implementation details. The next three sections of the report elaborate on the workload, results and conclusions. Appended to the report is a description of the tool, SES/Workbench, used in our simulation, and internal details of our implementation of the protocol.

Quantum energy teleportation in a quantum Hall system

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

Yusa, Go; Izumida, Wataru; Hotta, Masahiro

2011-09-15

We propose an experimental method for a quantum protocol termed quantum energy teleportation (QET), which allows energy transportation to a remote location without physical carriers. Using a quantum Hall system as a realistic model, we discuss the physical significance of QET and estimate the order of energy gain using reasonable experimental parameters.

Interactive browsing of 3D environment over the Internet

NASA Astrophysics Data System (ADS)

Zhang, Cha; Li, Jin

2000-12-01

In this paper, we describe a system for wandering in a realistic environment over the Internet. The environment is captured by the concentric mosaic, compressed via the reference block coder (RBC), and accessed and delivered over the Internet through the virtual media (Vmedia) access protocol. Capturing the environment through the concentric mosaic is easy. We mount a camera at the end of a level beam, and shoot images as the beam rotates. The huge dataset of the concentric mosaic is then compressed through the RBC, which is specifically designed for both high compression efficiency and just-in-time (JIT) rendering. Through the JIT rendering function, only a portion of the RBC bitstream is accessed, decoded and rendered for each virtual view. A multimedia communication protocol -- the Vmedia protocol, is then proposed to deliver the compressed concentric mosaic data over the Internet. Only the bitstream segments corresponding to the current view are streamed over the Internet. Moreover, the delivered bitstream segments are managed by a local Vmedia cache so that frequently used bitstream segments need not be streamed over the Internet repeatedly, and the Vmedia is able to handle a RBC bitstream larger than its memory capacity. A Vmedia concentric mosaic interactive browser is developed where the user can freely wander in a realistic environment, e.g., rotate around, walk forward/backward and sidestep, even under a tight bandwidth of 33.6 kbps.

Implementing an intravenous insulin protocol in your practice: practical advice to overcome clinical, administrative, and financial barriers.

PubMed

Kelly, Janet L; Hirsch, Irl B; Furnary, Anthony P

2006-01-01

Diabetes mellitus is the fourth most common comorbid condition among hospitalized patients, and 30% of patients undergoing open-heart surgery have diabetes. The link between hyperglycemia and poor outcome has been well described, and large clinical trials have shown that aggressive control of blood glucose with an insulin infusion can improve these outcomes. The barriers to implementing an insulin infusion protocol are numerous, despite the fact that doing so is paramount to clinical success. Barriers include safety concerns, such as fear of hypoglycemia, insufficient nursing staff to patient ratios, lack of administrative and physician support, various system and procedural issues, and resistance to change. Key steps to overcome the barriers include building support with multidisciplinary champions, involving key staff, educating staff, and administrators of the clinical and economic benefits of improving glycemic control, setting realistic goals, selecting a validated insulin infusion protocol, and internally marketing the success of the protocol.

Investigation of Interference Models for RFID Systems.

PubMed

Zhang, Linchao; Ferrero, Renato; Gandino, Filippo; Rebaudengo, Maurizio

2016-02-04

The reader-to-reader collision in an RFID system is a challenging problem for communications technology. In order to model the interference between RFID readers, different interference models have been proposed, mainly based on two approaches: single and additive interference. The former only considers the interference from one reader within a certain range, whereas the latter takes into account the sum of all of the simultaneous interferences in order to emulate a more realistic behavior. Although the difference between the two approaches has been theoretically analyzed in previous research, their effects on the estimated performance of the reader-to-reader anti-collision protocols have not yet been investigated. In this paper, the influence of the interference model on the anti-collision protocols is studied by simulating a representative state-of-the-art protocol. The results presented in this paper highlight that the use of additive models, although more computationally intensive, is mandatory to improve the performance of anti-collision protocols.

Using generalizability theory to develop clinical assessment protocols.

PubMed

Preuss, Richard A

2013-04-01

Clinical assessment protocols must produce data that are reliable, with a clinically attainable minimal detectable change (MDC). In a reliability study, generalizability theory has 2 advantages over classical test theory. These advantages provide information that allows assessment protocols to be adjusted to match individual patient profiles. First, generalizability theory allows the user to simultaneously consider multiple sources of measurement error variance (facets). Second, it allows the user to generalize the findings of the main study across the different study facets and to recalculate the reliability and MDC based on different combinations of facet conditions. In doing so, clinical assessment protocols can be chosen based on minimizing the number of measures that must be taken to achieve a realistic MDC, using repeated measures to minimize the MDC, or simply based on the combination that best allows the clinician to monitor an individual patient's progress over a specified period of time.

Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment.

PubMed

Jagosh, Justin; Pluye, Pierre; Wong, Geoff; Cargo, Margaret; Salsberg, Jon; Bush, Paula L; Herbert, Carol P; Green, Lawrence W; Greenhalgh, Trish; Macaulay, Ann C

2014-06-01

Realist review has increased in popularity as a methodology for complex intervention assessment. Our experience suggests that the process of designing a realist review requires its customization to areas under investigation. To elaborate on this idea, we first describe the logic underpinning realist review and then present critical reflections on our application experience, organized in seven areas. These are the following: (1) the challenge of identifying middle range theory; (2) addressing heterogeneity and lack of conceptual clarity; (3) the challenge of appraising the quality of complex evidence; (4) the relevance of capturing unintended outcomes; (5) understanding the process of context, mechanism, and outcome (CMO) configuring; (6) incorporating middle-range theory in the CMO configuration process; and (7) using middle range theory to advance the conceptualization of outcomes - both visible and seemingly 'hidden'. One conclusion from our experience is that the degree of heterogeneity of the evidence base will determine whether theory can drive the development of review protocols from the outset, or will follow only after an intense period of data immersion. We hope that presenting a critical reflection on customizing realist review will convey how the methodology can be tailored to the often complex and idiosyncratic features of health research, leading to innovative evidence syntheses. Copyright © 2013 John Wiley & Sons, Ltd.

A link-adding strategy for transport efficiency of complex networks

NASA Astrophysics Data System (ADS)

Ma, Jinlong; Han, Weizhan; Guo, Qing; Wang, Zhenyong; Zhang, Shuai

2016-12-01

The transport efficiency is one of the critical parameters to evaluate the performance of a network. In this paper, we propose an improved efficient (IE) strategy to enhance the network transport efficiency of complex networks by adding a fraction of links to an existing network based on the node’s local degree centrality and the shortest path length. Simulation results show that the proposed strategy can bring better traffic capacity and shorter average shortest path length than the low-degree-first (LDF) strategy under the shortest path routing protocol. It is found that the proposed strategy is beneficial to the improvement of overall traffic handling and delivering ability of the network. This study can alleviate the congestion in networks, and is helpful to design and optimize realistic networks.

Community engagement to enhance trust between Gypsy/Travellers, and maternity, early years' and child dental health services: protocol for a multi-method exploratory study.

PubMed

McFadden, Alison; Atkin, Karl; Bell, Kerry; Innes, Nicola; Jackson, Cath; Jones, Helen; MacGillivray, Steve; Siebelt, Lindsay

2016-11-14

Gypsy/Travellers have poor health and experience discrimination alongside structural and cultural barriers when accessing health services and consequently may mistrust those services. Our study aims to investigate which approaches to community engagement are most likely to be effective at enhancing trust between Gypsy/Travellers and mainstream health services. This multi-method 30-month study, commenced in June 2015, and comprises four stages. 1. Three related reviews: a) systematic review of Gypsy/Travellers' access to health services; b) systematic review of reviews of how trust has been conceptualised within healthcare; c) realist synthesis of community engagement approaches to enhance trust and increase Gypsy/Travellers' participation in health services. The reviews will consider any economic literature; 2. Online consultation with health and social care practitioners, and civil society organisations on existing engagement activities, including perceptions of barriers and good practice; 3. Four in-depth case studies of different Gypsy/Traveller communities, focusing on maternity, early years and child dental health services. The case studies include the views of 32-48 mothers of pre-school children, 32-40 healthcare providers and 8-12 informants from third sector organisations. 4. Two stakeholder workshops exploring whether policy options are realistic, sustainable and replicable. Case study data will be analysed thematically informed by the evaluative framework derived from the realist synthesis in stage one. The main outputs will be: a) an evaluative framework of Gypsy/Travellers' engagement with health services; b) recommendations for policy and practice; c) evidence on which to base future implementation strategies including estimation of costs. Our novel multi-method study seeks to provide recommendations for policy and practice that have potential to improve uptake and delivery of health services, and to reduce lifetime health inequalities for Gypsy/Travellers. The findings may have wider resonance for other marginalised populations. Strengths and limitations of the study are discussed. Prospero registration for literature reviews: CRD42015021955 and CRD42015021950 UKCRN reference: 20036.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013 John Wiley & Sons Ltd.

Experimental verification of multipartite entanglement in quantum networks

PubMed Central

McCutcheon, W.; Pappa, A.; Bell, B. A.; McMillan, A.; Chailloux, A.; Lawson, T.; Mafu, M.; Markham, D.; Diamanti, E.; Kerenidis, I.; Rarity, J. G.; Tame, M. S.

2016-01-01

Multipartite entangled states are a fundamental resource for a wide range of quantum information processing tasks. In particular, in quantum networks, it is essential for the parties involved to be able to verify if entanglement is present before they carry out a given distributed task. Here we design and experimentally demonstrate a protocol that allows any party in a network to check if a source is distributing a genuinely multipartite entangled state, even in the presence of untrusted parties. The protocol remains secure against dishonest behaviour of the source and other parties, including the use of system imperfections to their advantage. We demonstrate the verification protocol in a three- and four-party setting using polarization-entangled photons, highlighting its potential for realistic photonic quantum communication and networking applications. PMID:27827361

Developing quantitative seed sampling protocols using simulations: A reply to comments from Guja et al. and Guerrant et al.

USDA-ARS?s Scientific Manuscript database

The letter is a reply to comments made on a previous publication: Optimal sampling of seeds from plant populations for ex-situ conservation of genetic biodiversity, considering realistic population structure (Hoban and Schlarbaum, 2014). The intent of the reply is to acknowledge some of the practica...

TraPy-MAC: Traffic Priority Aware Medium Access Control Protocol for Wireless Body Area Network.

PubMed

Ullah, Fasee; Abdullah, Abdul Hanan; Kaiwartya, Omprakash; Cao, Yue

2017-06-01

Recently, Wireless Body Area Network (WBAN) has witnessed significant attentions in research and product development due to the growing number of sensor-based applications in healthcare domain. Design of efficient and effective Medium Access Control (MAC) protocol is one of the fundamental research themes in WBAN. Static on-demand slot allocation to patient data is the main approach adopted in the design of MAC protocol in literature, without considering the type of patient data specifically the level of severity on patient data. This leads to the degradation of the performance of MAC protocols considering effectiveness and traffic adjustability in realistic medical environments. In this context, this paper proposes a Traffic Priority-Aware MAC (TraPy-MAC) protocol for WBAN. It classifies patient data into emergency and non-emergency categories based on the severity of patient data. The threshold value aided classification considers a number of parameters including type of sensor, body placement location, and data transmission time for allocating dedicated slots patient data. Emergency data are not required to carry out contention and slots are allocated by giving the due importance to threshold value of vital sign data. The contention for slots is made efficient in case of non-emergency data considering threshold value in slot allocation. Moreover, the slot allocation to emergency and non-emergency data are performed parallel resulting in performance gain in channel assignment. Two algorithms namely, Detection of Severity on Vital Sign data (DSVS), and ETS Slots allocation based on the Severity on Vital Sign (ETS-SVS) are developed for calculating threshold value and resolving the conflicts of channel assignment, respectively. Simulations are performed in ns2 and results are compared with the state-of-the-art MAC techniques. Analysis of results attests the benefit of TraPy-MAC in comparison with the state-of-the-art MAC in channel assignment in realistic medical environments.

Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol.

PubMed

Mukumbang, Ferdinand C; Van Belle, Sara; Marchal, Bruno; Van Wyk, Brian

2016-04-04

Suboptimal retention in care and poor treatment adherence are key challenges to antiretroviral therapy (ART) in sub-Saharan Africa. Community-based approaches to HIV service delivery are recommended to improve patient retention in care and ART adherence. The implementation of the adherence clubs in the Western Cape province of South Africa was with variable success in terms of implementation and outcomes. The need for operational guidelines for its implementation has been identified. Therefore, understanding the contexts and mechanisms for successful implementation of the adherence clubs is crucial to inform the roll-out to the rest of South Africa. The protocol outlines an evaluation of adherence club intervention in selected primary healthcare facilities in the metropolitan area of the Western Cape Province, using the realist approach. In the first phase, an exploratory study design will be used. Document review and key informant interviews will be used to elicit the programme theory. In phase two, a multiple case study design will be used to describe the adherence clubs in five contrastive sites. Semistructured interviews will be conducted with purposively selected programme implementers and members of the clubs to assess the context and mechanisms of the adherence clubs. For the programme's primary outcomes, a longitudinal retrospective cohort analysis will be conducted using routine patient data. Data analysis will involve classifying emerging themes using the context-mechanism-outcome (CMO) configuration, and refining the primary CMO configurations to conjectured CMO configurations. Finally, we will compare the conjectured CMO configurations from the cases with the initial programme theory. The final CMOs obtained will be translated into middle range theories. The study will be conducted according to the principles of the declaration of Helsinki (1964). Ethics clearance was obtained from the University of the Western Cape. Dissemination will be done through publications and curation. 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/

Development and characterization of a dynamic lesion phantom for the quantitative evaluation of dynamic contrast-enhanced MRI.

PubMed

Freed, Melanie; de Zwart, Jacco A; Hariharan, Prasanna; Myers, Matthew R; Badano, Aldo

2011-10-01

To develop a dynamic lesion phantom that is capable of producing physiological kinetic curves representative of those seen in human dynamic contrast-enhanced MRI (DCE-MRI) data. The objective of this phantom is to provide a platform for the quantitative comparison of DCE-MRI protocols to aid in the standardization and optimization of breast DCE-MRI. The dynamic lesion consists of a hollow, plastic mold with inlet and outlet tubes to allow flow of a contrast agent solution through the lesion over time. Border shape of the lesion can be controlled using the lesion mold production method. The configuration of the inlet and outlet tubes was determined using fluid transfer simulations. The total fluid flow rate was determined using x-ray images of the lesion for four different flow rates (0.25, 0.5, 1.0, and 1.5 ml/s) to evaluate the resultant kinetic curve shape and homogeneity of the contrast agent distribution in the dynamic lesion. High spatial and temporal resolution x-ray measurements were used to estimate the true kinetic curve behavior in the dynamic lesion for benign and malignant example curves. DCE-MRI example data were acquired of the dynamic phantom using a clinical protocol. The optimal inlet and outlet tube configuration for the lesion molds was two inlet molds separated by 30° and a single outlet tube directly between the two inlet tubes. X-ray measurements indicated that 1.0 ml/s was an appropriate total fluid flow rate and provided truth for comparison with MRI data of kinetic curves representative of benign and malignant lesions. DCE-MRI data demonstrated the ability of the phantom to produce realistic kinetic curves. The authors have constructed a dynamic lesion phantom, demonstrated its ability to produce physiological kinetic curves, and provided estimations of its true kinetic curve behavior. This lesion phantom provides a tool for the quantitative evaluation of DCE-MRI protocols, which may lead to improved discrimination of breast cancer lesions.

The evaluation of a healthcare passport to improve quality of care and communication for people living with dementia (EQuIP): a protocol paper for a qualitative, longitudinal study.

PubMed

Leavey, Gerard; Abbott, Aine; Watson, Max; Todd, Stephen; Coates, Vivien; McIlfactrick, Sonja; McCormack, Brendan; Waterhouse-Bradley, Bethany; Curran, Emma

2016-08-09

There is an urgent need for the development of simple communication tools that convey the strengths, assets, and healthcare needs of people living with dementia. A Healthcare Passport may improve communication with range of health and social support services, enhancing quality and continuity of care, and to permit a consideration of the challenges and how these might be managed effectively and compassionately. This study aims to evaluate the acceptability and use of this type of intervention for people living with dementia and their carers. This is a qualitative longitudinal study informed by a critical realist review. The participants will be individuals identified as having mild-moderate dementia and informal carers. The in-depth interviews will occur at three points over the course of 18 months as they use the passport. This will be supplemented by analysis of the content of the passports and information from health and social care providers on the daily practicalities of using the passport in a range of healthcare settings. By using a critical realist review and a qualitative, longitudinal approach, the study allows for the assessment of a complex intervention in a manner which goes beyond evaluating the basic efficacy of the passport, but looking more deeply at how it worked, for whom, and in what context. It has the potential to develop new data on how interventions improve communication across a range of service providers, while encouraging health and social care professionals to respect and encourage the development of self-management and retention of personhood throughout the progression of life-limiting illnesses.

Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation.

PubMed

Butler, Claire; Brigden, Charlotte; Gage, Heather; Williams, Peter; Holdsworth, Laura; Greene, Kay; Wee, Bee; Barclay, Stephen; Wilson, Patricia

2018-05-16

Hospice at home (HAH) services aim to enable patients to be cared for and die in their place of choice, if that is at home, and to achieve a 'good death'. There is a considerable range of HAH services operating in England. The published evidence focuses on evaluations of individual services which vary considerably, and there is a lack of consistency in terms of the outcome measures reported. The evidence, therefore, does not provide generalisable information, so the question 'What are the features of hospice at home service models that work, for whom, and under what circumstances?' remains unanswered. The study aims to answer this question. This is a mixed-methods study in three phases informed by realist evaluation methodology. All HAH services in England will be invited to participate in a telephone survey to enable the development of a typology of services. In the second phase, case study sites representing the different service types will collect patient data and recruit carers, service managers and commissioners to gather quantitative and qualitative data about service provision and outcomes. A third phase will synthesise and refine the results through consensus workshops. The first survey phase has university ethics approval and the second phase, Integrated Research Application System (IRAS) and Health Research Authority (HRA) approval (IRAS ID:205986, REC:17/LO/0880); the third phase does not require ethics approval. Dissemination will be facilitated by project coapplicants with established connections to national policy-making forums, in addition to publications, conference presentations and reports targeted to service providers and commissioners. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Realist explanatory theory building method for social epidemiology: a protocol for a mixed method multilevel study of neighbourhood context and postnatal depression.

PubMed

Eastwood, John G; Jalaludin, Bin B; Kemp, Lynn A

2014-01-01

A recent criticism of social epidemiological studies, and multi-level studies in particular has been a paucity of theory. We will present here the protocol for a study that aims to build a theory of the social epidemiology of maternal depression. We use a critical realist approach which is trans-disciplinary, encompassing both quantitative and qualitative traditions, and that assumes both ontological and hierarchical stratification of reality. We describe a critical realist Explanatory Theory Building Method comprising of an: 1) emergent phase, 2) construction phase, and 3) confirmatory phase. A concurrent triangulated mixed method multilevel cross-sectional study design is described. The Emergent Phase uses: interviews, focus groups, exploratory data analysis, exploratory factor analysis, regression, and multilevel Bayesian spatial data analysis to detect and describe phenomena. Abductive and retroductive reasoning will be applied to: categorical principal component analysis, exploratory factor analysis, regression, coding of concepts and categories, constant comparative analysis, drawing of conceptual networks, and situational analysis to generate theoretical concepts. The Theory Construction Phase will include: 1) defining stratified levels; 2) analytic resolution; 3) abductive reasoning; 4) comparative analysis (triangulation); 5) retroduction; 6) postulate and proposition development; 7) comparison and assessment of theories; and 8) conceptual frameworks and model development. The strength of the critical realist methodology described is the extent to which this paradigm is able to support the epistemological, ontological, axiological, methodological and rhetorical positions of both quantitative and qualitative research in the field of social epidemiology. The extensive multilevel Bayesian studies, intensive qualitative studies, latent variable theory, abductive triangulation, and Inference to Best Explanation provide a strong foundation for Theory Construction. The study will contribute to defining the role that realism and mixed methods can play in explaining the social determinants and developmental origins of health and disease.

Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India.

PubMed

Liu, Hueiming; Lindley, Richard; Alim, Mohammed; Felix, Cynthia; Gandhi, Dorcas B C; Verma, Shweta J; Tugnawat, Deepak Kumar; Syrigapu, Anuradha; Ramamurthy, Ramaprabhu Krishnappa; Pandian, Jeyaraj D; Walker, Marion; Forster, Anne; Anderson, Craig S; Langhorne, Peter; Murthy, Gudlavalleti Venkata Satyanarayana; Shamanna, Bindiganavale Ramaswamy; Hackett, Maree L; Maulik, Pallab K; Harvey, Lisa A; Jan, Stephen

2016-09-15

We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting. The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation. The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation. CTRI/2013/04/003557. 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/

SU-F-T-50: Evaluation of Monte Carlo Simulations Performance for Pediatric Brachytherapy Dosimetry

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

Chatzipapas, C; Kagadis, G; Papadimitroulas, P

Purpose: Pediatric tumors are generally treated with multi-modal procedures. Brachytherapy can be used with pediatric tumors, especially given that in this patient population low toxicity on normal tissues is critical as is the suppression of the probability for late malignancies. Our goal is to validate the GATE toolkit on realistic brachytherapy applications, and evaluate brachytherapy plans on pediatrics for accurate dosimetry on sensitive and critical organs of interest. Methods: The GATE Monte Carlo (MC) toolkit was used. Two High Dose Rate (HDR) 192Ir brachytherapy sources were simulated (Nucletron mHDR-v1 and Varian VS2000), and fully validated using the AAPM and ESTROmore » protocols. A realistic brachytherapy plan was also simulated using the XCAT anthropomorphic computational model .The simulated data were compared to the clinical dose points. Finally, a 14 years old girl with vaginal rhabdomyosarcoma was modelled based on clinical procedures for the calculation of the absorbed dose per organ. Results: The MC simulations resulted in accurate dosimetry in terms of dose rate constant (Λ), radial dose gL(r) and anisotropy function F(r,θ) for both sources.The simulations were executed using ∼1010 number of primaries resulting in statistical uncertainties lower than 2%.The differences between the theoretical values and the simulated ones ranged from 0.01% up to 3.3%, with the largest discrepancy (6%) being observed in the dose rate constant calculation.The simulated DVH using an adult female XCAT model was also compared to a clinical one resulting in differences smaller than 5%. Finally, a realistic pediatric brachytherapy simulation was performed to evaluate the absorbed dose per organ and to calculate DVH with respect to heterogeneities of the human anatomy. Conclusion: GATE is a reliable tool for brachytherapy simulations both for source modeling and for dosimetry in anthropomorphic voxelized models. Our project aims to evaluate a variety of pediatric brachytherapy schemes using a population of pediatric phantoms for several pathological cases. This study is part of a project that has received funding from the European Union Horizon2020 research and innovation programme under the MarieSklodowska-Curiegrantagreement.No691203.The results published in this study reflect only the authors view and the Research Executive Agency (REA) and the European Commission is not responsible for any use that may be madeof the information it contains.« less

A realist evaluation of the management of a well- performing regional hospital in Ghana

PubMed Central

2010-01-01

Background Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. Methods We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. Results We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. Conclusion This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. PMID:20100330

A realist evaluation of the management of a well-performing regional hospital in Ghana.

PubMed

Marchal, Bruno; Dedzo, McDamien; Kegels, Guy

2010-01-25

Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited external validity of a traditional case study. We developed a realist evaluation framework for hypothesis formulation, data collection, data analysis and synthesis of the findings. Focusing on the role of human resource management in hospital performance, we formulated our hypothesis around the high commitment management concept. Mixed methods were used in data collection, including individual and group interviews, observations and document reviews. We found that the human resource management approach (the actual intervention) included induction of new staff, training and personal development, good communication and information sharing, and decentralised decision-making. We identified 3 additional practices: ensuring optimal physical working conditions, access to top managers and managers' involvement on the work floor. Teamwork, recognition and trust emerged as key elements of the organisational climate. Interviewees reported high levels of organisational commitment. The analysis unearthed perceived organisational support and reciprocity as underlying mechanisms that link the management practices with commitment. Methodologically, we found that realist evaluation can be fruitfully used to develop detailed case studies that analyse how management interventions work and in which conditions. Analysing the links between intervention, mechanism and outcome increases the explaining power, while identification of essential context elements improves the usefulness of the findings for decision-makers in other settings (external validity). We also identified a number of practical difficulties and priorities for further methodological development. This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers.

Quantum fingerprinting with coherent states and a constant mean number of photons

NASA Astrophysics Data System (ADS)

Arrazola, Juan Miguel; Lütkenhaus, Norbert

2014-06-01

We present a protocol for quantum fingerprinting that is ready to be implemented with current technology and is robust to experimental errors. The basis of our scheme is an implementation of the signal states in terms of a coherent state in a superposition of time-bin modes. Experimentally, this requires only the ability to prepare coherent states of low amplitude and to interfere them in a balanced beam splitter. The states used in the protocol are arbitrarily close in trace distance to states of O (log2n) qubits, thus exhibiting an exponential separation in abstract communication complexity compared to the classical case. The protocol uses a number of optical modes that is proportional to the size n of the input bit strings but a total mean photon number that is constant and independent of n. Given the expended resources, our protocol achieves a task that is provably impossible using classical communication only. In fact, even in the presence of realistic experimental errors and loss, we show that there exist a large range of input sizes for which our quantum protocol transmits an amount of information that can be more than two orders of magnitude smaller than a classical fingerprinting protocol.

Realist Evaluation: An Emerging Theory in Support of Practice.

ERIC Educational Resources Information Center

Henry, Gary T., Ed.; Julnes, George, Ed.; Mark, Melvin M., Ed.

1998-01-01

The five articles of this sourcebook, organized around the five-component framework for evaluation described by W. Shadish, T. Cook, and L. Leviton (1991), present a new theory of realist evaluation that captures the sensemaking contributions of postpositivism and the sensitivity to values from the constructivist traditions. (SLD)

PRP: peripheral routing protocol for WSN realistic marginal mobility model

NASA Astrophysics Data System (ADS)

Tudorache, I. G.; Popescu, A. M.; Kemp, A. H.

2017-02-01

This article proposes a new routing protocol called Peripheral Routing Protocol (PRP) for the scenario where the mobile destination (D) moves at the wireless sensor network (WSN) periphery for gathering data. From a connectivity point of view, when D follows the marginal mobility model (MMM), the WSN becomes a hybrid network: a sparse network, because of the interrupted connectivity between D and the rest of the nodes and a well-connected network, because of the connectivity between all the other nodes of the WSN except D. It will be proven through MATLAB simulations that, for a military application scenario where D's connectivity to the WSN varies between 10% and 95%, compared with the 100% case, PRP outperforms routing protocols recommended for Mobile Ad-hoc Networks (MANET) in three ways: it maintains an average Packet Delivery Ratio (PDR) over 90%, a below 10% and 5% increase for the Average End to End Delay (AETED) and energy per transmitted packet.

Tunable axial gauge fields in engineered Weyl semimetals: semiclassical analysis and optical lattice implementations

NASA Astrophysics Data System (ADS)

Roy, Sthitadhi; Kolodrubetz, Michael; Goldman, Nathan; Grushin, Adolfo G.

2018-04-01

In this work, we describe a toolbox to realize and probe synthetic axial gauge fields in engineered Weyl semimetals. These synthetic electromagnetic fields, which are sensitive to the chirality associated with Weyl nodes, emerge due to spatially and temporally dependent shifts of the corresponding Weyl momenta. First, we introduce two realistic models, inspired by recent cold-atom developments, which are particularly suitable for the exploration of these synthetic axial gauge fields. Second, we describe how to realize and measure the effects of such axial fields through center-of-mass observables, based on semiclassical equations of motion and exact numerical simulations. In particular, we suggest realistic protocols to reveal an axial Hall response due to the axial electric field \

Protocol—the RAMESES II study: developing guidance and reporting standards for realist evaluation

PubMed Central

Greenhalgh, Trisha; Wong, Geoff; Jagosh, Justin; Greenhalgh, Joanne; Manzano, Ana; Westhorp, Gill; Pawson, Ray

2015-01-01

Introduction Realist evaluation is an increasingly popular methodology in health services research. For realist evaluations (RE) this project aims to: develop quality and reporting standards and training materials; build capacity for undertaking and critically evaluating them; produce resources and training materials for lay participants, and those seeking to involve them. Methods To achieve our aims, we will: (1) Establish management and governance infrastructure; (2) Recruit an interdisciplinary Delphi panel of 35 participants with diverse relevant experience of RE; (3) Summarise current literature and expert opinion on best practice in RE; (4) Run an online Delphi panel to generate and refine items for quality and reporting standards; (5) Capture ‘real world’ experiences and challenges of RE—for example, by providing ongoing support to realist evaluations, hosting the RAMESES JISCmail list on realist research, and feeding problems and insights from these into the deliberations of the Delphi panel; (6) Produce quality and reporting standards; (7) Collate examples of the learning and training needs of researchers, students, reviewers and lay members in relation to RE; (8) Develop, deliver and evaluate training materials for RE and deliver training workshops; and (9) Develop and evaluate information and resources for patients and other lay participants in RE (eg, draft template information sheets and model consent forms) and; (10) Disseminate training materials and other resources. Planned outputs: (1) Quality and reporting standards and training materials for RE. (2) Methodological support for RE. (3) Increase in capacity to support and evaluate RE. (4) Accessible, plain-English resources for patients and the public participating in RE. Discussion The realist evaluation is a relatively new approach to evaluation and its overall place in the is not yet fully established. As with all primary research approaches, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency. PMID:26238395

Concise Review: Stem Cell Trials Using Companion Animal Disease Models.

PubMed

Hoffman, Andrew M; Dow, Steven W

2016-07-01

Studies to evaluate the therapeutic potential of stem cells in humans would benefit from more realistic animal models. In veterinary medicine, companion animals naturally develop many diseases that resemble human conditions, therefore, representing a novel source of preclinical models. To understand how companion animal disease models are being studied for this purpose, we reviewed the literature between 2008 and 2015 for reports on stem cell therapies in dogs and cats, excluding laboratory animals, induced disease models, cancer, and case reports. Disease models included osteoarthritis, intervertebral disc degeneration, dilated cardiomyopathy, inflammatory bowel diseases, Crohn's fistulas, meningoencephalomyelitis (multiple sclerosis-like), keratoconjunctivitis sicca (Sjogren's syndrome-like), atopic dermatitis, and chronic (end-stage) kidney disease. Stem cells evaluated in these studies included mesenchymal stem-stromal cells (MSC, 17/19 trials), olfactory ensheathing cells (OEC, 1 trial), or neural lineage cells derived from bone marrow MSC (1 trial), and 16/19 studies were performed in dogs. The MSC studies (13/17) used adipose tissue-derived MSC from either allogeneic (8/13) or autologous (5/13) sources. The majority of studies were open label, uncontrolled studies. Endpoints and protocols were feasible, and the stem cell therapies were reportedly safe and elicited beneficial patient responses in all but two of the trials. In conclusion, companion animals with naturally occurring diseases analogous to human conditions can be recruited into clinical trials and provide realistic insight into feasibility, safety, and biologic activity of novel stem cell therapies. However, improvements in the rigor of manufacturing, study design, and regulatory compliance will be needed to better utilize these models. Stem Cells 2016;34:1709-1729. © 2016 AlphaMed Press.

Emulation of the laparoscopic environment for image-guided liver surgery via an abdominal phantom system with anatomical ligamenture

NASA Astrophysics Data System (ADS)

Heiselman, Jon S.; Collins, Jarrod A.; Clements, Logan W.; Weis, Jared A.; Simpson, Amber L.; Geevarghese, Sunil K.; Jarnagin, William R.; Miga, Michael I.

2017-03-01

In order to rigorously validate techniques for image-guided liver surgery (IGLS), an accurate mock representation of the intraoperative surgical scene with quantifiable localization of subsurface targets would be highly desirable. However, many attempts to reproduce the laparoscopic environment have encountered limited success due to neglect of several crucial design aspects. The laparoscopic setting is complicated by factors such as gas insufflation of the abdomen, changes in patient orientation, incomplete organ mobilization from ligaments, and limited access to organ surface data. The ability to accurately represent the influences of anatomical changes and procedural limitations is critical for appropriate evaluation of IGLS methodologies such as registration and deformation correction. However, these influences have not yet been comprehensively integrated into a platform usable for assessment of methods in laparoscopic IGLS. In this work, a mock laparoscopic liver simulator was created with realistic ligamenture to emulate the complexities of this constrained surgical environment for the realization of laparoscopic IGLS. The mock surgical system reproduces an insufflated abdominal cavity with dissectible ligaments, variable levels of incline matching intraoperative patient positioning, and port locations in accordance with surgical protocol. True positions of targets embedded in a tissue-mimicking phantom are measured from CT images. Using this setup, image-to-physical registration accuracy was evaluated for simulations of laparoscopic right and left lobe mobilization to assess rigid registration performance under more realistic laparoscopic conditions. Preliminary results suggest that non-rigid organ deformations and the region of organ surface data collected affect the ability to attain highly accurate registrations in laparoscopic applications.

Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh.

PubMed

Adams, Alayne; Sedalia, Saroj; McNab, Shanon; Sarker, Malabika

2016-03-01

Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the three MNH programmes under consideration employed different implementation models to deliver similar services and meet similar MNH goals. Programme targets included adoption of recommended antenatal, post-natal and essential newborn care practices; health systems strengthening through improved referral, accountability and administrative systems, and increased community knowledge. Drawing on focused examples from this research, seven steps for operationalizing the realist evaluation approach are offered, while emphasizing the need to iterate and innovate in terms of methods and analysis strategies. The paper concludes by reflecting on lessons learned in applying realist evaluation, and the unique insights it yields regarding implementation strategies for successful MNH programming. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Improving access to high-quality primary care for socioeconomically disadvantaged older people in rural areas: a mixed method study protocol

PubMed Central

Ford, John A; Jones, Andrew P; Wong, Geoff; Clark, Allan B; Porter, Tom; Shakespeare, Tom; Swart, Ann Marie; Steel, Nicholas

2015-01-01

Introduction The UK has an ageing population, especially in rural areas, where deprivation is high among older people. Previous research has identified this group as at high risk of poor access to healthcare. The aim of this study is to generate a theory of how socioeconomically disadvantaged older people from rural areas access primary care, to develop an intervention based on this theory and test it in a feasibility trial. Methods and analysis On the basis of the MRC Framework for Developing and Evaluating Complex Interventions, three methods will be used to generate the theory. First, a realist review will elucidate the patient pathway based on existing literature. Second, an analysis of the English Longitudinal Study of Ageing will be completed using structural equation modelling. Third, 15 semistructured interviews will be undertaken with patients and four focus groups with health professionals. A triangulation protocol will be used to allow each of these methods to inform and be informed by each other, and to integrate data into one overall realist theory. Based on this theory, an intervention will be developed in discussion with stakeholders to ensure that the intervention is feasible and practical. The intervention will be tested within a feasibility trial, the design of which will depend on the intervention. Lessons from the feasibility trial will be used to refine the intervention and gather the information needed for a definitive trial. Ethics and dissemination Ethics approval from the regional ethics committee has been granted for the focus groups with health professionals and interviews with patients. Ethics approval will be sought for the feasibility trial after the intervention has been designed. Findings will be disseminated to the key stakeholders involved in intervention development, to researchers, clinicians and health planners through peer-reviewed journal articles and conference publications, and locally through a dissemination event. PMID:26384728

Interventions targeted at primary care practitioners to improve the identification and referral of patients with co-morbid obesity: a realist review protocol.

PubMed

Blane, David N; Macdonald, Sara; Morrison, David; O'Donnell, Catherine A

2015-05-01

Obesity is one of the most significant public health challenges in the developed world. Recent policy has suggested that more can be done in primary care to support adults with obesity. In particular, general practitioners (GPs) and practice nurses (PNs) could improve the identification and referral of adults with obesity to appropriate weight management services. Previous interventions targeted at primary care practitioners in this area have had mixed results, suggesting a more complex interplay between patients, practitioners, and systems. The objectives of this review are (i) to identify the underlying 'programme theory' of interventions targeted at primary care practitioners to improve the identification and referral of adults with obesity and (ii) to explore how and why GPs and PNs identify and refer individuals with obesity, particularly in the context of weight-related co-morbidity. This protocol will explain the rationale for using a realist review approach and outline the key steps in this process. Realist review is a theory-led approach to knowledge synthesis that provides an explanatory analysis aimed at discerning what works, for whom, in what circumstances, how, and why. In this review, scoping interviews with key stakeholders involved in the planning and delivery of adult weight management services in Scotland helped to inform the identification of formal theories - from psychology, sociology, and implementation science - that will be tested as the review progresses. A comprehensive search strategy is described, including scope for iterative searching. Data analysis is outlined in three stages (describing context-mechanism-outcome configurations, exploring patterns in these configurations, and developing and testing middle-range theories, informed by the formal theories previously identified), culminating in the production of explanatory programme theory that considers individual, interpersonal, and institutional/systems-level components. This is the first realist review that we are aware of looking at interventions targeted at primary care practitioners to improve the weight management of adults with obesity. Engagement with stakeholders at an early stage is a unique feature of realist review. This shapes the scope of the review, identification of candidate theories and dissemination strategies. The findings of this review will inform policy and future interventions. PROSPERO CRD42014009391.

ICONE: An International Consortium of Neuro Endovascular Centres.

PubMed

Raymond, J; White, P; Kallmes, D F; Spears, J; Marotta, T; Roy, D; Guilbert, F; Weill, A; Nguyen, T; Molyneux, A J; Cloft, H; Cekirge, S; Saatci, I; Bracard, S; Meder, J F; Moret, J; Cognard, C; Qureshi, A I; Turk, A S; Berenstein, A

2008-06-30

The proliferation of new endovascular devices and therapeutic strategies calls for a prudentand rational evaluation of their clinical benefit. This evaluation must be done in an effective manner and in collaboration with industry. Such research initiative requires organisation a land methodological support to survive and thrive in a competitive environment. We propose the formation of an international consortium, an academic alliance committed to the pursuit of effective neurovascular therapies. Such a consortium would be dedicated to the designand execution of basic science, device developmentand clinical trials. The Consortium is owned and operated by its members. Members are international leaders in neurointerventional research and clinical practice. The Consortium brings competency, knowledge, and expertise to industry as well as to its membership across aspectrum of research initiatives such as: expedited review of clinical trials, protocol development, surveys and systematic reviews; laboratory expertise and support for research design and grant applications to public agencies. Once objectives and protocols are approved, the Consortium provides a stable network of centers capable of timely realization of clinical trials or pre clinical investigations in an optimal environment. The Consortium is a non-profit organization. The potential revenue generated from clientsponsored financial agreements will be redirected to the academic and research objectives of the organization. The Consortium wishes to work inconcert with industry, to support emerging trends in neurovascular therapeutic development. The Consortium is a realistic endeavour optimally structured to promote excellence through scientific appraisal of our treatments, and to accelerate technical progress while maximizing patients' safety and welfare.

Research protocol: a realist synthesis of cross-border patient mobility from low-income and middle-income countries

PubMed Central

Durham, Jo; Blondell, Sarah J

2014-01-01

Introduction People are increasingly mobile for numerous reasons, including healthcare. Patient mobility has vast implications for individuals, communities and whole populations and yet, to date, research on patient mobility has been quite limited. Only a small body of evidence exists on patient mobility between low-income and middle-income countries, instead having focused primarily on cross-border movement between high-income and low-income countries. In this paper, we present a protocol for examining this under-studied phenomenon. Methods and analysis We propose to examine patient mobility between low-income and middle-income countries using a realist synthesis approach. Specifically, we aim to document why patients from low-income and middle-income countries cross international borders for healthcare, by identifying the mechanisms through which patients decide to cross-borders, and the contextual characteristics of domestic health markets that influence this choice. An underlying theory was established, based on the lead author's experience and a brief literature review, which will provide the basis to analyse search results in a subsequent paper. Search results will be obtained from databases (Ovid Medline, EMBASE, Scopus, EconLit, Web of Science) and the grey literature. An expert committee will be enlisted, prior to screening results, to review search results to ensure comprehensiveness. Based on this preliminary theory, we propose that, in some low-income and middle-income country markets, the interaction between demand-side and supply-side determinants results in market imperfections that, in turn, lead to patient movement across borders. Ethics and dissemination The study does not involve primary research and, therefore, does not require formal ethical approval; we do, however, follow the relevant standards of utility, usefulness, feasibility, propriety, accuracy and accountability. The standards of realist and meta-narrative evidence synthesis (RAMESES) will be adhered to in reporting the findings of the review. Once completed, the findings of the resulting manuscript will be published in a peer-reviewed journal. Trial registration number This protocol has been registered with PROSPERO, registration number CRD42014014391. PMID:25406157

Shared Activity Coordination

NASA Technical Reports Server (NTRS)

Clement, Bradley J.; Barrett, Anthony C.

2003-01-01

Interacting agents that interleave planning and execution must reach consensus on their commitments to each other. In domains where agents have varying degrees of interaction and different constraints on communication and computation, agents will require different coordination protocols in order to efficiently reach consensus in real time. We briefly describe a largely unexplored class of real-time, distributed planning problems (inspired by interacting spacecraft missions), new challenges they pose, and a general approach to solving the problems. These problems involve self-interested agents that have infrequent communication but collaborate on joint activities. We describe a Shared Activity Coordination (SHAC) framework that provides a decentralized algorithm for negotiating the scheduling of shared activities in a dynamic environment, a soft, real-time approach to reaching consensus during execution with limited communication, and a foundation for customizing protocols for negotiating planner interactions. We apply SHAC to a realistic simulation of interacting Mars missions and illustrate the simplicity of protocol development.

Continual coordination through shared activities

NASA Technical Reports Server (NTRS)

Clement, Bradley J.; Barrett, Anthony C.

2003-01-01

Interacting agents that interleave planning and execution must reach consensus on their commitments to each other. In domains where agents have varying degrees of interaction and different constraints on communication and computation, agents will require different coordination protocols in order to efficiently reach consensus in real time. We briefly describe a largely unexplored class of realtime, distributed planning problems (inspired by interacting spacecraft missions), new challenges they pose, and a general approach to solving the problems. These problems involve self-interested agents that have infrequent communication but collaborate on joint activities. We describe a Shared Activity Coordination (SHAC) framework that provides a decentralized algorithm for negotiating the scheduling of shared activities over the lifetimes of separate missions, a soft, real-time approach to reaching consensus during execution with limited communication, and a foundation for customizing protocols for negotiating planner interactions. We apply SHAC to a realistic simulation of interacting Mars missions and illustrate the simplicity of protocol development.

Security of subcarrier wave quantum key distribution against the collective beam-splitting attack.

PubMed

Miroshnichenko, G P; Kozubov, A V; Gaidash, A A; Gleim, A V; Horoshko, D B

2018-04-30

We consider a subcarrier wave quantum key distribution (QKD) system, where quantum encoding is carried out at weak sidebands generated around a coherent optical beam as a result of electro-optical phase modulation. We study security of two protocols, B92 and BB84, against one of the most powerful attacks for this class of systems, the collective beam-splitting attack. Our analysis includes the case of high modulation index, where the sidebands are essentially multimode. We demonstrate numerically and experimentally that a subcarrier wave QKD system with realistic parameters is capable of distributing cryptographic keys over large distances in presence of collective attacks. We also show that BB84 protocol modification with discrimination of only one state in each basis performs not worse than the original BB84 protocol in this class of QKD systems, thus significantly simplifying the development of cryptographic networks using the considered QKD technique.

Evidence for the need of realistic radio communications for airline pilot simulator training and evaluation

DOT National Transportation Integrated Search

2003-11-05

This paper presents arguments in favor of realistic representation of radio communications during training and evaluation of airline pilots in the simulator. A survey of airlines showed that radio communications are mainly role-played by Instructor/E...

Dosimetry applications in GATE Monte Carlo toolkit.

PubMed

Papadimitroulas, Panagiotis

2017-09-01

Monte Carlo (MC) simulations are a well-established method for studying physical processes in medical physics. The purpose of this review is to present GATE dosimetry applications on diagnostic and therapeutic simulated protocols. There is a significant need for accurate quantification of the absorbed dose in several specific applications such as preclinical and pediatric studies. GATE is an open-source MC toolkit for simulating imaging, radiotherapy (RT) and dosimetry applications in a user-friendly environment, which is well validated and widely accepted by the scientific community. In RT applications, during treatment planning, it is essential to accurately assess the deposited energy and the absorbed dose per tissue/organ of interest, as well as the local statistical uncertainty. Several types of realistic dosimetric applications are described including: molecular imaging, radio-immunotherapy, radiotherapy and brachytherapy. GATE has been efficiently used in several applications, such as Dose Point Kernels, S-values, Brachytherapy parameters, and has been compared against various MC codes which are considered as standard tools for decades. Furthermore, the presented studies show reliable modeling of particle beams when comparing experimental with simulated data. Examples of different dosimetric protocols are reported for individualized dosimetry and simulations combining imaging and therapy dose monitoring, with the use of modern computational phantoms. Personalization of medical protocols can be achieved by combining GATE MC simulations with anthropomorphic computational models and clinical anatomical data. This is a review study, covering several dosimetric applications of GATE, and the different tools used for modeling realistic clinical acquisitions with accurate dose assessment. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Is islet transplantation a realistic approach to curing diabetes?

PubMed

Jin, Sang-Man; Kim, Kwang-Won

2017-01-01

Since the report of type 1 diabetes reversal in seven consecutive patients by the Edmonton protocol in 2000, pancreatic islet transplantation has been reappraised based on accumulated clinical evidence. Although initially expected to therapeutically target long-term insulin independence, islet transplantation is now indicated for more specific clinical benefits. With the long-awaited report of the first phase 3 clinical trial in 2016, allogeneic islet transplantation is now transitioning from an experimental to a proven therapy for type 1 diabetes with problematic hypoglycemia. Islet autotransplantation has already been therapeutically proven in chronic pancreatitis with severe abdominal pain refractory to conventional treatments, and it holds promise for preventing diabetes after partial pancreatectomy due to benign pancreatic tumors. Based on current evidence, this review focuses on islet transplantation as a realistic approach to treating diabetes.

The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

PubMed

Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

2018-03-01

Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

Security proof of a three-state quantum-key-distribution protocol without rotational symmetry

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

Fung, C.-H.F.; Lo, H.-K.

2006-10-15

Standard security proofs of quantum-key-distribution (QKD) protocols often rely on symmetry arguments. In this paper, we prove the security of a three-state protocol that does not possess rotational symmetry. The three-state QKD protocol we consider involves three qubit states, where the first two states |0{sub z}> and |1{sub z}> can contribute to key generation, and the third state |+>=(|0{sub z}>+|1{sub z}>)/{radical}(2) is for channel estimation. This protocol has been proposed and implemented experimentally in some frequency-based QKD systems where the three states can be prepared easily. Thus, by founding on the security of this three-state protocol, we prove that thesemore » QKD schemes are, in fact, unconditionally secure against any attacks allowed by quantum mechanics. The main task in our proof is to upper bound the phase error rate of the qubits given the bit error rates observed. Unconditional security can then be proved not only for the ideal case of a single-photon source and perfect detectors, but also for the realistic case of a phase-randomized weak coherent light source and imperfect threshold detectors. Our result in the phase error rate upper bound is independent of the loss in the channel. Also, we compare the three-state protocol with the Bennett-Brassard 1984 (BB84) protocol. For the single-photon source case, our result proves that the BB84 protocol strictly tolerates a higher quantum bit error rate than the three-state protocol, while for the coherent-source case, the BB84 protocol achieves a higher key generation rate and secure distance than the three-state protocol when a decoy-state method is used.« less

Optimizing performance of hybrid FSO/RF networks in realistic dynamic scenarios

NASA Astrophysics Data System (ADS)

Llorca, Jaime; Desai, Aniket; Baskaran, Eswaran; Milner, Stuart; Davis, Christopher

2005-08-01

Hybrid Free Space Optical (FSO) and Radio Frequency (RF) networks promise highly available wireless broadband connectivity and quality of service (QoS), particularly suitable for emerging network applications involving extremely high data rate transmissions such as high quality video-on-demand and real-time surveillance. FSO links are prone to atmospheric obscuration (fog, clouds, snow, etc) and are difficult to align over long distances due the use of narrow laser beams and the effect of atmospheric turbulence. These problems can be mitigated by using adjunct directional RF links, which provide backup connectivity. In this paper, methodologies for modeling and simulation of hybrid FSO/RF networks are described. Individual link propagation models are derived using scattering theory, as well as experimental measurements. MATLAB is used to generate realistic atmospheric obscuration scenarios, including moving cloud layers at different altitudes. These scenarios are then imported into a network simulator (OPNET) to emulate mobile hybrid FSO/RF networks. This framework allows accurate analysis of the effects of node mobility, atmospheric obscuration and traffic demands on network performance, and precise evaluation of topology reconfiguration algorithms as they react to dynamic changes in the network. Results show how topology reconfiguration algorithms, together with enhancements to TCP/IP protocols which reduce the network response time, enable the network to rapidly detect and act upon link state changes in highly dynamic environments, ensuring optimized network performance and availability.

A Multi-Center Space Data System Prototype Based on CCSDS Standards

NASA Technical Reports Server (NTRS)

Rich, Thomas M.

2016-01-01

Deep space missions beyond earth orbit will require new methods of data communications in order to compensate for increasing Radio Frequency (RF) propagation delay. The Consultative Committee for Space Data Systems (CCSDS) standard protocols Spacecraft Monitor & Control (SM&C), Asynchronous Message Service (AMS), and Delay/Disruption Tolerant Networking (DTN) provide such a method. However, the maturity level of this protocol stack is insufficient for mission inclusion at this time. This Space Data System prototype is intended to provide experience which will raise the Technical Readiness Level (TRL) of this protocol set. In order to reduce costs, future missions can take advantage of these standard protocols, which will result in increased interoperability between control centers. This prototype demonstrates these capabilities by implementing a realistic space data system in which telemetry is published to control center applications at the Jet Propulsion Lab (JPL), the Marshall Space Flight Center (MSFC), and the Johnson Space Center (JSC). Reverse publishing paths for commanding from each control center are also implemented. The target vehicle consists of realistic flight computer hardware running Core Flight Software (CFS) in the integrated Power, Avionics, and Power (iPAS) Pathfinder Lab at JSC. This prototype demonstrates a potential upgrade path for future Deep Space Network (DSN) modification, in which the automatic error recovery and communication gap compensation capabilities of DTN would be exploited. In addition, SM&C provides architectural flexibility by allowing new service providers and consumers to be added efficiently anywhere in the network using the common interface provided by SM&C's Message Abstraction Layer (MAL). In FY 2015, this space data system was enhanced by adding telerobotic operations capability provided by the Robot API Delegate (RAPID) family of protocols developed at NASA. RAPID is one of several candidates for consideration and inclusion in a new international standard being developed by the CCSDS Telerobotic Operations Working Group. Software gateways for the purpose of interfacing RAPID messages with the existing SM&C based infrastructure were developed. Telerobotic monitor, control, and bridge applications were written in the RAPID framework, which were then tailored to the NAO telerobotic test article hardware, a product of Aldebaran Robotics.

A novel ultra high-throughput 16S rRNA gene amplicon sequencing library preparation method for the Illumina HiSeq platform.

PubMed

de Muinck, Eric J; Trosvik, Pål; Gilfillan, Gregor D; Hov, Johannes R; Sundaram, Arvind Y M

2017-07-06

Advances in sequencing technologies and bioinformatics have made the analysis of microbial communities almost routine. Nonetheless, the need remains to improve on the techniques used for gathering such data, including increasing throughput while lowering cost and benchmarking the techniques so that potential sources of bias can be better characterized. We present a triple-index amplicon sequencing strategy to sequence large numbers of samples at significantly lower c ost and in a shorter timeframe compared to existing methods. The design employs a two-stage PCR protocol, incorpo rating three barcodes to each sample, with the possibility to add a fourth-index. It also includes heterogeneity spacers to overcome low complexity issues faced when sequencing amplicons on Illumina platforms. The library preparation method was extensively benchmarked through analysis of a mock community in order to assess biases introduced by sample indexing, number of PCR cycles, and template concentration. We further evaluated the method through re-sequencing of a standardized environmental sample. Finally, we evaluated our protocol on a set of fecal samples from a small cohort of healthy adults, demonstrating good performance in a realistic experimental setting. Between-sample variation was mainly related to batch effects, such as DNA extraction, while sample indexing was also a significant source of bias. PCR cycle number strongly influenced chimera formation and affected relative abundance estimates of species with high GC content. Libraries were sequenced using the Illumina HiSeq and MiSeq platforms to demonstrate that this protocol is highly scalable to sequence thousands of samples at a very low cost. Here, we provide the most comprehensive study of performance and bias inherent to a 16S rRNA gene amplicon sequencing method to date. Triple-indexing greatly reduces the number of long custom DNA oligos required for library preparation, while the inclusion of variable length heterogeneity spacers minimizes the need for PhiX spike-in. This design results in a significant cost reduction of highly multiplexed amplicon sequencing. The biases we characterize highlight the need for highly standardized protocols. Reassuringly, we find that the biological signal is a far stronger structuring factor than the various sources of bias.

Fair loss-tolerant quantum coin flipping

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

Berlin, Guido; Brassard, Gilles; Bussieres, Felix

Coin flipping is a cryptographic primitive in which two spatially separated players, who do not trust each other, wish to establish a common random bit. If we limit ourselves to classical communication, this task requires either assumptions on the computational power of the players or it requires them to send messages to each other with sufficient simultaneity to force their complete independence. Without such assumptions, all classical protocols are so that one dishonest player has complete control over the outcome. If we use quantum communication, on the other hand, protocols have been introduced that limit the maximal bias that dishonestmore » players can produce. However, those protocols would be very difficult to implement in practice because they are susceptible to realistic losses on the quantum channel between the players or in their quantum memory and measurement apparatus. In this paper, we introduce a quantum protocol and we prove that it is completely impervious to loss. The protocol is fair in the sense that either player has the same probability of success in cheating attempts at biasing the outcome of the coin flip. We also give explicit and optimal cheating strategies for both players.« less

Efficiency of Adaptive Temperature-Based Replica Exchange for Sampling Large-Scale Protein Conformational Transitions.

PubMed

Zhang, Weihong; Chen, Jianhan

2013-06-11

Temperature-based replica exchange (RE) is now considered a principal technique for enhanced sampling of protein conformations. It is also recognized that existence of sharp cooperative transitions (such as protein folding/unfolding) can lead to temperature exchange bottlenecks and significantly reduce the sampling efficiency. Here, we revisit two adaptive temperature-based RE protocols, namely, exchange equalization (EE) and current maximization (CM), that were previously examined using atomistic simulations (Lee and Olson, J. Chem. Physics2011, 134, 24111). Both protocols aim to overcome exchange bottlenecks by adaptively adjusting the simulation temperatures, either to achieve uniform exchange rates (in EE) or to maximize temperature diffusion (CM). By designing a realistic yet computationally tractable coarse-grained protein model, one can sample many reversible folding/unfolding transitions using conventional constant temperature molecular dynamics (MD), standard REMD, EE-REMD, and CM-REMD. This allows rigorous evaluation of the sampling efficiency, by directly comparing the rates of folding/unfolding transitions and convergence of various thermodynamic properties of interest. The results demonstrate that both EE and CM can indeed enhance temperature diffusion compared to standard RE, by ∼3- and over 10-fold, respectively. Surprisingly, the rates of reversible folding/unfolding transitions are similar in all three RE protocols. The convergence rates of several key thermodynamic properties, including the folding stability and various 1D and 2D free energy surfaces, are also similar. Therefore, the efficiency of RE protocols does not appear to be limited by temperature diffusion, but by the inherent rates of spontaneous large-scale conformational rearrangements. This is particularly true considering that virtually all RE simulations of proteins in practice involve exchange attempt frequencies (∼ps(-1)) that are several orders of magnitude faster than the slowest protein motions (∼μs(-1)). Our results also suggest that the efficiency of RE will not likely be improved by other protocols that aim to accelerate exchange or temperature diffusion. Instead, protocols with some types of guided tempering will likely be necessary to drive faster large-scale conformational transitions.

Optimization and comparison of simultaneous and separate acquisition protocols for dual isotope myocardial perfusion SPECT.

PubMed

Ghaly, Michael; Links, Jonathan M; Frey, Eric C

2015-07-07

Dual-isotope simultaneous-acquisition (DISA) rest-stress myocardial perfusion SPECT (MPS) protocols offer a number of advantages over separate acquisition. However, crosstalk contamination due to scatter in the patient and interactions in the collimator degrade image quality. Compensation can reduce the effects of crosstalk, but does not entirely eliminate image degradations. Optimizing acquisition parameters could further reduce the impact of crosstalk. In this paper we investigate the optimization of the rest Tl-201 energy window width and relative injected activities using the ideal observer (IO), a realistic digital phantom population and Monte Carlo (MC) simulated Tc-99m and Tl-201 projections as a means to improve image quality. We compared performance on a perfusion defect detection task for Tl-201 acquisition energy window widths varying from 4 to 40 keV centered at 72 keV for a camera with a 9% energy resolution. We also investigated 7 different relative injected activities, defined as the ratio of Tc-99m and Tl-201 activities, while keeping the total effective dose constant at 13.5 mSv. For each energy window and relative injected activity, we computed the IO test statistics using a Markov chain Monte Carlo (MCMC) method for an ensemble of 1,620 triplets of fixed and reversible defect-present, and defect-absent noisy images modeling realistic background variations. The volume under the 3-class receiver operating characteristic (ROC) surface (VUS) was estimated and served as the figure of merit. For simultaneous acquisition, the IO suggested that relative Tc-to-Tl injected activity ratios of 2.6-5 and acquisition energy window widths of 16-22% were optimal. For separate acquisition, we observed a broad range of optimal relative injected activities from 2.6 to 12.1 and acquisition energy window of widths 16-22%. A negative correlation between Tl-201 injected activity and the width of the Tl-201 energy window was observed in these ranges. The results also suggested that DISA methods could potentially provide image quality as good as that obtained with separate acquisition protocols. We compared observer performance for the optimized protocols and the current clinical protocol using separate acquisition. The current clinical protocols provided better performance at a cost of injecting the patient with approximately double the injected activity of Tc-99m and Tl-201, resulting in substantially increased radiation dose.

TOXICOLOGICAL EVALUATION OF REALISTIC EMISSIONS OF SOURCE AEROSOLS (TERESA): APPLICATION TO POWER PLANT-DERIVED PM2.5

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

Annette Rohr

2006-03-01

TERESA (Toxicological Evaluation of Realistic Emissions of Source Aerosols) involves exposing laboratory rats to realistic coal-fired power plant and mobile source emissions to help determine the relative toxicity of these PM sources. There are three coal-fired power plants in the TERESA program; this report describes the results of fieldwork conducted at the first plant, located in the Upper Midwest. The project was technically challenging by virtue of its novel design and requirement for the development of new techniques. By examining aged, atmospherically transformed aerosol derived from power plant stack emissions, we were able to evaluate the toxicity of PM derivedmore » from coal combustion in a manner that more accurately reflects the exposure of concern than existing methodologies. TERESA also involves assessment of actual plant emissions in a field setting--an important strength since it reduces the question of representativeness of emissions. A sampling system was developed and assembled to draw emissions from the stack; stack sampling conducted according to standard EPA protocol suggested that the sampled emissions are representative of those exiting the stack into the atmosphere. Two mobile laboratories were then outfitted for the study: (1) a chemical laboratory in which the atmospheric aging was conducted and which housed the bulk of the analytical equipment; and (2) a toxicological laboratory, which contained animal caging and the exposure apparatus. Animal exposures were carried out from May-November 2004 to a number of simulated atmospheric scenarios. Toxicological endpoints included (1) pulmonary function and breathing pattern; (2) bronchoalveolar lavage fluid cytological and biochemical analyses; (3) blood cytological analyses; (4) in vivo oxidative stress in heart and lung tissue; and (5) heart and lung histopathology. Results indicated no differences between exposed and control animals in any of the endpoints examined. Exposure concentrations for the scenarios utilizing secondary particles (oxidized emissions) ranged from 70-256 {micro}g/m{sup 3}, and some of the atmospheres contained high acidity levels (up to 49 {micro}g/m{sup 3} equivalent of sulfuric acid). However, caution must be used in generalizing these results to other power plants utilizing different coal types and with different plant configurations, as the emissions may vary based on these factors.« less

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC).

PubMed

Rycroft-Malone, Jo; Wilkinson, Joyce E; Burton, Christopher R; Andrews, Gavin; Ariss, Steven; Baker, Richard; Dopson, Sue; Graham, Ian; Harvey, Gill; Martin, Graham; McCormack, Brendan G; Staniszewska, Sophie; Thompson, Carl

2011-07-19

The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances. This study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum. The idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement.

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

PubMed Central

2011-01-01

Background The English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances. Design and methods This study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum. Discussion The idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement. PMID:21771329

Adoption, Acceptability, and Effectiveness of a Mobile Health App for Personalized Prostate Cancer Survivorship Care: Protocol for a Realist Case Study of the Ned App

PubMed Central

Cafazzo, Joseph A; Feifer, Andrew

2017-01-01

Background By 2030, prostate cancer will be the most commonly diagnosed cancer in North America. To mitigate this impending challenge, comprehensive support mechanisms for disease- and treatment-specific changes in health and well-being must be proactively designed and thoughtfully implemented for streamlined survivorship care. mHealth apps have been lauded as a promising complement to current outpatient treatment and monitoring strategies, but have not yet been widely used to support prostate cancer survivorship needs. A realist evaluation is needed to examine the impact of such apps on the prostate cancer survivorship experience. Objective We seek to gain an understanding of how an mHealth app for prostate cancer survivorship care called Ned (No Evident Disease) is adopted and accepted by patients, caregivers, and clinicians. We also aim to determine the effect of Ned on health-related quality of life, satisfaction with cancer care, unmet needs, self-efficacy, and prostate cancer-related levels of anxiety. Methods The Ned case study is a 12-month mixed-methods embedded single-case study with a nested within-group pre-post comparison of health outcomes. We will give 400 patients, 200 caregivers, and 10 clinicians access to Ned. Participants will be asked to complete study assessments at baseline, 2 months, 6 months, and 12 months. We will conduct 30 semistructured qualitative interviews with patients (n=20) and their caregivers (n=10) poststudy to gain insight into their experience with the app. Results We recruited our first survivor in October 2017 and anticipate completing this study by May 2019. Conclusions This will, to our knowledge, be the first realist case study to evaluate an app for prostate cancer survivorship care. Prostate cancer survivors are set to increase in number and longevity, heightening the need for integrated survivorship solutions to provide them with optimal and durable outcomes. The knowledge gained from this study will comprehensively inform how and why Ned works, for whom, and in what circumstances. Understanding the impact of digital health interventions such as Ned on how survivors care for themselves is critical to realizing patient-centered care. PMID:29025699

Classification and evaluation strategies of auto-segmentation approaches for PET: Report of AAPM task group No. 211

PubMed Central

Hatt, Mathieu; Lee, John A.; Schmidtlein, Charles R.; Naqa, Issam El; Caldwell, Curtis; De Bernardi, Elisabetta; Lu, Wei; Das, Shiva; Geets, Xavier; Gregoire, Vincent; Jeraj, Robert; MacManus, Michael P.; Mawlawi, Osama R.; Nestle, Ursula; Pugachev, Andrei B.; Schöder, Heiko; Shepherd, Tony; Spezi, Emiliano; Visvikis, Dimitris; Zaidi, Habib; Kirov, Assen S.

2017-01-01

Purpose The purpose of this educational report is to provide an overview of the present state-of-the-art PET auto-segmentation (PET-AS) algorithms and their respective validation, with an emphasis on providing the user with help in understanding the challenges and pitfalls associated with selecting and implementing a PET-AS algorithm for a particular application. Approach A brief description of the different types of PET-AS algorithms is provided using a classification based on method complexity and type. The advantages and the limitations of the current PET-AS algorithms are highlighted based on current publications and existing comparison studies. A review of the available image datasets and contour evaluation metrics in terms of their applicability for establishing a standardized evaluation of PET-AS algorithms is provided. The performance requirements for the algorithms and their dependence on the application, the radiotracer used and the evaluation criteria are described and discussed. Finally, a procedure for algorithm acceptance and implementation, as well as the complementary role of manual and auto-segmentation are addressed. Findings A large number of PET-AS algorithms have been developed within the last 20 years. Many of the proposed algorithms are based on either fixed or adaptively selected thresholds. More recently, numerous papers have proposed the use of more advanced image analysis paradigms to perform semi-automated delineation of the PET images. However, the level of algorithm validation is variable and for most published algorithms is either insufficient or inconsistent which prevents recommending a single algorithm. This is compounded by the fact that realistic image configurations with low signal-to-noise ratios (SNR) and heterogeneous tracer distributions have rarely been used. Large variations in the evaluation methods used in the literature point to the need for a standardized evaluation protocol. Conclusions Available comparison studies suggest that PET-AS algorithms relying on advanced image analysis paradigms provide generally more accurate segmentation than approaches based on PET activity thresholds, particularly for realistic configurations. However, this may not be the case for simple shape lesions in situations with a narrower range of parameters, where simpler methods may also perform well. Recent algorithms which employ some type of consensus or automatic selection between several PET-AS methods have potential to overcome the limitations of the individual methods when appropriately trained. In either case, accuracy evaluation is required for each different PET scanner and scanning and image reconstruction protocol. For the simpler, less robust approaches, adaptation to scanning conditions, tumor type, and tumor location by optimization of parameters is necessary. The results from the method evaluation stage can be used to estimate the contouring uncertainty. All PET-AS contours should be critically verified by a physician. A standard test, i.e., a benchmark dedicated to evaluating both existing and future PET-AS algorithms needs to be designed, to aid clinicians in evaluating and selecting PET-AS algorithms and to establish performance limits for their acceptance for clinical use. The initial steps toward designing and building such a standard are undertaken by the task group members. PMID:28120467

What Today's Educational Technology Needs: Defensible Evaluations and Realistic Implementation.

ERIC Educational Resources Information Center

Roweton, William E.; And Others

It is argued that in order to make computer assisted instruction effective in the schools, educators should pay more attention to implementation issues (including modifying teacher attitudes, changing classroom routines, and offering realistic technical training and support) and to producing understandable product and performance evaluations.…

Faculty Development for Educators: A Realist Evaluation

ERIC Educational Resources Information Center

Sorinola, Olanrewaju O.; Thistlethwaite, Jill; Davies, David; Peile, Ed

2015-01-01

The effectiveness of faculty development (FD) activities for educators in UK medical schools remains underexplored. This study used a realist approach to evaluate FD and to test the hypothesis that motivation, engagement and perception are key mechanisms of effective FD activities. The authors observed and interviewed 33 course participants at one…

A Mobile Asset Tracking System Architecture under Mobile-Stationary Co-Existing WSNs

PubMed Central

Kim, Tae Hyon; Jo, Hyeong Gon; Lee, Jae Shin; Kang, Soon Ju

2012-01-01

The tracking of multiple wireless mobile nodes is not easy with current legacy WSN technologies, due to their inherent technical complexity, especially when heavy traffic and frequent movement of mobile nodes are encountered. To enable mobile asset tracking under these legacy WSN systems, it is necessary to design a specific system architecture that can manage numerous mobile nodes attached to mobile assets. In this paper, we present a practical system architecture including a communication protocol, a three-tier network, and server-side middleware for mobile asset tracking in legacy WSNs consisting of mobile-stationary co-existing infrastructures, and we prove the functionality of this architecture through careful evaluation in a test bed. Evaluation was carried out in a microwave anechoic chamber as well as on a straight road near our office. We evaluated communication mobility performance between mobile and stationary nodes, location-awareness performance, system stability under numerous mobile node conditions, and the successful packet transfer rate according to the speed of the mobile nodes. The results indicate that the proposed architecture is sufficiently robust for application in realistic mobile asset tracking services that require a large number of mobile nodes. PMID:23242277

RNA-seq mixology: designing realistic control experiments to compare protocols and analysis methods

PubMed Central

Holik, Aliaksei Z.; Law, Charity W.; Liu, Ruijie; Wang, Zeya; Wang, Wenyi; Ahn, Jaeil; Asselin-Labat, Marie-Liesse; Smyth, Gordon K.

2017-01-01

Abstract Carefully designed control experiments provide a gold standard for benchmarking different genomics research tools. A shortcoming of many gene expression control studies is that replication involves profiling the same reference RNA sample multiple times. This leads to low, pure technical noise that is atypical of regular studies. To achieve a more realistic noise structure, we generated a RNA-sequencing mixture experiment using two cell lines of the same cancer type. Variability was added by extracting RNA from independent cell cultures and degrading particular samples. The systematic gene expression changes induced by this design allowed benchmarking of different library preparation kits (standard poly-A versus total RNA with Ribozero depletion) and analysis pipelines. Data generated using the total RNA kit had more signal for introns and various RNA classes (ncRNA, snRNA, snoRNA) and less variability after degradation. For differential expression analysis, voom with quality weights marginally outperformed other popular methods, while for differential splicing, DEXSeq was simultaneously the most sensitive and the most inconsistent method. For sample deconvolution analysis, DeMix outperformed IsoPure convincingly. Our RNA-sequencing data set provides a valuable resource for benchmarking different protocols and data pre-processing workflows. The extra noise mimics routine lab experiments more closely, ensuring any conclusions are widely applicable. PMID:27899618

SU-E-I-88: Realistic Pathological Simulations of the NCAT and Zubal Anthropomorphic Models, Based on Clinical PET/CT Data.

PubMed

Papadimitroulas, P; Loudos, G; Le Maitre, A; Efthimiou, N; Visvikis, D; Nikiforidis, G; Kagadis, G C

2012-06-01

In the present study a patient-specific dataset of realistic PET simulations was created, taking into account the variability of clinical oncology data. Tumor variability was tested in the simulated results. A comparison of the produced simulated data was performed to clinical PET/CT data, for the validation and the evaluation of the procedure. Clinical PET/CT data of oncology patients were used as the basis of the simulated variability inserting patient-specific characteristics in the NCAT and the Zubal anthropomorphic phantoms. GATE Monte Carlo toolkit was used for simulating a commercial PET scanner. The standard computational anthropomorphic phantoms were adapted to the CT data (organ shapes), using a fitting algorithm. The activity map was derived from PET images. Patient tumors were segmented and inserted in the phantom, using different activity distributions. The produced simulated data were reconstructed using the STIR opensource software and compared to the original clinical ones. The accuracy of the procedure was tested in four different oncology cases. Each pathological situation was illustrated simulating a) a healthy body, b) insertion of the clinical tumor with homogenous activity, and c) insertion of the clinical tumor with variable activity (voxel-by-voxel) based on the clinical PET data. The accuracy of the presented dataset was compared to the original PET/CT data. Partial Volume Correction (PVC) was also applied in the simulated data. In this study patient-specific characteristics were used in computational anthropomorphic models for simulating realistic pathological patients. Voxel-by-voxel activity distribution with PVC within the tumor gives the most accurate results. Radiotherapy applications can utilize the benefits of the accurate realistic imaging simulations, using the anatomicaland biological information of each patient. Further work will incorporate the development of analytical anthropomorphic models with motion and cardiac correction, combined with pathological patients to achieve high accuracy in tumor imaging. This research was supported by the Joint Research and Technology Program between Greece and France; 2009-2011 (protocol ID: 09FR103). © 2012 American Association of Physicists in Medicine.

Using comprehensive geriatric assessment for quality improvements in healthcare of older people in UK care homes: protocol for realist review within Proactive Healthcare of Older People in Care Homes (PEACH) study.

PubMed

Zubair, Maria; Chadborn, Neil H; Gladman, John R F; Dening, Tom; Gordon, Adam L; Goodman, Claire

2017-10-10

Care home residents are relatively high users of healthcare resources and may have complex needs. Comprehensive geriatric assessment (CGA) may benefit care home residents and improve efficiency of care delivery. This is an approach to care in which there is a thorough multidisciplinary assessment (physical and mental health, functioning and physical and social environments) and a care plan based on this assessment, usually delivered by a multidisciplinary team. The CGA process is known to improve outcomes for community-dwelling older people and those in receipt of hospital care, but less is known about its efficacy in care home residents. Realist review was selected as the most appropriate method to explore the complex nature of the care home setting and multidisciplinary delivery of care. The aim of the realist review is to identify and characterise a programme theory that underpins the CGA intervention. The realist review will extract data from research articles which describe the causal mechanisms through which the practice of CGA generates outcomes. The focus of the intervention is care homes, and the outcomes of interest are health-related quality of life and satisfaction with services; for both residents and staff. Further outcomes may include appropriate use of National Health Service services and resources of older care home residents. The review will proceed through three stages: (1) identifying the candidate programme theories that underpin CGA through interviews with key stakeholders, systematic search of the peer-reviewed and non-peer-reviewed evidence, (2) identifying the evidence relevant to CGA in UK care homes and refining the programme theories through refining and iterating the systematic search, lateral searches and seeking further information from study authors and (3) analysis and synthesis of evidence, involving the testing of the programme theories. The PEACH project was identified as service development following submission to the UK Health Research Authority and subsequent review by the University of Nottingham Research Ethics Committee. The study protocols have been reviewed as part of good governance by the Nottinghamshire Healthcare Foundation Trust. We aim to publish this realist review in a peer-reviewed journal with international readership. We will disseminate findings to public and stakeholders using knowledge mobilisation techniques. Stakeholders will include the Quality Improvement Collaboratives within PEACH study. National networks, such as British Society of Gerontology and National Care Association will be approached for wider dissemination. The realist review has been registered on International Prospective Register of Systematic Reviews (PROSPERO 2017: CRD42017062601). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surface radiation dose comparison of a dedicated extremity cone beam computed tomography (CBCT) device and a multidetector computed tomography (MDCT) machine in pediatric ankle and wrist phantoms

PubMed Central

Nagy, Eszter; Apfaltrer, Georg; Riccabona, Michael; Singer, Georg; Stücklschweiger, Georg; Guss, Helmuth; Sorantin, Erich

2017-01-01

Objectives To evaluate and compare surface doses of a cone beam computed tomography (CBCT) and a multidetector computed tomography (MDCT) device in pediatric ankle and wrist phantoms. Methods Thermoluminescent dosimeters (TLD) were used to measure and compare surface doses between CBCT and MDCT in a left ankle and a right wrist pediatric phantom. In both modalities adapted pediatric dose protocols were utilized to achieve realistic imaging conditions. All measurements were repeated three times to prove test-retest reliability. Additionally, objective and subjective image quality parameters were assessed. Results Average surface doses were 3.8 ±2.1 mGy for the ankle, and 2.2 ±1.3 mGy for the wrist in CBCT. The corresponding surface doses in optimized MDCT were 4.5 ±1.3 mGy for the ankle, and 3.4 ±0.7 mGy for the wrist. Overall, mean surface dose was significantly lower in CBCT (3.0 ±1.9 mGy vs. 3.9 ±1.2 mGy, p<0.001). Subjectively rated general image quality was not significantly different between the study protocols (p = 0.421), whereas objectively measured image quality parameters were in favor of CBCT (p<0.001). Conclusions Adapted extremity CBCT imaging protocols have the potential to fall below optimized pediatric ankle and wrist MDCT doses at comparable image qualities. These possible dose savings warrant further development and research in pediatric extremity CBCT applications. PMID:28570626

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

PubMed

Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

2018-01-01

Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol.

PubMed

Forster, N; Dalkin, S M; Lhussier, M; Hodgson, P; Carr, S M

2016-01-20

Welfare advice services can be used to address health inequalities, for example, through Citizens Advice Bureau (CAB). Recent reviews highlight evidence for the impact of advice services in improving people's financial position and improving mental health and well-being, daily living and social relationships. There is also some evidence for the impact of advice services in increasing accessibility of health services, and reducing general practitioner appointments and prescriptions. However, direct evidence for the impact of advice services on lifestyle behaviour and physical health is currently much less well established. There is a need for greater empirical testing of theories around the specific mechanisms through which advice services and associated financial or non-financial benefits may generate health improvements. A realist evaluation will be conducted, operationalised in 5 phases: building the explanatory framework; refining the explanatory framework; testing the explanatory framework through empirical data (mixed methods); development of a bespoke data recording template to capture longer term impact; and verification of findings with a range of CAB services. This research will therefore aim to build, refine and test an explanatory framework about how CAB services can be optimally implemented to achieve health improvement. The study was approved by the ethics committee at Northumbria University, UK. Project-related ethical issues are described and quality control aspects of the study are considered. A stakeholder mapping exercise will inform the dissemination of results in order to ensure all relevant institutions and organisations are targeted. 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/

Cryptography from noisy storage.

PubMed

Wehner, Stephanie; Schaffner, Christian; Terhal, Barbara M

2008-06-06

We show how to implement cryptographic primitives based on the realistic assumption that quantum storage of qubits is noisy. We thereby consider individual-storage attacks; i.e., the dishonest party attempts to store each incoming qubit separately. Our model is similar to the model of bounded-quantum storage; however, we consider an explicit noise model inspired by present-day technology. To illustrate the power of this new model, we show that a protocol for oblivious transfer is secure for any amount of quantum-storage noise, as long as honest players can perform perfect quantum operations. Our model also allows us to show the security of protocols that cope with noise in the operations of the honest players and achieve more advanced tasks such as secure identification.

Development and characterization of a dynamic lesion phantom for the quantitative evaluation of dynamic contrast-enhanced MRI

PubMed Central

Freed, Melanie; de Zwart, Jacco A.; Hariharan, Prasanna; R. Myers, Matthew; Badano, Aldo

2011-01-01

Purpose: To develop a dynamic lesion phantom that is capable of producing physiological kinetic curves representative of those seen in human dynamic contrast-enhanced MRI (DCE-MRI) data. The objective of this phantom is to provide a platform for the quantitative comparison of DCE-MRI protocols to aid in the standardization and optimization of breast DCE-MRI. Methods: The dynamic lesion consists of a hollow, plastic mold with inlet and outlet tubes to allow flow of a contrast agent solution through the lesion over time. Border shape of the lesion can be controlled using the lesion mold production method. The configuration of the inlet and outlet tubes was determined using fluid transfer simulations. The total fluid flow rate was determined using x-ray images of the lesion for four different flow rates (0.25, 0.5, 1.0, and 1.5 ml∕s) to evaluate the resultant kinetic curve shape and homogeneity of the contrast agent distribution in the dynamic lesion. High spatial and temporal resolution x-ray measurements were used to estimate the true kinetic curve behavior in the dynamic lesion for benign and malignant example curves. DCE-MRI example data were acquired of the dynamic phantom using a clinical protocol. Results: The optimal inlet and outlet tube configuration for the lesion molds was two inlet molds separated by 30° and a single outlet tube directly between the two inlet tubes. X-ray measurements indicated that 1.0 ml∕s was an appropriate total fluid flow rate and provided truth for comparison with MRI data of kinetic curves representative of benign and malignant lesions. DCE-MRI data demonstrated the ability of the phantom to produce realistic kinetic curves. Conclusions: The authors have constructed a dynamic lesion phantom, demonstrated its ability to produce physiological kinetic curves, and provided estimations of its true kinetic curve behavior. This lesion phantom provides a tool for the quantitative evaluation of DCE-MRI protocols, which may lead to improved discrimination of breast cancer lesions. PMID:21992378

Must Metaethical Realism Make a Semantic Claim?

PubMed

Kahane, Guy

2013-02-01

Mackie drew attention to the distinct semantic and metaphysical claims made by meta ethical realists, arguing that although our evaluative discourse is cognitive and objective, there are no objective evaluative facts. This distinction, however, also opens up a reverse possibility: that our evaluative discourse is antirealist, yet objective values do exist. I suggest that this seemingly far-fetched possibility merits serious attention; realism seems com mitted to its intelligibility, and, despite appearances, it isn't incoherent, ineffable, inherently implausible or impossible to defend. I argue that reflection on this possibility should lead us to revise our understanding of the debate between realists and antirealists. It is not only that the realist's semantic claim is insufficient for realism to be true, as Mackie argued; it's not even necessary. Robust metaethical realism is best understood as making a purely metaphysical claim. It is thus not enough for antirealists to show that our discourse is antirealist. They must directly attack the realist's metaphysical claim.

Multimodal biometrics for identity documents (MBioID).

PubMed

Dessimoz, Damien; Richiardi, Jonas; Champod, Christophe; Drygajlo, Andrzej

2007-04-11

The MBioID initiative has been set up to address the following germane question: What and how biometric technologies could be deployed in identity documents in the foreseeable future? This research effort proposes to look at current and future practices and systems of establishing and using biometric identity documents (IDs) and evaluate their effectiveness in large-scale developments. The first objective of the MBioID project is to present a review document establishing the current state-of-the-art related to the use of multimodal biometrics in an IDs application. This research report gives the main definitions, properties and the framework of use related to biometrics, an overview of the main standards developed in the biometric industry and standardisation organisations to ensure interoperability, as well as some of the legal framework and the issues associated to biometrics such as privacy and personal data protection. The state-of-the-art in terms of technological development is also summarised for a range of single biometric modalities (2D and 3D face, fingerprint, iris, on-line signature and speech), chosen according to ICAO recommendations and availabilities, and for various multimodal approaches. This paper gives a summary of the main elements of that report. The second objective of the MBioID project is to propose relevant acquisition and evaluation protocols for a large-scale deployment of biometric IDs. Combined with the protocols, a multimodal database will be acquired in a realistic way, in order to be as close as possible to a real biometric IDs deployment. In this paper, the issues and solutions related to the acquisition setup are briefly presented.

A New Realistic Evaluation Analysis Method: Linked Coding of Context, Mechanism, and Outcome Relationships

ERIC Educational Resources Information Center

Jackson, Suzanne F.; Kolla, Gillian

2012-01-01

In attempting to use a realistic evaluation approach to explore the role of Community Parents in early parenting programs in Toronto, a novel technique was developed to analyze the links between contexts (C), mechanisms (M) and outcomes (O) directly from experienced practitioner interviews. Rather than coding the interviews into themes in terms of…

Realist Evaluation in Wraparound: A New Approach in Social Work Evidence-Based Practice

ERIC Educational Resources Information Center

Kazi, Mansoor A. F.; Pagkos, Brian; Milch, Heidi A.

2011-01-01

Objectives: The purpose of this study was to develop a realist evaluation paradigm in social work evidence-based practice. Method: Wraparound (at Gateway-Longview Inc., New York) used a reliable outcome measure and an electronic database to systematically collect and analyze data on the interventions, the client demographics and circumstances, and…

Objective and automated protocols for the evaluation of biomedical search engines using No Title Evaluation protocols.

PubMed

Campagne, Fabien

2008-02-29

The evaluation of information retrieval techniques has traditionally relied on human judges to determine which documents are relevant to a query and which are not. This protocol is used in the Text Retrieval Evaluation Conference (TREC), organized annually for the past 15 years, to support the unbiased evaluation of novel information retrieval approaches. The TREC Genomics Track has recently been introduced to measure the performance of information retrieval for biomedical applications. We describe two protocols for evaluating biomedical information retrieval techniques without human relevance judgments. We call these protocols No Title Evaluation (NT Evaluation). The first protocol measures performance for focused searches, where only one relevant document exists for each query. The second protocol measures performance for queries expected to have potentially many relevant documents per query (high-recall searches). Both protocols take advantage of the clear separation of titles and abstracts found in Medline. We compare the performance obtained with these evaluation protocols to results obtained by reusing the relevance judgments produced in the 2004 and 2005 TREC Genomics Track and observe significant correlations between performance rankings generated by our approach and TREC. Spearman's correlation coefficients in the range of 0.79-0.92 are observed comparing bpref measured with NT Evaluation or with TREC evaluations. For comparison, coefficients in the range 0.86-0.94 can be observed when evaluating the same set of methods with data from two independent TREC Genomics Track evaluations. We discuss the advantages of NT Evaluation over the TRels and the data fusion evaluation protocols introduced recently. Our results suggest that the NT Evaluation protocols described here could be used to optimize some search engine parameters before human evaluation. Further research is needed to determine if NT Evaluation or variants of these protocols can fully substitute for human evaluations.

Physiological responses to simulated firefighter exercise protocols in varying environments.

PubMed

Horn, Gavin P; Kesler, Richard M; Motl, Robert W; Hsiao-Wecksler, Elizabeth T; Klaren, Rachel E; Ensari, Ipek; Petrucci, Matthew N; Fernhall, Bo; Rosengren, Karl S

2015-01-01

For decades, research to quantify the effects of firefighting activities and personal protective equipment on physiology and biomechanics has been conducted in a variety of testing environments. It is unknown if these different environments provide similar information and comparable responses. A novel Firefighting Activities Station, which simulates four common fireground tasks, is presented for use with an environmental chamber in a controlled laboratory setting. Nineteen firefighters completed three different exercise protocols following common research practices. Simulated firefighting activities conducted in an environmental chamber or live-fire structures elicited similar physiological responses (max heart rate: 190.1 vs 188.0 bpm, core temperature response: 0.047°C/min vs 0.043°C/min) and accelerometry counts. However, the response to a treadmill protocol commonly used in laboratory settings resulted in significantly lower heart rate (178.4 vs 188.0 bpm), core temperature response (0.037°C/min vs 0.043°C/min) and physical activity counts compared with firefighting activities in the burn building. Practitioner Summary: We introduce a new approach for simulating realistic firefighting activities in a controlled laboratory environment for ergonomics assessment of fire service equipment and personnel. Physiological responses to this proposed protocol more closely replicate those from live-fire activities than a traditional treadmill protocol and are simple to replicate and standardise.

Predicting thermal history a-priori for magnetic nanoparticle hyperthermia of internal carcinoma

NASA Astrophysics Data System (ADS)

Dhar, Purbarun; Sirisha Maganti, Lakshmi

2017-08-01

This article proposes a simplistic and realistic method where a direct analytical expression can be derived for the temperature field within a tumour during magnetic nanoparticle hyperthermia. The approximated analytical expression for thermal history within the tumour is derived based on the lumped capacitance approach and considers all therapy protocols and parameters. The present method is simplistic and provides an easy framework for estimating hyperthermia protocol parameters promptly. The model has been validated with respect to several experimental reports on animal models such as mice/rabbit/hamster and human clinical trials. It has been observed that the model is able to accurately estimate the thermal history within the carcinoma during the hyperthermia therapy. The present approach may find implications in a-priori estimation of the thermal history in internal tumours for optimizing magnetic hyperthermia treatment protocols with respect to the ablation time, tumour size, magnetic drug concentration, field strength, field frequency, nanoparticle material and size, tumour location, and so on.

Adapting realist synthesis methodology: The case of workplace harassment interventions.

PubMed

Carr, Tracey; Quinlan, Elizabeth; Robertson, Susan; Gerrard, Angie

2017-12-01

Realist synthesis techniques can be used to assess complex interventions by extracting and synthesizing configurations of contexts, mechanisms, and outcomes found in the literature. Our novel and multi-pronged approach to the realist synthesis of workplace harassment interventions describes our pursuit of theory to link macro and program level theories. After discovering the limitations of a dogmatic approach to realist synthesis, we adapted our search strategy and focused our analysis on a subset of data. We tailored our realist synthesis to understand how, why, and under what circumstances workplace harassment interventions are effective. The result was a conceptual framework to test our theory-based interventions and provide the basis for subsequent realist evaluation. Our experience documented in this article contributes to an understanding of how, under what circumstances, and with what consequences realist synthesis principles can be customized. Copyright © 2017 John Wiley & Sons, Ltd.

A physical breast phantom for 2D and 3D x-ray imaging made through inkjet printing

NASA Astrophysics Data System (ADS)

Ikejimba, Lynda C.; Graff, Christian G.; Rosenthal, Shani; Badal, Andreu; Ghammraoui, Bahaa; Lo, Joseph Y.; Glick, Stephen J.

2017-03-01

Physical breast phantoms are used for imaging evaluation studies with 2D and 3D breast x-ray systems, serving as surrogates for human patients. However, there is a presently a limited selection of available phantoms that are realistic, in terms of containing the complex tissue architecture of the human breast. In addition, not all phantoms can be successfully utilized for both 2D and 3D breast imaging. Additionally, many of the phantoms are uniform or unrealistic in appearance, expensive, or difficult to obtain. The purpose of this work was to develop a new method to generate realistic physical breast phantoms using easy to obtain and inexpensive materials. First, analytical modeling was used to design a virtual model, which was then compressed using finite element modeling. Next, the physical phantom was realized through inkjet printing with a standard inkjet printer using parchment paper and specialized inks, formulated using silver nanoparticles and a bismuth salt. The printed phantom sheets were then aligned and held together using a custom designed support plate made of PMMA, and imaged on clinical FFDM and DBT systems. Objects of interest were also placed within the phantom to simulate microcalcifications, pathologies that often occur in the breast. The linear attenuation coefficients of the inks and parchment were compared against tissue equivalent samples and found to be similar to breast tissue. The phantom is promising for use in imaging studies and developing QC protocols.

A realist evaluation of social prescribing: an exploration into the context and mechanisms underpinning a pathway linking primary care with the voluntary sector.

PubMed

Bertotti, Marcello; Frostick, Caroline; Hutt, Patrick; Sohanpal, Ratna; Carnes, Dawn

2018-05-01

This article adopts a realist approach to evaluate a social prescribing pilot in the areas of Hackney and City in London (United Kingdom). It unpacks the contextual factors and mechanisms that influenced the development of this pilot for the benefits of GPs, commissioners and practitioners, and reflects on the realist approach to evaluation as a tool for the evaluation of health interventions. Primary care faces considerable challenges including the increase in long-term conditions, GP consultation rates, and widening health inequalities. With its emphasis on linking primary care to non-clinical community services via a social prescribing coordinator (SPC), some models of social prescribing could contribute to reduce the burden on primary care, tackle health inequalities and encourage people to make greater use of non-clinical forms of support. This realist analysis was based on qualitative interviews with users, commissioners, a GP survey, focus groups and learning events to explore stakeholders' experience. To enable a detailed analysis, we adapted the realist approach by subdividing the social prescribing pathway into stages, each with contextual factors, mechanisms and outcomes. SPCs were pivotal to the effective functioning of the social prescribing service and responsible for the activation and initial beneficial impact on users. Although social prescribing shows significant potential for the benefit of patients and primary care, several challenges need to be considered and overcome, including 'buy in' from some GPs, branding, and funding for the third sector in a context where social care cuts are severely affecting the delivery of health care. With its emphasis on context and mechanisms, the realist evaluation approach is useful in understanding how to identify and improve health interventions, and analyse in greater detail the contribution of different stakeholders. As the SPC is central to social prescribing, more needs to be done to understand their role conceptually and practically.

Toxicity of environmentally realistic concentrations of chlorpyrifos and terbuthylazine in indoor microcosms.

PubMed

Pereira, Ana Santos; Cerejeira, Maria José; Daam, Michiel A

2017-09-01

Few studies have been conducted into the evaluation of environmentally realistic pesticide mixtures using model ecosystems. In the present study, the effects of single and combined environmentally realistic concentrations of the herbicide terbuthylazine and the insecticide chlorpyrifos were evaluated using laboratory microcosms. Direct toxic effects of chlorpyrifos were noted on copepod nauplii and cladocerans and the recovery of the latter was likely related with the decrease observed in rotifer abundances. Terbuthylazine potentiated the effect of chlorpyrifos on feeding rates of Daphnia magna, presumably by triggering the transformation of chlorpyrifos to more toxic oxon-analogs. Possible food-web interactions resulting from multiple chemical (and other) stressors likely to be present in edge-of-field water bodies need to be further evaluated. Copyright © 2017 Elsevier Ltd. All rights reserved.

Optimization and comparison of simultaneous and separate acquisition protocols for dual isotope myocardial perfusion SPECT

PubMed Central

Ghaly, Michael; Links, Jonathan M; Frey, Eric C

2015-01-01

Dual-isotope simultaneous-acquisition (DISA) rest-stress myocardial perfusion SPECT (MPS) protocols offer a number of advantages over separate acquisition. However, crosstalk contamination due to scatter in the patient and interactions in the collimator degrade image quality. Compensation can reduce the effects of crosstalk, but does not entirely eliminate image degradations. Optimizing acquisition parameters could further reduce the impact of crosstalk. In this paper we investigate the optimization of the rest Tl-201 energy window width and relative injected activities using the ideal observer (IO), a realistic digital phantom population and Monte Carlo (MC) simulated Tc-99m and Tl-201 projections as a means to improve image quality. We compared performance on a perfusion defect detection task for Tl-201 acquisition energy window widths varying from 4 to 40 keV centered at 72 keV for a camera with a 9% energy resolution. We also investigated 7 different relative injected activities, defined as the ratio of Tc-99m and Tl-201 activities, while keeping the total effective dose constant at 13.5 mSv. For each energy window and relative injected activity, we computed the IO test statistics using a Markov chain Monte Carlo (MCMC) method for an ensemble of 1,620 triplets of fixed and reversible defect-present, and defect-absent noisy images modeling realistic background variations. The volume under the 3-class receiver operating characteristic (ROC) surface (VUS) was estimated and served as the figure of merit. For simultaneous acquisition, the IO suggested that relative Tc-to-Tl injected activity ratios of 2.6–5 and acquisition energy window widths of 16–22% were optimal. For separate acquisition, we observed a broad range of optimal relative injected activities from 2.6 to 12.1 and acquisition energy window of widths 16–22%. A negative correlation between Tl-201 injected activity and the width of the Tl-201 energy window was observed in these ranges. The results also suggested that DISA methods could potentially provide image quality as good as that obtained with separate acquisition protocols. We compared observer performance for the optimized protocols and the current clinical protocol using separate acquisition. The current clinical protocols provided better performance at a cost of injecting the patient with approximately double the injected activity of Tc-99m and Tl-201, resulting in substantially increased radiation dose. PMID:26083239

Topological quantum computing with a very noisy network and local error rates approaching one percent.

PubMed

Nickerson, Naomi H; Li, Ying; Benjamin, Simon C

2013-01-01

A scalable quantum computer could be built by networking together many simple processor cells, thus avoiding the need to create a single complex structure. The difficulty is that realistic quantum links are very error prone. A solution is for cells to repeatedly communicate with each other and so purify any imperfections; however prior studies suggest that the cells themselves must then have prohibitively low internal error rates. Here we describe a method by which even error-prone cells can perform purification: groups of cells generate shared resource states, which then enable stabilization of topologically encoded data. Given a realistically noisy network (≥10% error rate) we find that our protocol can succeed provided that intra-cell error rates for initialisation, state manipulation and measurement are below 0.82%. This level of fidelity is already achievable in several laboratory systems.

AURP: An AUV-Aided Underwater Routing Protocol for Underwater Acoustic Sensor Networks

PubMed Central

Yoon, Seokhoon; Azad, Abul K.; Oh, Hoon; Kim, Sunghwan

2012-01-01

Deploying a multi-hop underwater acoustic sensor network (UASN) in a large area brings about new challenges in reliable data transmissions and survivability of network due to the limited underwater communication range/bandwidth and the limited energy of underwater sensor nodes. In order to address those challenges and achieve the objectives of maximization of data delivery ratio and minimization of energy consumption of underwater sensor nodes, this paper proposes a new underwater routing scheme, namely AURP (AUV-aided underwater routing protocol), which uses not only heterogeneous acoustic communication channels but also controlled mobility of multiple autonomous underwater vehicles (AUVs). In AURP, the total data transmissions are minimized by using AUVs as relay nodes, which collect sensed data from gateway nodes and then forward to the sink. Moreover, controlled mobility of AUVs makes it possible to apply a short-range high data rate underwater channel for transmissions of a large amount of data. To the best to our knowledge, this work is the first attempt to employ multiple AUVs as relay nodes in a multi-hop UASN to improve the network performance in terms of data delivery ratio and energy consumption. Simulations, which are incorporated with a realistic underwater acoustic communication channel model, are carried out to evaluate the performance of the proposed scheme, and the results indicate that a high delivery ratio and low energy consumption can be achieved. PMID:22438740

AURP: an AUV-aided underwater routing protocol for underwater acoustic sensor networks.

PubMed

Yoon, Seokhoon; Azad, Abul K; Oh, Hoon; Kim, Sunghwan

2012-01-01

Deploying a multi-hop underwater acoustic sensor network (UASN) in a large area brings about new challenges in reliable data transmissions and survivability of network due to the limited underwater communication range/bandwidth and the limited energy of underwater sensor nodes. In order to address those challenges and achieve the objectives of maximization of data delivery ratio and minimization of energy consumption of underwater sensor nodes, this paper proposes a new underwater routing scheme, namely AURP (AUV-aided underwater routing protocol), which uses not only heterogeneous acoustic communication channels but also controlled mobility of multiple autonomous underwater vehicles (AUVs). In AURP, the total data transmissions are minimized by using AUVs as relay nodes, which collect sensed data from gateway nodes and then forward to the sink. Moreover, controlled mobility of AUVs makes it possible to apply a short-range high data rate underwater channel for transmissions of a large amount of data. To the best to our knowledge, this work is the first attempt to employ multiple AUVs as relay nodes in a multi-hop UASN to improve the network performance in terms of data delivery ratio and energy consumption. Simulations, which are incorporated with a realistic underwater acoustic communication channel model, are carried out to evaluate the performance of the proposed scheme, and the results indicate that a high delivery ratio and low energy consumption can be achieved.

Evaluations on the potential productivity of winter wheat based on agro-ecological zone in the world

NASA Astrophysics Data System (ADS)

Wang, H.; Li, Q.; Du, X.; Zhao, L.; Lu, Y.; Li, D.; Liu, J.

2015-04-01

Wheat is the most widely grown crop globally and an essential source of calories in human diets. Maintaining and increasing global wheat production is therefore strongly linked to food security. In this paper, the evaluation model of winter wheat potential productivity was proposed based on agro-ecological zone and the historical winter wheat yield data in recent 30 years (1983-2011) obtained from FAO. And the potential productions of winter wheat in the world were investigated. The results showed that the realistic potential productivity of winter wheat in Western Europe was highest and it was more than 7500 kg/hm2. The realistic potential productivity of winter wheat in North China Plain were also higher, which was about 6000 kg/hm2. However, the realistic potential productivity of winter wheat in the United States which is the main winter wheat producing country were not high, only about 3000 kg/hm2. In addition to these regions which were the main winter wheat producing areas, the realistic potential productivity in other regions of the world were very low and mainly less than 1500 kg/hm2, like in southwest region of Russia. The gaps between potential productivity and realistic productivity of winter wheat in Kazakhstan and India were biggest, and the percentages of the gap in realistic productivity of winter wheat in Kazakhstan and India were more than 40%. In Russia, the gap between potential productivity and realistic productivity of winter wheat was lowest and the percentage of the gap in realistic productivity of winter wheat in Russia was only 10%.

Application of the Canadian CT head rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines

PubMed Central

Sultan, H; Boyle, A; Pereira, M; Antoun, N; Maimaris, C

2004-01-01

Objective: : In 2002 a new protocol was introduced based on the Canadian CT rules. Before this the Royal College of Surgeons "Galasko" report guidelines had been followed. This study evaluates the effects of the protocol and discusses the impact of the implementation of the NICE head injury guidelines—also based on the Canadian CT rules. Methods: A "before and after" study was undertaken, using data from accident and emergency cards and hospital notes of adult patients with head injuries presenting to the emergency department over seven months in 2001 and nine months in 2002. The two groups were compared to see how rates of computed tomography (CT), admission for observation, discharge, and skull radiography had changed after introduction of the protocol. Results: : Head CT rates in patients with minor head injuries (MHI) increased significantly from 47 of 330 (14%) to 58 of 267 (20%) (p<0.05). There were also significantly increased rates of admission for observation, from 111 (34%) to 119 (45%). Skull radiography rates fell considerably from 33% of all patients with head injuries in 2001 to 1.6% in 2002, without any adverse effect. Conclusions: This study shows that it is possible to replace the current practice in the UK of risk stratification of adult MHI based on skull radiography, with slightly modified versions of the Canadian CT rule/NICE guidelines. This will result in a large reduction in skull radiography and will be associated with modest increases in CT and admissions rates. If introduction of the NICE guideline is to be realistic, the study suggests that it will not be cost neutral. PMID:15208222

Improving access to high-quality primary care for socioeconomically disadvantaged older people in rural areas: a mixed method study protocol.

PubMed

Ford, John A; Jones, Andrew P; Wong, Geoff; Clark, Allan B; Porter, Tom; Shakespeare, Tom; Swart, Ann Marie; Steel, Nicholas

2015-09-18

The UK has an ageing population, especially in rural areas, where deprivation is high among older people. Previous research has identified this group as at high risk of poor access to healthcare. The aim of this study is to generate a theory of how socioeconomically disadvantaged older people from rural areas access primary care, to develop an intervention based on this theory and test it in a feasibility trial. On the basis of the MRC Framework for Developing and Evaluating Complex Interventions, three methods will be used to generate the theory. First, a realist review will elucidate the patient pathway based on existing literature. Second, an analysis of the English Longitudinal Study of Ageing will be completed using structural equation modelling. Third, 15 semistructured interviews will be undertaken with patients and four focus groups with health professionals. A triangulation protocol will be used to allow each of these methods to inform and be informed by each other, and to integrate data into one overall realist theory. Based on this theory, an intervention will be developed in discussion with stakeholders to ensure that the intervention is feasible and practical. The intervention will be tested within a feasibility trial, the design of which will depend on the intervention. Lessons from the feasibility trial will be used to refine the intervention and gather the information needed for a definitive trial. Ethics approval from the regional ethics committee has been granted for the focus groups with health professionals and interviews with patients. Ethics approval will be sought for the feasibility trial after the intervention has been designed. Findings will be disseminated to the key stakeholders involved in intervention development, to researchers, clinicians and health planners through peer-reviewed journal articles and conference publications, and locally through a dissemination event. 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.

Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review

PubMed Central

Kastner, Monika; Perrier, Laure; Hamid, Jemila; Tricco, Andrea C; Cardoso, Roberta; Ivers, Noah M; Liu, Barbara; Marr, Sharon; Holroyd-Leduc, Jayna; Wong, Geoff; Graves, Lisa; Straus, Sharon E

2015-01-01

Introduction The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions. Methods and analysis We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies. Ethics and dissemination Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders. Trial registration number Our protocol is registered with PROSPERO (registration number CRD42014014489). PMID:25649215

Using a Virtual Store As a Research Tool to Investigate Consumer In-store Behavior.

PubMed

Ploydanai, Kunalai; van den Puttelaar, Jos; van Herpen, Erica; van Trijp, Hans

2017-07-24

People's responses to products and/or choice environments are crucial to understanding in-store consumer behaviors. Currently, there are various approaches (e.g., surveys or laboratory settings) to study in-store behaviors, but the external validity of these is limited by their poor capability to resemble realistic choice environments. In addition, building a real store to meet experimental conditions while controlling for undesirable effects is costly and highly difficult. A virtual store developed by virtual reality techniques potentially transcends these limitations by offering the simulation of a 3D virtual store environment in a realistic, flexible, and cost-efficient way. In particular, a virtual store interactively allows consumers (participants) to experience and interact with objects in a tightly controlled yet realistic setting. This paper presents the key elements of using a desktop virtual store to study in-store consumer behavior. Descriptions of the protocol steps to: 1) build the experimental store, 2) prepare the data management program, 3) run the virtual store experiment, and 4) organize and export data from the data management program are presented. The virtual store enables participants to navigate through the store, choose a product from alternatives, and select or return products. Moreover, consumer-related shopping behaviors (e.g., shopping time, walking speed, and number and type of products examined and bought) can also be collected. The protocol is illustrated with an example of a store layout experiment showing that shelf length and shelf orientation influence shopping- and movement-related behaviors. This demonstrates that the use of a virtual store facilitates the study of consumer responses. The virtual store can be especially helpful when examining factors that are costly or difficult to change in real life (e.g., overall store layout), products that are not presently available in the market, and routinized behaviors in familiar environments.

Dissipation in adiabatic quantum computers: lessons from an exactly solvable model

NASA Astrophysics Data System (ADS)

Keck, Maximilian; Montangero, Simone; Santoro, Giuseppe E.; Fazio, Rosario; Rossini, Davide

2017-11-01

We introduce and study the adiabatic dynamics of free-fermion models subject to a local Lindblad bath and in the presence of a time-dependent Hamiltonian. The merit of these models is that they can be solved exactly, and will help us to study the interplay between nonadiabatic transitions and dissipation in many-body quantum systems. After the adiabatic evolution, we evaluate the excess energy (the average value of the Hamiltonian) as a measure of the deviation from reaching the final target ground state. We compute the excess energy in a variety of different situations, where the nature of the bath and the Hamiltonian is modified. We find robust evidence of the fact that an optimal working time for the quantum annealing protocol emerges as a result of the competition between the nonadiabatic effects and the dissipative processes. We compare these results with the matrix-product-operator simulations of an Ising system and show that the phenomenology we found also applies for this more realistic case.

Security of two quantum cryptography protocols using the same four qubit states

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

Branciard, Cyril; Ecole Nationale Superieure des Telecommunications, 46, rue Barrault, 75013 Paris; Gisin, Nicolas

2005-09-15

The first quantum cryptography protocol, proposed by Bennett and Brassard in 1984 (BB84), has been widely studied in recent years. This protocol uses four states (more precisely, two complementary bases) for the encoding of the classical bit. Recently, it has been noticed that by using the same four states, but a different encoding of information, one can define a protocol which is more robust in practical implementations, specifically when attenuated laser pulses are used instead of single-photon sources [V. Scarani et al., Phys. Rev. Lett. 92, 057901 (2004), referred to as the SARG04 protocol]. We present a detailed study ofmore » SARG04 in two different regimes. In the first part, we consider an implementation with a single-photon source: we derive bounds on the error rate Q for security against all possible attacks by the eavesdropper. The lower and the upper bound obtained for SARG04 (Q < or approx. 10.95% and Q > or approx. 14.9%, respectively) are close to those obtained for BB84 (Q < or approx. 12.4% and Q > or approx. 14.6%, respectively). In the second part, we consider a realistic source consisting of an attenuated laser and improve on previous analysis by allowing Alice to optimize the mean number of photons as a function of the distance. The SARG04 protocol is found to perform better than BB84, both in secret-key rate and in maximal achievable distance, for a wide class of Eve's attacks.« less

Fabrication of anatomically tapered foveal pits for retinal phantoms for optical coherence tomography

NASA Astrophysics Data System (ADS)

Lee, Gary C. F.; Smith, Gennifer T.; Agrawal, Monica; Ellerbee, Audrey K.

2015-03-01

Optical Coherence Tomography (OCT) has become a standard tool for diagnosing retinal disease in many ophthalmology clinics. Nonetheless, the technical and clinical research communities still lack a standardized phantom that could aid in evaluating and normalizing the various scan protocols and OCT machines employed at different institutions. Existing retinal phantoms designed for OCT imaging mimic some important features of the retina, such as the thickness and scattering properties of its many layers. However, the morphology of the foveal pit and the visible tapering of the retinal layers underlying the surface surrounding the pit remains a challenge to replicate in current phantoms. Recent attempts at creating a realistic foveal pit include molding, ablation and laser etching but have not proved sufficient to replicate this particular anatomical feature. In this work, we demonstrate a new fabrication procedure that is capable of replicating the tapered appearance of the retinal layers near the foveal pit using a combination of spin-coating and replica molding. The ability to create an anatomically correct foveal pit will allow for a new phantom better suited for intra- and inter-system evaluation and for improved testing of retinal segmentation algorithms.

Supporting creativity and appreciation of uncertainty in exploring geo-coded public health data.

PubMed

Thew, S L; Sutcliffe, A; de Bruijn, O; McNaught, J; Procter, R; Jarvis, Paul; Buchan, I

2011-01-01

We present a prototype visualisation tool, ADVISES (Adaptive Visualization for e-Science), designed to support epidemiologists and public health practitioners in exploring geo-coded datasets and generating spatial epidemiological hypotheses. The tool is designed to support creative thinking while providing the means for the user to evaluate the validity of the visualization in terms of statistical uncertainty. We present an overview of the application and the results of an evaluation exploring public health researchers' responses to maps as a new way of viewing familiar data, in particular the use of thematic maps with adjoining descriptive statistics and forest plots to support the generation and evaluation of new hypotheses. A series of qualitative evaluations involved one experienced researcher asking 21 volunteers to interact with the system to perform a series of relatively complex, realistic map-building and exploration tasks, using a 'think aloud' protocol, followed by a semi-structured interview The volunteers were academic epidemiologists and UK National Health Service analysts. All users quickly and confidently created maps, and went on to spend substantial amounts of time exploring and interacting with system, generating hypotheses about their maps. Our findings suggest that the tool is able to support creativity and statistical appreciation among public health professionals and epidemiologists building thematic maps. Software such as this, introduced appropriately, could increase the capability of existing personnel for generating public health intelligence.

Realistic evaluation of an emergency department-based mental health nurse practitioner outpatient service in Australia.

PubMed

Wand, Timothy; White, Kathryn; Patching, Joanna

2011-06-01

Evaluation of new models of care requires consideration of the complexity inherent within health care programs and their sensitivity to local contextual factors as well as broader community, social and political influences. Evaluation frameworks that are flexible and responsive while maintaining research rigor are therefore required. Realistic evaluation was adopted as the methodology for the implementation and evaluation of an emergency department-based mental health nurse practitioner outpatient service in Sydney, Australia. The aim of realistic evaluation is to generate, test and refine theories of how programs work within a given context. This paper represents the final methodological step from the completed evaluation. A summary of quantitative and qualitative findings from the mixed-methods evaluation is presented, which is transformed into a set of overarching statements or "middle range theories". Middle range theory statements seek to explain the success of a program and provide transferable lessons for practitioners wishing to implement similar programs elsewhere. For example, the research team consider that early consultation with key local stakeholders and emergency department ownership of the project was pivotal to the implementation process. © 2011 Blackwell Publishing Asia Pty Ltd.

Transforming the patient care environment with Lean Six Sigma and realistic evaluation.

PubMed

Black, Jason

2009-01-01

Lean Six Sigma (LSS) is a structured methodology for transforming processes, but it does not fully consider the complex social interactions that cause processes to form in hospital organizations. By combining LSS implementations with the concept of Realistic Evaluation, a methodology that promotes change by assessing and considering the individual characteristics of an organization's social environment, successful and sustainable process improvement is more likely.

Beyond the hype: deep neural networks outperform established methods using a ChEMBL bioactivity benchmark set.

PubMed

Lenselink, Eelke B; Ten Dijke, Niels; Bongers, Brandon; Papadatos, George; van Vlijmen, Herman W T; Kowalczyk, Wojtek; IJzerman, Adriaan P; van Westen, Gerard J P

2017-08-14

The increase of publicly available bioactivity data in recent years has fueled and catalyzed research in chemogenomics, data mining, and modeling approaches. As a direct result, over the past few years a multitude of different methods have been reported and evaluated, such as target fishing, nearest neighbor similarity-based methods, and Quantitative Structure Activity Relationship (QSAR)-based protocols. However, such studies are typically conducted on different datasets, using different validation strategies, and different metrics. In this study, different methods were compared using one single standardized dataset obtained from ChEMBL, which is made available to the public, using standardized metrics (BEDROC and Matthews Correlation Coefficient). Specifically, the performance of Naïve Bayes, Random Forests, Support Vector Machines, Logistic Regression, and Deep Neural Networks was assessed using QSAR and proteochemometric (PCM) methods. All methods were validated using both a random split validation and a temporal validation, with the latter being a more realistic benchmark of expected prospective execution. Deep Neural Networks are the top performing classifiers, highlighting the added value of Deep Neural Networks over other more conventional methods. Moreover, the best method ('DNN_PCM') performed significantly better at almost one standard deviation higher than the mean performance. Furthermore, Multi-task and PCM implementations were shown to improve performance over single task Deep Neural Networks. Conversely, target prediction performed almost two standard deviations under the mean performance. Random Forests, Support Vector Machines, and Logistic Regression performed around mean performance. Finally, using an ensemble of DNNs, alongside additional tuning, enhanced the relative performance by another 27% (compared with unoptimized 'DNN_PCM'). Here, a standardized set to test and evaluate different machine learning algorithms in the context of multi-task learning is offered by providing the data and the protocols. Graphical Abstract .

Validation of a real-time wireless telemedicine system, using bluetooth protocol and a mobile phone, for remote monitoring patient in medical practice.

PubMed

Yousef, Jasemian; Lars, A N

2005-06-22

This paper validates the integration of a generic real-time wireless telemedicine system utilising Global System for Mobile Communications (GSM), BLUETOOTH protocol and General Packet Radio Service (GPRS) for cellular network in clinical practice. In the first experiment, the system was tested on 24 pacemaker patients at Aalborg Hospital (Denmark), in order to see if the pacemaker implant would be affected by the system. I the second experiment, the system was tested on 15 non risky arrhythmia heart patients, in order to evaluate and validate the system application in clinical practice, for patient monitoring. Electrocardiograms were selected as the continuously monitored parameter in the present study. The results showed that the system had no negative effects on the pacemaker implants. The experiment results showed, that in a realistic environment for the patients, the system had 96.1 % up-time, 3.2 (kbps) throughput, 10(-3) (packet/s) Packet Error Rate and 10(-3) (packet/s) Packet Lost Rate. During 24 hours test the network did not respond for 57 minutes, from which 83.1 % was in the range of 0-3 minutes, 15.4 % was in the range of 3-5 minutes, and only 0.7 % of the down-time was > or = 5 and < or = 6 minutes. By a subjective evaluation, it was demonstrated that the system is applicable and the patients as well as the healthcare personals were highly confident with the system. Moreover, the patients had high degree of mobility and freedom, employing the system. In conclusion, this generic telemedicine system showed a high reliability, quality and performance, and the design can provide a basic principle for real-time wireless remote monitoring systems used in clinical practice.

Optimization of Rb-82 PET acquisition and reconstruction protocols for myocardial perfusion defect detection

NASA Astrophysics Data System (ADS)

Tang, Jing; Rahmim, Arman; Lautamäki, Riikka; Lodge, Martin A.; Bengel, Frank M.; Tsui, Benjamin M. W.

2009-05-01

The purpose of this study is to optimize the dynamic Rb-82 cardiac PET acquisition and reconstruction protocols for maximum myocardial perfusion defect detection using realistic simulation data and task-based evaluation. Time activity curves (TACs) of different organs under both rest and stress conditions were extracted from dynamic Rb-82 PET images of five normal patients. Combined SimSET-GATE Monte Carlo simulation was used to generate nearly noise-free cardiac PET data from a time series of 3D NCAT phantoms with organ activities modeling different pre-scan delay times (PDTs) and total acquisition times (TATs). Poisson noise was added to the nearly noise-free projections and the OS-EM algorithm was applied to generate noisy reconstructed images. The channelized Hotelling observer (CHO) with 32× 32 spatial templates corresponding to four octave-wide frequency channels was used to evaluate the images. The area under the ROC curve (AUC) was calculated from the CHO rating data as an index for image quality in terms of myocardial perfusion defect detection. The 0.5 cycle cm-1 Butterworth post-filtering on OS-EM (with 21 subsets) reconstructed images generates the highest AUC values while those from iteration numbers 1 to 4 do not show different AUC values. The optimized PDTs for both rest and stress conditions are found to be close to the cross points of the left ventricular chamber and myocardium TACs, which may promote an individualized PDT for patient data processing and image reconstruction. Shortening the TATs for <~3 min from the clinically employed acquisition time does not affect the myocardial perfusion defect detection significantly for both rest and stress studies.

Evaluating an in-home multicomponent cognitive behavioural programme to manage concerns about falls and associated activity avoidance in frail community-dwelling older people: Design of a randomised control trial [NCT01358032

PubMed Central

2011-01-01

Background Concerns about falls are frequently reported by older people. These concerns can have serious consequences such as an increased risk of falls and the subsequent avoidance of activities. Previous studies have shown the effectiveness of a multicomponent group programme to reduce concerns about falls. However, owing to health problems older people may not be able to attend a group programme. Therefore, we adapted the group approach to an individual in-home programme. Methods/Design A two-group randomised controlled trial has been developed to evaluate the in-home multicomponent cognitive behavioural programme to manage concerns about falls and associated activity avoidance in frail older people living in the community. Persons were eligible for study if they were 70 years of age or over, perceived their general health as fair or poor, had at least some concerns about falls and associated avoidance of activity. After screening for eligibility in a random sample of older people, eligible persons received a baseline assessment and were subsequently allocated to the intervention or control group. Persons assigned to the intervention group were invited to participate in the programme, while those assigned to the control group received care as usual. The programme consists of seven sessions, comprising three home visits and four telephone contacts. The sessions are aimed at instilling adaptive and realistic views about falls, as well as increasing activity and safe behaviour. An effect evaluation, a process evaluation and an economic evaluation are conducted. Follow-up measurements for the effect evaluation are carried out 5 and 12 months after the baseline measurement. The primary outcomes of the effect evaluation are concerns about falls and avoidance of activity as a result of these concerns. Other outcomes are disability and falls. The process evaluation measures: the population characteristics reached; protocol adherence by facilitators; protocol adherence by participants (engagement in exposure and homework); opinions about the programme of participants and facilitators; perceived benefits and achievements; and experienced barriers. The economic evaluation examines the impact on health-care utilisation, as well as related costs. Discussion A total number of 389 participants is included in the study. Final results are expected in 2012. Trial registration NCT01358032 PMID:21933436

Development of an HPV Educational Protocol for Adolescents

PubMed Central

Wetzel, Caitlin; Tissot, Abbigail; Kollar, Linda M.; Hillard, Paula A.; Stone, Rachel; Kahn, Jessica A.

2007-01-01

Study Objectives To develop an educational protocol about HPV and Pap tests for adolescents, to evaluate the protocol for understandability and clarity, and to evaluate the protocol for its effectiveness in increasing knowledge about HPV. Design In phase 1, investigators and adolescents developed the protocol. In phase 2, adolescents evaluated the protocol qualitatively, investigators evaluated its effectiveness in increasing HPV knowledge in a sample of adolescents, and the protocol was revised. In phase 3, investigators evaluated the effectiveness of the revised protocol in an additional adolescent sample. Setting Urban, hospital-based teen health center. Participants A total of 252 adolescent girls and boys in the three study phases. Main Outcome Measures Pre- and post-protocol knowledge about HPV, measured using a 10- or 11-item scale. Results Scores on the HPV knowledge scale increased significantly (p<.0001) among adolescents who participated in phases 2 and 3 after they received the protocol. Initial differences in scores based on race, insurance type and condom use were not noted post-protocol. Conclusion The protocol significantly increased knowledge scores about HPV in this population, regardless of sociodemographic characteristics and risk behaviors. Effective, developmentally appropriate educational protocols about HPV and Pap tests are particularly important in clinical settings as cervical cancer screening guidelines evolve, HPV DNA testing is integrated into screening protocols, and HPV vaccines become available. In-depth, one-on-one education about HPV may also prevent adverse psychosocial responses and promote healthy sexual and Pap screening behaviors in adolescents with abnormal HPV or Pap test results. Synopsis The investigators developed an educational protocol about HPV and Pap tests and evaluated its effectiveness in increasing knowledge about HPV among adolescents. PMID:17868894

High Resolution Visualization Applied to Future Heavy Airlift Concept Development and Evaluation

NASA Technical Reports Server (NTRS)

FordCook, A. B.; King, T.

2012-01-01

This paper explores the use of high resolution 3D visualization tools for exploring the feasibility and advantages of future military cargo airlift concepts and evaluating compatibility with existing and future payload requirements. Realistic 3D graphic representations of future airlifters are immersed in rich, supporting environments to demonstrate concepts of operations to key personnel for evaluation, feedback, and development of critical joint support. Accurate concept visualizations are reviewed by commanders, platform developers, loadmasters, soldiers, scientists, engineers, and key principal decision makers at various stages of development. The insight gained through the review of these physically and operationally realistic visualizations is essential to refining design concepts to meet competing requirements in a fiscally conservative defense finance environment. In addition, highly accurate 3D geometric models of existing and evolving large military vehicles are loaded into existing and proposed aircraft cargo bays. In this virtual aircraft test-loading environment, materiel developers, engineers, managers, and soldiers can realistically evaluate the compatibility of current and next-generation airlifters with proposed cargo.

Demonstration and Certification of Amphibian Ecological Risk Assessment Protocol. Cost and Performance Report (Version 2)

DTIC Science & Technology

2009-07-01

sediment protocol, respectively). The soil protocol evaluates impacts to adult salamanders and the sediment protocol evaluates impacts to larval tadpoles ...the sediment protocol evaluates impacts to larval tadpoles . When selecting appropriate receptors to derive ERA-based remedial goals, amphibians...Sediment tests are conducted with recently hatched tadpoles (i.e., Rana pipiens; Gosner Stages 17-20). Young tadpoles are placed in beakers

Role-playing for more realistic technical skills training.

PubMed

Nikendei, C; Zeuch, A; Dieckmann, P; Roth, C; Schäfer, S; Völkl, M; Schellberg, D; Herzog, W; Jünger, J

2005-03-01

Clinical skills are an important and necessary part of clinical competence. Simulation plays an important role in many fields of medical education. Although role-playing is common in communication training, there are no reports about the use of student role-plays in the training of technical clinical skills. This article describes an educational intervention with analysis of pre- and post-intervention self-selected student survey evaluations. After one term of skills training, a thorough evaluation showed that the skills-lab training did not seem very realistic nor was it very demanding for trainees. To create a more realistic training situation and to enhance students' involvement, case studies and role-plays with defined roles for students (i.e. intern, senior consultant) were introduced into half of the sessions. Results of the evaluation in the second term showed that sessions with role-playing were rated significantly higher than sessions without role-playing.

Chapter 2: Commercial and Industrial Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Gowans, Dakers; Telarico, Chad

The Commercial and Industrial Lighting Evaluation Protocol (the protocol) describes methods to account for gross energy savings resulting from the programmatic installation of efficient lighting equipment in large populations of commercial, industrial, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. A separate Uniform Methods Project (UMP) protocol, Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol, addresses methods for evaluating savings resulting from lighting control measures such as adding time clocks, tuning energy management system commands, and adding occupancy sensors.

Robust relativistic bit commitment

NASA Astrophysics Data System (ADS)

Chakraborty, Kaushik; Chailloux, André; Leverrier, Anthony

2016-12-01

Relativistic cryptography exploits the fact that no information can travel faster than the speed of light in order to obtain security guarantees that cannot be achieved from the laws of quantum mechanics alone. Recently, Lunghi et al. [Phys. Rev. Lett. 115, 030502 (2015), 10.1103/PhysRevLett.115.030502] presented a bit-commitment scheme where each party uses two agents that exchange classical information in a synchronized fashion, and that is both hiding and binding. A caveat is that the commitment time is intrinsically limited by the spatial configuration of the players, and increasing this time requires the agents to exchange messages during the whole duration of the protocol. While such a solution remains computationally attractive, its practicality is severely limited in realistic settings since all communication must remain perfectly synchronized at all times. In this work, we introduce a robust protocol for relativistic bit commitment that tolerates failures of the classical communication network. This is done by adding a third agent to both parties. Our scheme provides a quadratic improvement in terms of expected sustain time compared with the original protocol, while retaining the same level of security.

Selection and application of microbial source tracking tools for water-quality investigations

USGS Publications Warehouse

Stoeckel, Donald M.

2005-01-01

Microbial source tracking (MST) is a complex process that includes many decision-making steps. Once a contamination problem has been defined, the potential user of MST tools must thoroughly consider study objectives before deciding upon a source identifier, a detection method, and an analytical approach to apply to the problem. Regardless of which MST protocol is chosen, underlying assumptions can affect the results and interpretation. It is crucial to incorporate tests of those assumptions in the study quality-control plan to help validate results and facilitate interpretation. Detailed descriptions of MST objectives, protocols, and assumptions are provided in this report to assist in selection and application of MST tools for water-quality investigations. Several case studies illustrate real-world applications of MST protocols over a range of settings, spatial scales, and types of contamination. Technical details of many available source identifiers and detection methods are included as appendixes. By use of this information, researchers should be able to formulate realistic expectations for the information that MST tools can provide and, where possible, successfully execute investigations to characterize sources of fecal contamination to resource waters.

Developing a realistic-prototyping road user cost evaluation tool for FDOT.

DOT National Transportation Integrated Search

2008-12-31

The objective of this project is to develop a realistic-prototyping RUC (Road User Cost) calculation tool that is userfriendly : and utilizing limited number of data inputs that are easy to use. The tool can help engineers to estimate RUC on : specif...

A Low-Cost Simulation Model for R-Wave Synchronized Atrial Pacing in Pediatric Patients with Postoperative Junctional Ectopic Tachycardia

PubMed Central

Michel, Miriam; Egender, Friedemann; Heßling, Vera; Dähnert, Ingo; Gebauer, Roman

2016-01-01

Background Postoperative junctional ectopic tachycardia (JET) occurs frequently after pediatric cardiac surgery. R-wave synchronized atrial (AVT) pacing is used to re-establish atrioventricular synchrony. AVT pacing is complex, with technical pitfalls. We sought to establish and to test a low-cost simulation model suitable for training and analysis in AVT pacing. Methods A simulation model was developed based on a JET simulator, a simulation doll, a cardiac monitor, and a pacemaker. A computer program simulated electrocardiograms. Ten experienced pediatric cardiologists tested the model. Their performance was analyzed using a testing protocol with 10 working steps. Results Four testers found the simulation model realistic; 6 found it very realistic. Nine claimed that the trial had improved their skills. All testers considered the model useful in teaching AVT pacing. The simulation test identified 5 working steps in which major mistakes in performance test may impede safe and effective AVT pacing and thus permitted specific training. The components of the model (exclusive monitor and pacemaker) cost less than $50. Assembly and training-session expenses were trivial. Conclusions A realistic, low-cost simulation model of AVT pacing is described. The model is suitable for teaching and analyzing AVT pacing technique. PMID:26943363

Assessment of calcium scoring performance in cardiac computed tomography.

PubMed

Ulzheimer, Stefan; Kalender, Willi A

2003-03-01

Electron beam tomography (EBT) has been used for cardiac diagnosis and the quantitative assessment of coronary calcium since the late 1980s. The introduction of mechanical multi-slice spiral CT (MSCT) scanners with shorter rotation times opened new possibilities of cardiac imaging with conventional CT scanners. The purpose of this work was to qualitatively and quantitatively evaluate the performance for EBT and MSCT for the task of coronary artery calcium imaging as a function of acquisition protocol, heart rate, spiral reconstruction algorithm (where applicable) and calcium scoring method. A cardiac CT semi-anthropomorphic phantom was designed and manufactured for the investigation of all relevant image quality parameters in cardiac CT. This phantom includes various test objects, some of which can be moved within the anthropomorphic phantom in a manner that mimics realistic heart motion. These tools were used to qualitatively and quantitatively demonstrate the accuracy of coronary calcium imaging using typical protocols for an electron beam (Evolution C-150XP, Imatron, South San Francisco, Calif.) and a 0.5-s four-slice spiral CT scanner (Sensation 4, Siemens, Erlangen, Germany). A special focus was put on the method of quantifying coronary calcium, and three scoring systems were evaluated (Agatston, volume, and mass scoring). Good reproducibility in coronary calcium scoring is always the result of a combination of high temporal and spatial resolution; consequently, thin-slice protocols in combination with retrospective gating on MSCT scanners yielded the best results. The Agatston score was found to be the least reproducible scoring method. The hydroxyapatite mass, being better reproducible and comparable on different scanners and being a physical quantitative measure, appears to be the method of choice for future clinical studies. The hydroxyapatite mass is highly correlated to the Agatston score. The introduced phantoms can be used to quantitatively assess the performance characteristics of, for example, different scanners, reconstruction algorithms, and quantification methods in cardiac CT. This is especially important for quantitative tasks, such as the determination of the amount of calcium in the coronary arteries, to achieve high and constant quality in this field.

Rate of transmission: a major determinant of the cost of clinical mastitis.

PubMed

Down, P M; Green, M J; Hudson, C D

2013-10-01

The aim of this research was to use probabilistic sensitivity analysis to evaluate the relative importance of different components of a model designed to estimate the cost of clinical mastitis (CM). A particular focus was placed on the importance of pathogen transmission relative to other factors, such as milk price or treatment costs. A stochastic Monte Carlo model was developed to simulate a case of CM at the cow level and to calculate the associated costs for 5 defined treatment protocols. The 5 treatment protocols modeled were 3 d of antibiotic intramammary treatment, 5 d of antibiotic intramammary treatment, 3 d of intramammary and systemic antibiotic treatment, 3d of intramammary and systemic antibiotic treatment plus 1 d of nonsteroidal antiinflammatory drug treatment, and 5 d of intramammary and systemic antibiotic treatment. Uniform distributions were used throughout the model to enable investigation of the cost of CM over a spectrum of clinically realistic scenarios without specifying which scenario was more or less likely. A risk of transmission parameter distribution, based on literature values, was included to model the effect of pathogen transmission to uninfected cows, from cows that remained subclinically infected after treatment for CM. Spearman rank correlation coefficients were used to evaluate the relationships between model input values and the estimated cost of CM. Linear regression models were used to explore the effect that changes to specific independent variables had on the cost of CM. Risk of transmission was found to have the strongest association with the cost of CM, followed by bacteriological cure rate, cost of culling, and yield loss. Other factors such as milk price, cost of labor, and cost of medicines were of minimal influence in comparison. The cost of CM was similar for all 5 treatment protocols. The results from this study suggest that, when seeking to minimize the economic impact of CM in dairy herds, great emphasis should be placed on the reduction of pathogen transmission from cows with CM to uninfected cows. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Development and validation of an artificial wetlab training system for the lumbar discectomy.

PubMed

Adermann, Jens; Geissler, Norman; Bernal, Luis E; Kotzsch, Susanne; Korb, Werner

2014-09-01

An initial research indicated that realistic haptic simulators with an adapted training concept are needed to enhance the training for spinal surgery. A cognitive task analysis (CTA) was performed to define a realistic and helpful scenario-based simulation. Based on the results a simulator for lumbar discectomy was developed. Additionally, a realistic training operating room was built for a pilot. The results were validated. The CTA showed a need for realistic scenario-based training in spine surgery. The developed simulator consists of synthetic bone structures, synthetic soft tissue and an advanced bleeding system. Due to the close interdisciplinary cooperation of surgeons between engineers and psychologists, the iterative multicentre validation showed that the simulator is visually and haptically realistic. The simulator offers integrated sensors for the evaluation of the traction being used and the compression during surgery. The participating surgeons in the pilot workshop rated the simulator and the training concept as very useful for the improvement of their surgical skills. In the context of the present work a precise definition for the simulator and training concept was developed. The additional implementation of sensors allows the objective evaluation of the surgical training by the trainer. Compared to other training simulators and concepts, the high degree of objectivity strengthens the acceptance of the feedback. The measured data of the nerve root tension and the compression of the dura can be used for intraoperative control and a detailed postoperative evaluation.

Attacks exploiting deviation of mean photon number in quantum key distribution and coin tossing

NASA Astrophysics Data System (ADS)

Sajeed, Shihan; Radchenko, Igor; Kaiser, Sarah; Bourgoin, Jean-Philippe; Pappa, Anna; Monat, Laurent; Legré, Matthieu; Makarov, Vadim

2015-03-01

The security of quantum communication using a weak coherent source requires an accurate knowledge of the source's mean photon number. Finite calibration precision or an active manipulation by an attacker may cause the actual emitted photon number to deviate from the known value. We model effects of this deviation on the security of three quantum communication protocols: the Bennett-Brassard 1984 (BB84) quantum key distribution (QKD) protocol without decoy states, Scarani-Acín-Ribordy-Gisin 2004 (SARG04) QKD protocol, and a coin-tossing protocol. For QKD we model both a strong attack using technology possible in principle and a realistic attack bounded by today's technology. To maintain the mean photon number in two-way systems, such as plug-and-play and relativistic quantum cryptography schemes, bright pulse energy incoming from the communication channel must be monitored. Implementation of a monitoring detector has largely been ignored so far, except for ID Quantique's commercial QKD system Clavis2. We scrutinize this implementation for security problems and show that designing a hack-proof pulse-energy-measuring detector is far from trivial. Indeed, the first implementation has three serious flaws confirmed experimentally, each of which may be exploited in a cleverly constructed Trojan-horse attack. We discuss requirements for a loophole-free implementation of the monitoring detector.

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis

PubMed Central

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-01-01

Introduction A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: ‘Understanding how to balance service and training conflicts’. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Methods and analysis Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. Ethics and dissemination A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. PMID:27118289

On implementation of DCTCP on three-tier and fat-tree data center network topologies.

PubMed

Zafar, Saima; Bashir, Abeer; Chaudhry, Shafique Ahmad

2016-01-01

A data center is a facility for housing computational and storage systems interconnected through a communication network called data center network (DCN). Due to a tremendous growth in the computational power, storage capacity and the number of inter-connected servers, the DCN faces challenges concerning efficiency, reliability and scalability. Although transmission control protocol (TCP) is a time-tested transport protocol in the Internet, DCN challenges such as inadequate buffer space in switches and bandwidth limitations have prompted the researchers to propose techniques to improve TCP performance or design new transport protocols for DCN. Data center TCP (DCTCP) emerge as one of the most promising solutions in this domain which employs the explicit congestion notification feature of TCP to enhance the TCP congestion control algorithm. While DCTCP has been analyzed for two-tier tree-based DCN topology for traffic between servers in the same rack which is common in cloud applications, it remains oblivious to the traffic patterns common in university and private enterprise networks which traverse the complete network interconnect spanning upper tier layers. We also recognize that DCTCP performance cannot remain unaffected by the underlying DCN architecture hence there is a need to test and compare DCTCP performance when implemented over diverse DCN architectures. Some of the most notable DCN architectures are the legacy three-tier, fat-tree, BCube, DCell, VL2, and CamCube. In this research, we simulate the two switch-centric DCN architectures; the widely deployed legacy three-tier architecture and the promising fat-tree architecture using network simulator and analyze the performance of DCTCP in terms of throughput and delay for realistic traffic patterns. We also examine how DCTCP prevents incast and outcast congestion when realistic DCN traffic patterns are employed in above mentioned topologies. Our results show that the underlying DCN architecture significantly impacts DCTCP performance. We find that DCTCP gives optimal performance in fat-tree topology and is most suitable for large networks.

A Performance Evaluation of NACK-Oriented Protocols as the Foundation of Reliable Delay- Tolerant Networking Convergence Layers

NASA Technical Reports Server (NTRS)

Iannicca, Dennis; Hylton, Alan; Ishac, Joseph

2012-01-01

Delay-Tolerant Networking (DTN) is an active area of research in the space communications community. DTN uses a standard layered approach with the Bundle Protocol operating on top of transport layer protocols known as convergence layers that actually transmit the data between nodes. Several different common transport layer protocols have been implemented as convergence layers in DTN implementations including User Datagram Protocol (UDP), Transmission Control Protocol (TCP), and Licklider Transmission Protocol (LTP). The purpose of this paper is to evaluate several stand-alone implementations of negative-acknowledgment based transport layer protocols to determine how they perform in a variety of different link conditions. The transport protocols chosen for this evaluation include Consultative Committee for Space Data Systems (CCSDS) File Delivery Protocol (CFDP), Licklider Transmission Protocol (LTP), NACK-Oriented Reliable Multicast (NORM), and Saratoga. The test parameters that the protocols were subjected to are characteristic of common communications links ranging from terrestrial to cis-lunar and apply different levels of delay, line rate, and error.

Sequential quantum secret sharing in a noisy environment aided with weak measurements

NASA Astrophysics Data System (ADS)

Ray, Maharshi; Chatterjee, Sourav; Chakrabarty, Indranil

2016-05-01

In this work we give a (n,n)-threshold protocol for sequential secret sharing of quantum information for the first time. By sequential secret sharing we refer to a situation where the dealer is not having all the secrets at the same time, at the beginning of the protocol; however if the dealer wishes to share secrets at subsequent phases she/he can realize it with the help of our protocol. First of all we present our protocol for three parties and later we generalize it for the situation where we have more (n> 3) parties. Interestingly, we show that our protocol of sequential secret sharing requires less amount of quantum as well as classical resource as compared to the situation wherein existing protocols are repeatedly used. Further in a much more realistic situation, we consider the sharing of qubits through two kinds of noisy channels, namely the phase damping channel (PDC) and the amplitude damping channel (ADC). When we carry out the sequential secret sharing in the presence of noise we observe that the fidelity of secret sharing at the kth iteration is independent of the effect of noise at the (k - 1)th iteration. In case of ADC we have seen that the average fidelity of secret sharing drops down to ½ which is equivalent to a random guess of the quantum secret. Interestingly, we find that by applying weak measurements one can enhance the average fidelity. This increase of the average fidelity can be achieved with certain trade off with the success probability of the weak measurements.

Investigating the organisational impacts of quality improvement: a protocol for a realist evaluation of improvement approaches drawing on the Resource Based View of the Firm

PubMed Central

Burton, Christopher R; Rycroft Malone, Jo; Robert, Glenn; Willson, Alan; Hopkins, Angela

2014-01-01

Introduction Little is understood about the role of quality improvement in enabling health organisations to survive and thrive in the contemporary context of financial and economic challenges. We will draw on the theoretical foundations of the ‘Resource Based View of the Firm’ (RBV) to develop insights into why health organisations engage in improvement work, how impacts are conceptualised, and ‘what works’ in delivering these impacts. Specifically, RBV theorises that the mix and use of resources across different organisations may explain differences in performance. Whether improvement work influences these resources is unclear. Methods and analysis Case study research will be conducted across health organisations participating in four approaches to improvement, including: a national improvement programme; a multiorganisational partnership around implementation; an organisational strategy for quality improvement; and a coproduction project designed to enhance the experience of a clinical service from the perspective of patients. Data will comprise in-depth interviews with key informants, observation of key events and documents; analysed within and then across cases. Adopting a realist perspective, the core tenets of RBV will be evaluated as a programme theory, focusing on the interplay between organisational conditions and behavioural or resource responses that are reported through engagement in improvement. Ethics and dissemination The study has been approved by Bangor University Ethics Committee. The investigation will not judge the relative merits of different approaches to healthcare quality improvement. Rather, we will develop unique insights into the organisational consequences, and dependencies of quality improvement, providing an opportunity to add to the explanatory potential of RBV in this and other contexts. In addition to scientific and lay reports of the study findings, research outputs will include a framework for constructing the economic impacts of quality improvement and practical guidance for health service managers that maximises the impacts of investment in quality improvement. PMID:25082421

Towards a Realist Sociology of Education: A Polyphonic Review Essay

ERIC Educational Resources Information Center

Grenfell, Michael; Hood, Susan; Barrett, Brian D.; Schubert, Dan

2017-01-01

This review essay evaluates Karl Maton's "Knowledge and Knowers: Towards a Realist Sociology of Education" as a recent examination of the sociological causes and effects of education in the tradition of the French social theorist Pierre Bourdieu and the British educational sociologist Basil Bernstein. Maton's book synthesizes the…

Standardized Patients Provide Realistic and Worthwhile Experiences for Athletic Training Students

ERIC Educational Resources Information Center

Walker, Stacy E.; Weidner, Thomas G.

2010-01-01

Context: Standardized patients are more prominently used to both teach and evaluate students' clinical skills and abilities. Objective: To investigate whether athletic training students perceived an encounter with a standardized patient (SP) as realistic and worthwhile and to determine their perceived comfort in future lower extremity evaluations…

Protocol for a realist review of workplace learning in postgraduate medical education and training.

PubMed

Wiese, Anel; Kilty, Caroline; Bergin, Colm; Flood, Patrick; Fu, Na; Horgan, Mary; Higgins, Agnes; Maher, Bridget; O'Kane, Grainne; Prihodova, Lucia; Slattery, Dubhfeasa; Bennett, Deirdre

2017-01-19

Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities. Those tasked with the design and delivery of postgraduate medical education and training need to understand the relationship between the processes of medical workplace learning and these contextual elements in order to optimise conditions for learning. We propose to conduct a realist synthesis of the literature to address the overarching questions; how, why and in what circumstances do doctors learn in clinical environments? This review is part of a funded projected with the overall aim of producing guidelines and recommendations for the design of high quality clinical learning environments for postgraduate medical education and training. We have chosen realist synthesis as a methodology because of its suitability for researching complexity and producing answers useful to policymakers and practitioners. This realist synthesis will follow the steps and procedures outlined by Wong et al. in the RAMESES Publication Standards for Realist Synthesis and the Realist Synthesis RAMESES Training Materials. The core research team is a multi-disciplinary group of researchers, clinicians and health professions educators. The wider research group includes experts in organisational behaviour and human resources management as well as the key stakeholders; doctors in training, patient representatives and providers of PGMET. This study will draw from the published literature and programme, and substantive, theories of workplace learning, to describe context, mechanism and outcome configurations for PGMET. This information will be useful to policymakers and practitioners in PGMET, who will be able to apply our findings within their own contexts. Improving the quality of clinical learning environments can improve the performance, humanism and wellbeing of learners and improve the quality and safety of patient care. The review is not registered with the PROSPERO International Prospective Register of Systematic Reviews as the review objectives relate solely to education outcomes.

Protocol - realist and meta-narrative evidence synthesis: Evolving Standards (RAMESES)

PubMed Central

2011-01-01

Background There is growing interest in theory-driven, qualitative and mixed-method approaches to systematic review as an alternative to (or to extend and supplement) conventional Cochrane-style reviews. These approaches offer the potential to expand the knowledge base in policy-relevant areas - for example by explaining the success, failure or mixed fortunes of complex interventions. However, the quality of such reviews can be difficult to assess. This study aims to produce methodological guidance, publication standards and training resources for those seeking to use the realist and/or meta-narrative approach to systematic review. Methods/design We will: [a] collate and summarise existing literature on the principles of good practice in realist and meta-narrative systematic review; [b] consider the extent to which these principles have been followed by published and in-progress reviews, thereby identifying how rigour may be lost and how existing methods could be improved; [c] using an online Delphi method with an interdisciplinary panel of experts from academia and policy, produce a draft set of methodological steps and publication standards; [d] produce training materials with learning outcomes linked to these steps; [e] pilot these standards and training materials prospectively on real reviews-in-progress, capturing methodological and other challenges as they arise; [f] synthesise expert input, evidence review and real-time problem analysis into more definitive guidance and standards; [g] disseminate outputs to audiences in academia and policy. The outputs of the study will be threefold: 1. Quality standards and methodological guidance for realist and meta-narrative reviews for use by researchers, research sponsors, students and supervisors 2. A 'RAMESES' (Realist and Meta-review Evidence Synthesis: Evolving Standards) statement (comparable to CONSORT or PRISMA) of publication standards for such reviews, published in an open-access academic journal. 3. A training module for researchers, including learning outcomes, outline course materials and assessment criteria. Discussion Realist and meta-narrative review are relatively new approaches to systematic review whose overall place in the secondary research toolkit is not yet fully established. As with all secondary research methods, guidance on quality assurance and uniform reporting is an important step towards improving quality and consistency of studies. PMID:21843376

Transitional care for formerly incarcerated persons with HIV: protocol for a realist review.

PubMed

Tsang, Jenkin; Mishra, Sharmistha; Rowe, Janet; O'Campo, Patricia; Ziegler, Carolyn; Kouyoumdjian, Fiona G; Matheson, Flora I; Bayoumi, Ahmed M; Zahid, Shatabdy; Antoniou, Tony

2017-02-13

Little is known about the mechanisms that influence the success or failure of programs to facilitate re-engagement with health and social services for formerly incarcerated persons with HIV. This review aims to identify how interventions to address such transitions work, for whom and under what circumstances. We will use realist review methodology to conduct our analysis. We will systematically search electronic databases and grey literature for English language qualitative and quantitative studies of interventions. Two investigators will independently screen citations and full-text articles, abstract data, appraise study quality and synthesize the literature. Data analysis will include identifying context-mechanism-outcome configurations, exploring and comparing patterns in these configurations, making comparisons across contexts and developing explanatory frameworks. This review will identify mechanisms that influence the success or failure of transition interventions for formerly incarcerated individuals with HIV. The findings will be integrated with those from complementary qualitative and quantitative studies to inform future interventions. PROSPERO CRD42016040054.

Simulation of Lunar Surface Communications Network Exploration Scenarios

NASA Technical Reports Server (NTRS)

Linsky, Thomas W.; Bhasin, Kul B.; White, Alex; Palangala, Srihari

2006-01-01

Simulations and modeling of surface-based communications networks provides a rapid and cost effective means of requirement analysis, protocol assessments, and tradeoff studies. Robust testing in especially important for exploration systems, where the cost of deployment is high and systems cannot be easily replaced or repaired. However, simulation of the envisioned exploration networks cannot be achieved using commercial off the shelf network simulation software. Models for the nonstandard, non-COTS protocols used aboard space systems are not readily available. This paper will address the simulation of realistic scenarios representative of the activities which will take place on the surface of the Moon, including selection of candidate network architectures, and the development of an integrated simulation tool using OPNET modeler capable of faithfully modeling those communications scenarios in the variable delay, dynamic surface environments. Scenarios for exploration missions, OPNET development, limitations, and simulations results will be provided and discussed.

Bound entangled states with a private key and their classical counterpart.

PubMed

Ozols, Maris; Smith, Graeme; Smolin, John A

2014-03-21

Entanglement is a fundamental resource for quantum information processing. In its pure form, it allows quantum teleportation and sharing classical secrets. Realistic quantum states are noisy and their usefulness is only partially understood. Bound-entangled states are central to this question--they have no distillable entanglement, yet sometimes still have a private classical key. We present a construction of bound-entangled states with a private key based on classical probability distributions. From this emerge states possessing a new classical analogue of bound entanglement, distinct from the long-sought bound information. We also find states of smaller dimensions and higher key rates than previously known. Our construction has implications for classical cryptography: we show that existing protocols are insufficient for extracting private key from our distributions due to their "bound-entangled" nature. We propose a simple extension of existing protocols that can extract a key from them.

Influence of measurement error on Maxwell's demon

NASA Astrophysics Data System (ADS)

Sørdal, Vegard; Bergli, Joakim; Galperin, Y. M.

2017-06-01

In any general cycle of measurement, feedback, and erasure, the measurement will reduce the entropy of the system when information about the state is obtained, while erasure, according to Landauer's principle, is accompanied by a corresponding increase in entropy due to the compression of logical and physical phase space. The total process can in principle be fully reversible. A measurement error reduces the information obtained and the entropy decrease in the system. The erasure still gives the same increase in entropy, and the total process is irreversible. Another consequence of measurement error is that a bad feedback is applied, which further increases the entropy production if the proper protocol adapted to the expected error rate is not applied. We consider the effect of measurement error on a realistic single-electron box Szilard engine, and we find the optimal protocol for the cycle as a function of the desired power P and error ɛ .

Unforgeable Noise-Tolerant Quantum Tokens

NASA Astrophysics Data System (ADS)

Yao, Norman; Pastawski, Fernando; Jiang, Liang; Lukin, Mikhail; Cirac, Ignacio

2012-06-01

The realization of devices which harness the laws of quantum mechanics represents an exciting challenge at the interface of modern technology and fundamental science. An exemplary paragon of the power of such quantum primitives is the concept of ``quantum money.'' A dishonest holder of a quantum bank-note will invariably fail in any forging attempts; indeed, under assumptions of ideal measurements and decoherence-free memories such security is guaranteed by the no-cloning theorem. In any practical situation, however, noise, decoherence and operational imperfections abound. Thus, the development of secure ``quantum money''-type primitives capable of tolerating realistic infidelities is of both practical and fundamental importance. Here, we propose a novel class of such protocols and demonstrate their tolerance to noise; moreover, we prove their rigorous security by determining tight fidelity thresholds. Our proposed protocols require only the ability to prepare, store and measure single qubit quantum memories, making their experimental realization accessible with current technologies.

Phase magnification by two-axis countertwisting for detection-noise robust interferometry

NASA Astrophysics Data System (ADS)

Anders, Fabian; Pezzè, Luca; Smerzi, Augusto; Klempt, Carsten

2018-04-01

Entanglement-enhanced atom interferometry has the potential of surpassing the standard quantum limit and eventually reaching the ultimate Heisenberg bound. The experimental progress is, however, hindered by various technical noise sources, including the noise in the detection of the output quantum state. The influence of detection noise can be largely overcome by exploiting echo schemes, where the entanglement-generating interaction is repeated after the interferometer sequence. Here, we propose an echo protocol that uses two-axis countertwisting as the main nonlinear interaction. We demonstrate that the scheme is robust to detection noise and its performance is superior compared to the already demonstrated one-axis twisting echo scheme. In particular, the sensitivity maintains the Heisenberg scaling in the limit of a large particle number. Finally, we show that the protocol can be implemented with spinor Bose-Einstein condensates. Our results thus outline a realistic approach to mitigate the detection noise in quantum-enhanced interferometry.

Experimental measurement-device-independent quantum key distribution with uncharacterized encoding.

PubMed

Wang, Chao; Wang, Shuang; Yin, Zhen-Qiang; Chen, Wei; Li, Hong-Wei; Zhang, Chun-Mei; Ding, Yu-Yang; Guo, Guang-Can; Han, Zheng-Fu

2016-12-01

Measurement-device-independent quantum key distribution (MDI QKD) is an efficient way to share secrets using untrusted measurement devices. However, the assumption on the characterizations of encoding states is still necessary in this promising protocol, which may lead to unnecessary complexity and potential loopholes in realistic implementations. Here, by using the mismatched-basis statistics, we present the first proof-of-principle experiment of MDI QKD with uncharacterized encoding sources. In this demonstration, the encoded states are only required to be constrained in a two-dimensional Hilbert space, and two distant parties (Alice and Bob) are resistant to state preparation flaws even if they have no idea about the detailed information of their encoding states. The positive final secure key rates of our system exhibit the feasibility of this novel protocol, and demonstrate its value for the application of secure communication with uncharacterized devices.

A quantum spin-probe molecular microscope

NASA Astrophysics Data System (ADS)

Perunicic, V. S.; Hill, C. D.; Hall, L. T.; Hollenberg, L. C. L.

2016-10-01

Imaging the atomic structure of a single biomolecule is an important challenge in the physical biosciences. Whilst existing techniques all rely on averaging over large ensembles of molecules, the single-molecule realm remains unsolved. Here we present a protocol for 3D magnetic resonance imaging of a single molecule using a quantum spin probe acting simultaneously as the magnetic resonance sensor and source of magnetic field gradient. Signals corresponding to specific regions of the molecule's nuclear spin density are encoded on the quantum state of the probe, which is used to produce a 3D image of the molecular structure. Quantum simulations of the protocol applied to the rapamycin molecule (C51H79NO13) show that the hydrogen and carbon substructure can be imaged at the angstrom level using current spin-probe technology. With prospects for scaling to large molecules and/or fast dynamic conformation mapping using spin labels, this method provides a realistic pathway for single-molecule microscopy.

Experimental loss-tolerant quantum coin flipping

PubMed Central

Berlín, Guido; Brassard, Gilles; Bussières, Félix; Godbout, Nicolas; Slater, Joshua A.; Tittel, Wolfgang

2011-01-01

Coin flipping is a cryptographic primitive in which two distrustful parties wish to generate a random bit to choose between two alternatives. This task is impossible to realize when it relies solely on the asynchronous exchange of classical bits: one dishonest player has complete control over the final outcome. It is only when coin flipping is supplemented with quantum communication that this problem can be alleviated, although partial bias remains. Unfortunately, practical systems are subject to loss of quantum data, which allows a cheater to force a bias that is complete or arbitrarily close to complete in all previous protocols and implementations. Here we report on the first experimental demonstration of a quantum coin-flipping protocol for which loss cannot be exploited to cheat better. By eliminating the problem of loss, which is unavoidable in any realistic setting, quantum coin flipping takes a significant step towards real-world applications of quantum communication. PMID:22127057

The role of the social worker in the in-vitro fertilization program.

PubMed

Greenfeld, D; Mazure, C; Haseltine, F; DeCherney, A

1984-01-01

The role of the clinical social worker in the In-Vitro fertilization Program is to help provide patients with an environment that includes realistic expectation and emphasizes the emotional spectrum of euphoria, anxiety and dysphoria that can accompany the demanding protocol. The literature supports the need for counseling and supportive psychotherapy in the infertility clinic but has not dealt specifically with the psychological demands of In-Vitro fertilization. This paper addresses the emotional stress of in-vitro fertilization and emphasizes the role of social worker as counselor, educator and guide.

Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: a realist process evaluation protocol.

PubMed

Randell, Rebecca; Greenhalgh, Joanne; Hindmarsh, Jon; Dowding, Dawn; Jayne, David; Pearman, Alan; Gardner, Peter; Croft, Julie; Kotze, Alwyn

2014-05-02

Robotic surgery offers many potential benefits for patients. While an increasing number of healthcare providers are purchasing surgical robots, there are reports that the technology is failing to be introduced into routine practice. Additionally, in robotic surgery, the surgeon is physically separated from the patient and the rest of the team, with the potential to negatively impact teamwork in the operating theatre. The aim of this study is to ascertain: how and under what circumstances robotic surgery is effectively introduced into routine practice; and how and under what circumstances robotic surgery impacts teamwork, communication and decision making, and subsequent patient outcomes. We will undertake a process evaluation alongside a randomised controlled trial comparing laparoscopic and robotic surgery for the curative treatment of rectal cancer. Realist evaluation provides an overall framework for the study. The study will be in three phases. In Phase I, grey literature will be reviewed to identify stakeholders' theories concerning how robotic surgery becomes embedded into surgical practice and its impacts. These theories will be refined and added to through interviews conducted across English hospitals that are using robotic surgery for rectal cancer resection with staff at different levels of the organisation, along with a review of documentation associated with the introduction of robotic surgery. In Phase II, a multi-site case study will be conducted across four English hospitals to test and refine the candidate theories. Data will be collected using multiple methods: the structured observation tool OTAS (Observational Teamwork Assessment for Surgery); video recordings of operations; ethnographic observation; and interviews. In Phase III, interviews will be conducted at the four case sites with staff representing a range of surgical disciplines, to assess the extent to which the results of Phase II are generalisable and to refine the resulting theories to reflect the experience of a broader range of surgical disciplines. The study will provide (i) guidance to healthcare organisations on factors likely to facilitate successful implementation and integration of robotic surgery, and (ii) guidance on how to ensure effective communication and teamwork when undertaking robotic surgery.

Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: a realist process evaluation protocol

PubMed Central

2014-01-01

Background Robotic surgery offers many potential benefits for patients. While an increasing number of healthcare providers are purchasing surgical robots, there are reports that the technology is failing to be introduced into routine practice. Additionally, in robotic surgery, the surgeon is physically separated from the patient and the rest of the team, with the potential to negatively impact teamwork in the operating theatre. The aim of this study is to ascertain: how and under what circumstances robotic surgery is effectively introduced into routine practice; and how and under what circumstances robotic surgery impacts teamwork, communication and decision making, and subsequent patient outcomes. Methods and design We will undertake a process evaluation alongside a randomised controlled trial comparing laparoscopic and robotic surgery for the curative treatment of rectal cancer. Realist evaluation provides an overall framework for the study. The study will be in three phases. In Phase I, grey literature will be reviewed to identify stakeholders’ theories concerning how robotic surgery becomes embedded into surgical practice and its impacts. These theories will be refined and added to through interviews conducted across English hospitals that are using robotic surgery for rectal cancer resection with staff at different levels of the organisation, along with a review of documentation associated with the introduction of robotic surgery. In Phase II, a multi-site case study will be conducted across four English hospitals to test and refine the candidate theories. Data will be collected using multiple methods: the structured observation tool OTAS (Observational Teamwork Assessment for Surgery); video recordings of operations; ethnographic observation; and interviews. In Phase III, interviews will be conducted at the four case sites with staff representing a range of surgical disciplines, to assess the extent to which the results of Phase II are generalisable and to refine the resulting theories to reflect the experience of a broader range of surgical disciplines. The study will provide (i) guidance to healthcare organisations on factors likely to facilitate successful implementation and integration of robotic surgery, and (ii) guidance on how to ensure effective communication and teamwork when undertaking robotic surgery. PMID:24885669

Group clinics for young adults with diabetes in an ethnically diverse, socioeconomically deprived setting (TOGETHER study): protocol for a realist review, co-design and mixed methods, participatory evaluation of a new care model.

PubMed

Papoutsi, Chrysanthi; Hargreaves, Dougal; Colligan, Grainne; Hagell, Ann; Patel, Anita; Campbell-Richards, Desirée; Viner, Russell M; Vijayaraghavan, Shanti; Marshall, Martin; Greenhalgh, Trisha; Finer, Sarah

2017-06-21

Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas. This participatory study will include three phases. In phase 1, we will carry out a realist review to synthesise the literature on group-based care for young adults with diabetes. This theory-driven understanding will provide the basis for phase 2, where we will draw on experience-based co-design methodologies to develop a new, group-based care model for young adults (aged <25 years, under the care of adult diabetes services). In phase 3, we will use a researcher-in-residence approach to implement and evaluate the co-designed group clinic model and compare with traditional care. We will employ qualitative (observations in clinics, patient and staff interviews and document analysis) and quantitative methods (eg, biological markers, patient enablement instrument and diabetes distress scale), including a cost analysis. National Health Service ethics approval has been granted (reference 17/NI/0019). The project will directly inform service redesign to better meet the needs of young adults with diabetes in socioeconomically deprived areas and may guide a possible cluster-randomised trial, powered to clinical and cost-effectiveness outcomes. Findings from this study may be transferable to other long-term conditions and/or age groups. Project outputs will include briefing statements, summaries and academic papers, tailored for different audiences, including people living with diabetes, clinicians, policy makers and strategic decision makers. PROSPERO (CRD42017058726). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Realistic Radio Communications in Pilot Simulator Training

NASA Technical Reports Server (NTRS)

Burki-Cohen, Judith; Kendra, Andrew J.; Kanki, Barbara G.; Lee, Alfred T.

2000-01-01

Simulators used for total training and evaluation of airline pilots must satisfy stringent criteria in order to assure their adequacy for training and checking maneuvers. Air traffic control and company radio communications simulation, however, may still be left to role-play by the already taxed instructor/evaluators in spite of their central importance in every aspect of the flight environment. The underlying premise of this research is that providing a realistic radio communications environment would increase safety by enhancing pilot training and evaluation. This report summarizes the first-year efforts of assessing the requirement and feasibility of simulating radio communications automatically. A review of the training and crew resource/task management literature showed both practical and theoretical support for the need for realistic radio communications simulation. A survey of 29 instructor/evaluators from 14 airlines revealed that radio communications are mainly role-played by the instructor/evaluators. This increases instructor/evaluators' own workload while unrealistically lowering pilot communications load compared to actual operations, with a concomitant loss in training/evaluation effectiveness. A technology review searching for an automated means of providing radio communications to and from aircraft with minimal human effort showed that while promising, the technology is still immature. Further research and the need for establishing a proof-of-concept are also discussed.

Extra-Vehicular Activity (EVA) glove evaluation test protocol

NASA Technical Reports Server (NTRS)

Hinman-Sweeney, E. M.

1994-01-01

One of the most critical components of a space suit is the gloves, yet gloves have traditionally presented significant design challenges. With continued efforts at glove development, a method for evaluating glove performance is needed. This paper presents a pressure-glove evaluation protocol. A description of this evaluation protocol, and its development is provided. The protocol allows comparison of one glove design to another, or any one design to bare-handed performance. Gloves for higher pressure suits may be evaluated at current and future design pressures to drive out differences in performance due to pressure effects. Using this protocol, gloves may be evaluated during design to drive out design problems and determine areas for improvement, or fully mature designs may be evaluated with respect to mission requirements. Several different test configurations are presented to handle these cases. This protocol was run on a prototype glove. The prototype was evaluated at two operating pressures and in the unpressurized state, with results compared to bare-handed performance. Results and analysis from this test series are provided, as is a description of the configuration used for this test.

Impact of integrated upper limb spasticity management including botulinum toxin A on patient-centred goal attainment: rationale and protocol for an international prospective, longitudinal cohort study (ULIS-III)

PubMed Central

Turner-Stokes, Lynne; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Fheodoroff, Klemens

2016-01-01

Objectives Describe the rationale and protocol for the Upper Limb International Spasticity (ULIS)-III study, which aims to evaluate the impact of integrated spasticity management, involving multiple botulinum toxin A (BoNT-A) injection cycles and concomitant therapies, on patient-centred goal attainment. Outline novel outcome assessment methods for ULIS-III and report initial evaluation data from goal setting in early stages of the study. Design Large international longitudinal cohort study of integrated upper limb spasticity management, including BoNT-A. Participants and setting ULIS-III is a 2-year study expected to enrol >1000 participants at 58 study centres across 14 countries. Interventions The study design is non-interventional and intended to reflect real-life clinical practice. It will describe injection practices and additional treatment strategies, and record clinical decision-making in a serial approach to long-term spasticity management. Outcome measures ULIS-III will use a goal-directed approach to selection of targeted standardised measures to capture the diversity of presentation, goals and outcomes. ULIS-III will implement the Upper Limb Spasticity Index, a battery of assessments including a structured approach to goal attainment scaling (Goal Attainment Scaling—Evaluation of Outcomes for Upper Limb Spasticity tool), alongside a limited set of standardised measures, chosen according to patients' selected goal areas. Concomitant therapy inputs, patient satisfaction with engagement in goal setting, health economic end points and health-related quality of life data will also be captured. Results of initial evaluation of goal quality Recruitment started in January 2015. By June 2015, 58 sites had been identified and initial data collected for 79 patients across 13 sites in 3 countries. Goal setting data were quality-checked and centres rated on the basis of function-related and Specific, Measurable, Achievable, Realistic, Timed (SMART) characteristics of goal statements. Overall, 11/13 centres achieved the highest rating (A++). Conclusions ULIS-III will provide valuable information regarding treatment of and outcomes from real-life upper limb spasticity management worldwide. Trial registration number NCT02454803; Pre-results. PMID:27315835

Combining Campbell Standards and the Realist Evaluation Approach: The Best of Two Worlds?

ERIC Educational Resources Information Center

van der Knaap, Leontien M.; Leeuw, Frans L.; Bogaerts, Stefan; Nijssen, Laura T. J.

2008-01-01

This article presents an approach to systematic reviews that combines the Campbell Collaboration Crime and Justice standards and the realist notion of contexts-mechanisms-outcomes (CMO) configurations. Both approaches have their advantages and drawbacks, and the authors will make a case for combining both approaches to profit from their advantages…

Healthy Cities Phase V evaluation: further synthesizing realism.

PubMed

de Leeuw, Evelyne; Green, Geoff; Tsouros, Agis; Dyakova, Mariana; Farrington, Jill; Faskunger, Johan; Grant, Marcus; Ison, Erica; Jackisch, Josephine; Lafond, Leah Janss; Lease, Helen; Mackiewicz, Karolina; Östergren, Per-Olof; Palmer, Nicola; Ritsatakis, Anna; Simos, Jean; Spanswick, Lucy; Webster, Premila; Zamaro, Gianna; Crown, June; Kickbusch, Ilona; Rasmussen, Niels; Scally, Gabriel; Biddle, Marian; Earl, Suzanne; Petersen, Connie; Devlin, Joan

2015-06-01

In this article we reflect on the quality of a realist synthesis paradigm applied to the evaluation of Phase V of the WHO European Healthy Cities Network. The programmatic application of this approach has led to very high response rates and a wealth of important data. All articles in this Supplement report that cities in the network move from small-scale, time-limited projects predominantly focused on health lifestyles to the significant inclusion of policies and programmes on systems and values for good health governance. The evaluation team felt that, due to time and resource limitations, it was unable to fully exploit the potential of realist synthesis. In particular, the synthetic integration of different strategic foci of Phase V designation areas did not come to full fruition. We recommend better and more sustained integration of realist synthesis in the practice of Healthy Cities in future Phases. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Evaluating anesthetic protocols for functional blood flow imaging in the rat eye

NASA Astrophysics Data System (ADS)

Moult, Eric M.; Choi, WooJhon; Boas, David A.; Baumann, Bernhard; Clermont, Allen C.; Feener, Edward P.; Fujimoto, James G.

2017-01-01

The purpose of this study is to evaluate the suitability of five different anesthetic protocols (isoflurane, isoflurane-xylazine, pentobarbital, ketamine-xylazine, and ketamine-xylazine-vecuronium) for functional blood flow imaging in the rat eye. Total retinal blood flow was measured at a series of time points using an ultrahigh-speed Doppler OCT system. Additionally, each anesthetic protocol was qualitatively evaluated according to the following criteria: (1) time-stability of blood flow, (2) overall rate of blood flow, (3) ocular immobilization, and (4) simplicity. We observed that different anesthetic protocols produced markedly different blood flows. Different anesthetic protocols also varied with respect to the four evaluated criteria. These findings suggest that the choice of anesthetic protocol should be carefully considered when designing and interpreting functional blood flow studies in the rat eye.

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

PubMed

Wright, Melanie C; Taekman, Jeffrey M; Barber, Linda; Hobbs, Gene; Newman, Mark F; Stafford-Smith, Mark

2005-12-01

Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection tools. High-fidelity patient simulation centers provide an ideal environment to apply human-centered design to clinical trial development. A draft of a complex clinical protocol was designed, evaluated and modified using a high-fidelity human patient simulator in the Duke University Human Simulation and Patient Safety Center. The process included walk-throughs, detailed modifications of the protocol and development of procedural aids. Training of monitors and coordinators provided an opportunity for observation of performance that was used to identify further improvements to the protocol. Evaluative steps were used to design the research protocol and procedures. Iterative modifications were made to the protocol and data collection tools. The success in use of human simulation in the preparation of a complex clinical drug trial suggests the benefits of human patient simulation extend beyond training and medical equipment evaluation. Human patient simulation can provide a context for informal expert evaluation of clinical protocol design and for formal "rehearsal" to evaluate the efficacy of procedures and support tools.

Goal-setting to Promote a Healthier Lifestyle in Later Life: Qualitative Evaluation of the AgeWell Trial

PubMed Central

Nelis, Sharon M.; Thom, Jeanette M.; Jones, Ian Rees; Hindle, John V.

2018-01-01

ABSTRACT Objective: We report a mixed method evaluation of the feasibility and implementation of the AgeWell goal-setting intervention to promote healthy ageing later life. Method: Researcher field notes, goal-setting interview content, and semi-structured interviews with participants were content analysed to review trial implementation and participants’ perspective on the goal-setting and mentoring intervention. Results: 75 people were recruited: 21 in the goal-setting and 22 in the goal-setting with mentoring arms of the intervention. Goal-setting was feasible in the main domains of interest. Adherence to the protocol was good and the mentoring schedule was adhered to. Participants reported satisfaction with their goal attainment, but barriers for non-achievement were also identified. Recommendations for small changes to the intervention included reducing the number of goals. Conclusions: Participants understood the goal-setting process, and were able to set realistic and achievable lifestyle goals. The intervention and the procedures were acceptable but changes in how goal-setting is both introduced and monitored are needed for wider implementation. Clinical Implications: Goal-setting can be a useful process to help people alter their lifestyle to allow them to age more successfully and reduce risk factors associated with dementia. PMID:29308992

Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review.

PubMed

Kastner, Monika; Perrier, Laure; Hamid, Jemila; Tricco, Andrea C; Cardoso, Roberta; Ivers, Noah M; Liu, Barbara; Marr, Sharon; Holroyd-Leduc, Jayna; Wong, Geoff; Graves, Lisa; Straus, Sharon E

2015-02-03

The burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions. We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies. Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders. Our protocol is registered with PROSPERO (registration number CRD42014014489). 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.

Development and validation of a remote home safety protocol.

PubMed

Romero, Sergio; Lee, Mi Jung; Simic, Ivana; Levy, Charles; Sanford, Jon

2018-02-01

Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations. This study describes the development and validation of a remote home safety protocol that can be used by a caregiver of an elderly person to video-record their home environment for later viewing and evaluation by a trained professional. The protocol was developed based on literature reviews and evaluations from clinical and content experts. Cognitive interviews were conducted with a group of six caregivers to validate the protocol. The final protocol included step-by-step directions to record indoor and outdoor areas of the home. The validation process resulted in modifications related to safety, clarity of the protocol, readability, visual appearance, technical descriptions and usability. Our final protocol includes detailed instructions that a caregiver should be able to follow to record a home environment for subsequent evaluation by a home safety professional. Implications for Rehabilitation The results of this study have several implications for rehabilitation practice The remote home safety evaluation protocol can potentially improve access to rehabilitation services for clients in remote areas and prevent unnecessary delays for needed care. Using our protocol, a patient's caregiver can partner with therapists to quickly and efficiently evaluate a patient's home before they are released from the hospital. Caregiver narration, which reflects a caregiver's own perspective, is critical to evaluating home safety. In-home safety evaluations, currently not available to all who need them due to access barriers, can enhance a patient's independence and provide a safer home environment.

Taking error into account when fitting models using Approximate Bayesian Computation.

PubMed

van der Vaart, Elske; Prangle, Dennis; Sibly, Richard M

2018-03-01

Stochastic computer simulations are often the only practical way of answering questions relating to ecological management. However, due to their complexity, such models are difficult to calibrate and evaluate. Approximate Bayesian Computation (ABC) offers an increasingly popular approach to this problem, widely applied across a variety of fields. However, ensuring the accuracy of ABC's estimates has been difficult. Here, we obtain more accurate estimates by incorporating estimation of error into the ABC protocol. We show how this can be done where the data consist of repeated measures of the same quantity and errors may be assumed to be normally distributed and independent. We then derive the correct acceptance probabilities for a probabilistic ABC algorithm, and update the coverage test with which accuracy is assessed. We apply this method, which we call error-calibrated ABC, to a toy example and a realistic 14-parameter simulation model of earthworms that is used in environmental risk assessment. A comparison with exact methods and the diagnostic coverage test show that our approach improves estimation of parameter values and their credible intervals for both models. © 2017 by the Ecological Society of America.

Direct Resin Composite Restoration of Maxillary Central Incisors with Fractured Tooth Fragment Reattachment: Case Report.

PubMed

Szmidt, Monika; Górski, Maciej; Barczak, Katarzyna; Buczkowska-Radlińska, Jadwiga

This article presents a clinical protocol to reconstruct two accidentally damaged maxillary central incisors using composite resin material and a fractured tooth component. A patient was referred to the clinic with fracture of the two maxillary central incisors. Clinical examination revealed that both teeth were fractured in the middle third of the crown and that the fractures involved enamel and dentin with no pulp exposure. The patient had also suffered a lower lip laceration. When the lip was evaluated, a fractured fragment of the maxillary right central incisor was found inside the wound. The missing part of the tooth was replaced via adhesive attachment. Due to the damage of the fractured part of the maxillary left central incisor, direct composite restoration of this tooth was performed. With the advent of adhesive dentistry, the process of fragment reattachment has become simplified and more reliable. This procedure provides improved function, is faster to perform, and provides long-lasting effects, indicating that reattachment of a coronal fragment is a realistic alternative to placement of conventional resin composite restorations.

How do microalgae perceive light in a high-rate pond? Towards more realistic Lagrangian experiments.

PubMed

Demory, David; Combe, Charlotte; Hartmann, Philipp; Talec, Amélie; Pruvost, Eric; Hamouda, Raouf; Souillé, Fabien; Lamare, Pierre-Olivier; Bristeau, Marie-Odile; Sainte-Marie, Jacques; Rabouille, Sophie; Mairet, Francis; Sciandra, Antoine; Bernard, Olivier

2018-05-01

Hydrodynamics in a high-rate production reactor for microalgae cultivation affects the light history perceived by cells. The interplay between cell movement and medium turbidity leads to a complex light pattern, whose forcing effects on photosynthesis and photoacclimation dynamics are non-trivial. Hydrodynamics of high density algal ponds mixed by a paddle wheel has been studied recently, although the focus has never been on describing its impact on photosynthetic growth efficiency. In this multidisciplinary downscaling study, we first reconstructed single cell trajectories in an open raceway using an original hydrodynamical model offering a powerful discretization of the Navier-Stokes equations tailored to systems with free surfaces. The trajectory of a particular cell was selected and the associated high-frequency light pattern was computed. This light pattern was then experimentally reproduced in an Arduino-driven computer controlled cultivation system with a low density Dunaliella salina culture. The effect on growth and pigment content was recorded for various frequencies of the light pattern, by setting different paddle wheel velocities. Results show that the frequency of this realistic signal plays a decisive role in the dynamics of photosynthesis, thus revealing an unexpected photosynthetic response compared to that recorded under the on/off signals usually used in the literature. Indeed, the light received by a single cell contains signals from low to high frequencies that nonlinearly interact with the photosynthesis process and differentially stimulate the various time scales associated with photoacclimation and energy dissipation. This study highlights the need for experiments with more realistic light stimuli to better understand microalgal growth at high cell densities. An experimental protocol is also proposed, with simple, yet more realistic, step functions for light fluctuations.

How do microalgae perceive light in a high-rate pond? Towards more realistic Lagrangian experiments

PubMed Central

Demory, David; Combe, Charlotte; Hartmann, Philipp; Talec, Amélie; Pruvost, Eric; Hamouda, Raouf; Souillé, Fabien; Lamare, Pierre-Olivier; Bristeau, Marie-Odile; Sainte-Marie, Jacques; Rabouille, Sophie; Mairet, Francis; Sciandra, Antoine

2018-01-01

Hydrodynamics in a high-rate production reactor for microalgae cultivation affects the light history perceived by cells. The interplay between cell movement and medium turbidity leads to a complex light pattern, whose forcing effects on photosynthesis and photoacclimation dynamics are non-trivial. Hydrodynamics of high density algal ponds mixed by a paddle wheel has been studied recently, although the focus has never been on describing its impact on photosynthetic growth efficiency. In this multidisciplinary downscaling study, we first reconstructed single cell trajectories in an open raceway using an original hydrodynamical model offering a powerful discretization of the Navier–Stokes equations tailored to systems with free surfaces. The trajectory of a particular cell was selected and the associated high-frequency light pattern was computed. This light pattern was then experimentally reproduced in an Arduino-driven computer controlled cultivation system with a low density Dunaliella salina culture. The effect on growth and pigment content was recorded for various frequencies of the light pattern, by setting different paddle wheel velocities. Results show that the frequency of this realistic signal plays a decisive role in the dynamics of photosynthesis, thus revealing an unexpected photosynthetic response compared to that recorded under the on/off signals usually used in the literature. Indeed, the light received by a single cell contains signals from low to high frequencies that nonlinearly interact with the photosynthesis process and differentially stimulate the various time scales associated with photoacclimation and energy dissipation. This study highlights the need for experiments with more realistic light stimuli to better understand microalgal growth at high cell densities. An experimental protocol is also proposed, with simple, yet more realistic, step functions for light fluctuations. PMID:29892466

Extracting aerobic system dynamics during unsupervised activities of daily living using wearable sensor machine learning models.

PubMed

Beltrame, Thomas; Amelard, Robert; Wong, Alexander; Hughson, Richard L

2018-02-01

Physical activity levels are related through algorithms to the energetic demand, with no information regarding the integrity of the multiple physiological systems involved in the energetic supply. Longitudinal analysis of the oxygen uptake (V̇o 2 ) by wearable sensors in realistic settings might permit development of a practical tool for the study of the longitudinal aerobic system dynamics (i.e., V̇o 2 kinetics). This study evaluated aerobic system dynamics based on predicted V̇o 2 data obtained from wearable sensors during unsupervised activities of daily living (μADL). Thirteen healthy men performed a laboratory-controlled moderate exercise protocol and were monitored for ≈6 h/day for 4 days (μADL data). Variables derived from hip accelerometer (ACC HIP ), heart rate monitor, and respiratory bands during μADL were extracted and processed by a validated random forest regression model to predict V̇o 2 . The aerobic system analysis was based on the frequency-domain analysis of ACC HIP and predicted V̇o 2 data obtained during μADL. Optimal samples for frequency domain analysis (constrained to ≤0.01 Hz) were selected when ACC HIP was higher than 0.05 g at a given frequency (i.e., participants were active). The temporal characteristics of predicted V̇o 2 data during μADL correlated with the temporal characteristics of measured V̇o 2 data during laboratory-controlled protocol ([Formula: see text] = 0.82, P < 0.001, n = 13). In conclusion, aerobic system dynamics can be investigated during unsupervised activities of daily living by wearable sensors. Although speculative, these algorithms have the potential to be incorporated into wearable systems for early detection of changes in health status in realistic environments by detecting changes in aerobic response dynamics. NEW & NOTEWORTHY The early detection of subclinical aerobic system impairments might be indicative of impaired physiological reserves that impact the capacity for physical activity. This study is the first to use wearable sensors in unsupervised activities of daily living in combination with novel machine learning algorithms to investigate the aerobic system dynamics with the potential to contribute to models of functional health status and guide future individualized health care in the normal population.

The Role of Additional Pulses in Electropermeabilization Protocols

PubMed Central

Suárez, Cecilia; Soba, Alejandro; Maglietti, Felipe; Olaiz, Nahuel; Marshall, Guillermo

2014-01-01

Electropermeabilization (EP) based protocols such as those applied in medicine, food processing or environmental management, are well established and widely used. The applied voltage, as well as tissue electric conductivity, are of utmost importance for assessing final electropermeabilized area and thus EP effectiveness. Experimental results from literature report that, under certain EP protocols, consecutive pulses increase tissue electric conductivity and even the permeabilization amount. Here we introduce a theoretical model that takes into account this effect in the application of an EP-based protocol, and its validation with experimental measurements. The theoretical model describes the electric field distribution by a nonlinear Laplace equation with a variable conductivity coefficient depending on the electric field, the temperature and the quantity of pulses, and the Penne's Bioheat equation for temperature variations. In the experiments, a vegetable tissue model (potato slice) is used for measuring electric currents and tissue electropermeabilized area in different EP protocols. Experimental measurements show that, during sequential pulses and keeping constant the applied voltage, the electric current density and the blackened (electropermeabilized) area increase. This behavior can only be attributed to a rise in the electric conductivity due to a higher number of pulses. Accordingly, we present a theoretical modeling of an EP protocol that predicts correctly the increment in the electric current density observed experimentally during the addition of pulses. The model also demonstrates that the electric current increase is due to a rise in the electric conductivity, in turn induced by temperature and pulse number, with no significant changes in the electric field distribution. The EP model introduced, based on a novel formulation of the electric conductivity, leads to a more realistic description of the EP phenomenon, hopefully providing more accurate predictions of treatment outcomes. PMID:25437512

Performance Comparison of Wireless Sensor Network Standard Protocols in an Aerospace Environment: ISA100.11a and ZigBee

NASA Technical Reports Server (NTRS)

Wagner, Raymond S.; Barton, Richard J.

2011-01-01

Wireless Sensor Networks (WSNs) can provide a substantial benefit in spacecraft systems, reducing launch weight and providing unprecedented flexibility by allowing instrumentation capabilities to grow and change over time. Achieving data transport reliability on par with that of wired systems, however, can prove extremely challenging in practice. Fortunately, much progress has been made in developing standard WSN radio protocols for applications from non-critical home automation to mission-critical industrial process control. The relative performances of candidate protocols must be compared in representative aerospace environments, however, to determine their suitability for spaceflight applications. In this paper, we will present the results of a rigorous laboratory analysis of the performance of two standards-based, low power, low data rate WSN protocols: ZigBee Pro and ISA100.11a. Both are based on IEEE 802.15.4 and augment that standard's specifications to build complete, multi-hop networking stacks. ZigBee Pro targets primarily the home and office automation markets, providing an ad-hoc protocol that is computationally lightweight and easy to implement in inexpensive system-on-a-chip components. As a result of this simplicity, however, ZigBee Pro can be susceptible to radio frequency (RF) interference. ISA100.11a, on the other hand, targets the industrial process control market, providing a robust, centrally-managed protocol capable of tolerating a significant amount of RF interference. To achieve these gains, a coordinated channel hopping mechanism is employed, which entails a greater computational complexity than ZigBee and requires more sophisticated and costly hardware. To guide future aerospace deployments, we must understand how well these standards relatively perform in analog environments under expected operating conditions. Specifically, we are interested in evaluating goodput -- application level throughput -- in a representative crewed environment in the presence of varying levels of 802.11g Wi-Fi traffic. To do so, we use the NASA Johnson Space Center Wireless Habitat Testbed (WHT), a metallic, habitation-sized module designed for co-existence testing of wireless systems. In its quiescent state, the sealed WHT provides an RF-quiet environment to which we can selectively add interfering systems; it also provides a realistic level of multi-path self-interference for systems under investigation. In our test, we deploy two representative five node networks, configured in a star topology with all nodes reporting directly to a WSN gateway. Each ZigBee network WSN node is built using a Texas Instruments (TI) CC2530 system-on-a-chip radio running TI's ZigBee Pro Z-stack. Each ISA100.11a network node is built using a Nivis VersaNode 210 system-on-a-chip radio. In both cases, radios interface with TI MSP430-F5438 microcontroller implementing a common test application. Interference is provided by a D-link 802.11g Wi-Fi router transporting traffic generated using the Iperf network testing tool. For the single-channel ZigBee network, effects of both direct and indirect Wi-Fi interference are evaluated. For the channel-hopping ISA100.11a network, effects of interference from multiple Wi-Fi routers configured in non-overlapping 802.11g channels are evaluated. Our results show that, in general, the more lightweight ZigBee network performs well at low interference levels, but performance degrades as interference increases. Conversely, the more complex and costly ISA100.11a network continues to perform well as Wi-Fi interference levels increase.

Reliable Freestanding Position-Based Routing in Highway Scenarios

PubMed Central

Galaviz-Mosqueda, Gabriel A.; Aquino-Santos, Raúl; Villarreal-Reyes, Salvador; Rivera-Rodríguez, Raúl; Villaseñor-González, Luis; Edwards, Arthur

2012-01-01

Vehicular Ad Hoc Networks (VANETs) are considered by car manufacturers and the research community as the enabling technology to radically improve the safety, efficiency and comfort of everyday driving. However, before VANET technology can fulfill all its expected potential, several difficulties must be addressed. One key issue arising when working with VANETs is the complexity of the networking protocols compared to those used by traditional infrastructure networks. Therefore, proper design of the routing strategy becomes a main issue for the effective deployment of VANETs. In this paper, a reliable freestanding position-based routing algorithm (FPBR) for highway scenarios is proposed. For this scenario, several important issues such as the high mobility of vehicles and the propagation conditions may affect the performance of the routing strategy. These constraints have only been partially addressed in previous proposals. In contrast, the design approach used for developing FPBR considered the constraints imposed by a highway scenario and implements mechanisms to overcome them. FPBR performance is compared to one of the leading protocols for highway scenarios. Performance metrics show that FPBR yields similar results when considering freespace propagation conditions, and outperforms the leading protocol when considering a realistic highway path loss model. PMID:23202159

A game theory-based obstacle avoidance routing protocol for wireless sensor networks.

PubMed

Guan, Xin; Wu, Huayang; Bi, Shujun

2011-01-01

The obstacle avoidance problem in geographic forwarding is an important issue for location-based routing in wireless sensor networks. The presence of an obstacle leads to several geographic routing problems such as excessive energy consumption and data congestion. Obstacles are hard to avoid in realistic environments. To bypass obstacles, most routing protocols tend to forward packets along the obstacle boundaries. This leads to a situation where the nodes at the boundaries exhaust their energy rapidly and the obstacle area is diffused. In this paper, we introduce a novel routing algorithm to solve the obstacle problem in wireless sensor networks based on a game-theory model. Our algorithm forms a concave region that cannot forward packets to achieve the aim of improving the transmission success rate and decreasing packet transmission delays. We consider the residual energy, out-degree and forwarding angle to determine the forwarding probability and payoff function of forwarding candidates. This achieves the aim of load balance and reduces network energy consumption. Simulation results show that based on the average delivery delay, energy consumption and packet delivery ratio performances our protocol is superior to other traditional schemes.

Reliable freestanding position-based routing in highway scenarios.

PubMed

Galaviz-Mosqueda, Gabriel A; Aquino-Santos, Raúl; Villarreal-Reyes, Salvador; Rivera-Rodríguez, Raúl; Villaseñor-González, Luis; Edwards, Arthur

2012-10-24

Vehicular Ad Hoc Networks (VANETs) are considered by car manufacturers and the research community as the enabling technology to radically improve the safety, efficiency and comfort of everyday driving. However, before VANET technology can fulfill all its expected potential, several difficulties must be addressed. One key issue arising when working with VANETs is the complexity of the networking protocols compared to those used by traditional infrastructure networks. Therefore, proper design of the routing strategy becomes a main issue for the effective deployment of VANETs. In this paper, a reliable freestanding position-based routing algorithm (FPBR) for highway scenarios is proposed. For this scenario, several important issues such as the high mobility of vehicles and the propagation conditions may affect the performance of the routing strategy. These constraints have only been partially addressed in previous proposals. In contrast, the design approach used for developing FPBR considered the constraints imposed by a highway scenario and implements mechanisms to overcome them. FPBR performance is compared to one of the leading protocols for highway scenarios. Performance metrics show that FPBR yields similar results when considering freespace propagation conditions, and outperforms the leading protocol when considering a realistic highway path loss model.

Preparedness and response to bioterrorism.

PubMed

Spencer, R C; Lightfoot, N F

2001-08-01

As we enter the 21st century the threats of biological warfare and bioterrorism (so called asymmetric threats) appear to be more real than ever before. Historical evidence suggests that biological weapons have been used, with varying degrees of success, for many centuries. Despite the international agreements to ban such weapons, namely the 1925 Geneva Protocol and the 1975 Biological and Toxin Weapons Convention, there is no effective international mechanism for challenging either the development of biological weapons or their use. Advances in technology and the rise of fundamentalist terror groups combine to present a significant threat to western democracies. A timely and definitive response to this threat will require co-operation between governments on a scale never seen before. There is a need for proper planning, good communication between various health, home office, defence and intelligence agencies and sufficient financial support for a realistic state of preparedness. The Department of Health has produced guidelines for responding to real or suspected incidents and the Public Health Laboratory Service (PHLS) has produced detailed protocols to inform the actions required by microbiologists and consultants in communicable disease control. These protocols will be published on the Department of Health and PHLS web sites. Copyright 2001 The British Infection Society.

Assessing older drivers: a primary care protocol to evaluate driving safety risk.

PubMed

Murden, Robert A; Unroe, Kathleen

2005-08-01

Most articles on elder drivers offer either general advice, or review testing protocols that divide drivers into two distinct groups: safe or unsafe. We believe it is unreasonable to expect any testing to fully separate drivers into just these two mutually exclusive groups, so we offer a protocol for a more practical approach. This protocol can be applied by primary care physicians. We review the justification for the many steps of this protocol, which have branches that lead to identifying drivers as low risk, high risk (for accidents) or needing further evaluation. Options for further evaluation are provided.

Felker's Five Keys to Self-Concept Enhancement: Secondary Classroom Research.

ERIC Educational Resources Information Center

Bernhoft, Franklin O.

A study incorporated Donald Felker's 5 Keys to Self-Concept Enhancement in 20 minutes of timed writing weekly or bi-weekly for three months using the Coopersmith Adult Form as pre-post measure. Felker's 5 Keys are: (1) adults, praise yourselves; (2) help children evaluate realistically; (3) teach children to set realistic goals; (4) teach children…

Project REALISTIC: Evaluation and Modification of REAding, LIStening, and ArithmeTIC Needs in Military Jobs Having Civilian Counterparts.

ERIC Educational Resources Information Center

Sticht, Thomas G.; And Others

The papers in this collection present a description of, and the results of, research in Work Unit REALISTIC. In addition to the first paper which is an overview, the three papers are: "Psychometric Determination of Relationships Among Literacy Skills and Job Proficiency,""Reading Ability, Readability, and Readership: Identifying…

The Effects of Talking-Head with Various Realism Levels on Students' Emotions in Learning

ERIC Educational Resources Information Center

Mohamad Ali, Ahmad Zamzuri; Hamdan, Mohd Najib

2017-01-01

The aim of this study was to evaluate the effects of various realistic levels of talking-head on students' emotions in pronunciation learning. Four talking-head characters with varying levels of realism were developed and tested: a nonrealistic three-dimensional character, a realistic three-dimensional character, a two-dimensional character, and…

Who needs inpatient detox? Development and implementation of a hospitalist protocol for the evaluation of patients for alcohol detoxification.

PubMed

Stephens, John R; Liles, E Allen; Dancel, Ria; Gilchrist, Michael; Kirsch, Jonathan; DeWalt, Darren A

2014-04-01

Clinicians caring for patients seeking alcohol detoxification face many challenges, including lack of evidence-based guidelines for treatment and high recidivism rates. To develop a standardized protocol for determining which alcohol dependent patients seeking detoxification need inpatient versus outpatient treatment, and to study the protocol's implementation. Review of best evidence by ad hoc task force and subsequent creation of standardized protocol. Prospective observational evaluation of initial protocol implementation. Patients presenting for alcohol detoxification. Development and implementation of a protocol for evaluation and treatment of patients requesting alcohol detoxification. Number of admissions per month with primary alcohol related diagnosis (DRG), 30-day readmission rate, and length of stay, all measured before and after protocol implementation. We identified one randomized clinical trial and three cohort studies to inform the choice of inpatient versus outpatient detoxification, along with one prior protocol in this population, and combined that data with clinical experience to create an institutional protocol. After implementation, the average number of alcohol related admissions was 15.9 per month, compared with 18.9 per month before implementation (p = 0.037). There was no difference in readmission rate or length of stay. Creation and utilization of a protocol led to standardization of care for patients requesting detoxification from alcohol. Initial evaluation of protocol implementation showed a decrease in number of admissions.

A protocol for evaluating video trackers under real-world conditions.

PubMed

Nawaz, Tahir; Cavallaro, Andrea

2013-04-01

The absence of a commonly adopted performance evaluation framework is hampering advances in the design of effective video trackers. In this paper, we present a single-score evaluation measure and a protocol to objectively compare trackers. The proposed measure evaluates tracking accuracy and failure, and combines them for both summative and formative performance assessment. The proposed protocol is composed of a set of trials that evaluate the robustness of trackers on a range of test scenarios representing several real-world conditions. The protocol is validated on a set of sequences with a diversity of targets (head, vehicle and person) and challenges (occlusions, background clutter, pose changes and scale changes) using six state-of-the-art trackers, highlighting their strengths and weaknesses on more than 187000 frames. The software implementing the protocol and the evaluation results are made available online and new results can be included, thus facilitating the comparison of trackers.

Chapter 15: Commercial New Construction Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W.; Keates, Steven

This protocol is intended to describe the recommended method when evaluating the whole-building performance of new construction projects in the commercial sector. The protocol focuses on energy conservation measures (ECMs) or packages of measures where evaluators can analyze impacts using building simulation. These ECMs typically require the use of calibrated building simulations under Option D of the International Performance Measurement and Verification Protocol (IPMVP).

How do you modernize a health service? A realist evaluation of whole-scale transformation in london.

PubMed

Greenhalgh, Trisha; Humphrey, Charlotte; Hughes, Jane; Macfarlane, Fraser; Butler, Ceri; Pawson, Ray

2009-06-01

Large-scale, whole-systems interventions in health care require imaginative approaches to evaluation that go beyond assessing progress against predefined goals and milestones. This project evaluated a major change effort in inner London, funded by a charitable donation of approximately $21 million, which spanned four large health care organizations, covered three services (stroke, kidney, and sexual health), and sought to "modernize" these services with a view to making health care more efficient, effective, and patient centered. This organizational case study draws on the principles of realist evaluation, a largely qualitative approach that is centrally concerned with testing and refining program theories by exploring the complex and dynamic interaction among context, mechanism, and outcome. This approach used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the case and follow its fortunes over the three-year study period. The methods included ethnographic observation, semistructured interviews, and scrutiny of documents and other contemporaneous materials. As well as providing ongoing formative feedback to the change teams in specific areas of activity, we undertook a more abstract, interpretive analysis, which explored the context-mechanism-outcome relationship using the guiding question "what works, for whom, under what circumstances?" In this example of large-scale service transformation, numerous projects and subprojects emerged, fed into one another, and evolved over time. Six broad mechanisms appeared to be driving the efforts of change agents: integrating services across providers, finding and using evidence, involving service users in the modernization effort, supporting self-care, developing the workforce, and extending the range of services. Within each of these mechanisms, different teams chose widely differing approaches and met with differing success. The realist analysis of the fortunes of different subprojects identified aspects of context and mechanism that accounted for observed outcomes (both intended and unintended). This study was one of the first applications of realist evaluation to a large-scale change effort in health care. Even when an ambitious change program shifts from its original goals and meets unforeseen challenges (indeed, precisely because the program morphs and adapts over time), realist evaluation can draw useful lessons about how particular preconditions make particular outcomes more likely, even though it cannot produce predictive guidance or a simple recipe for success. Noting recent calls by others for the greater use of realist evaluation in health care, this article considers some of the challenges and limitations of this method in the light of this experience and suggests that its use will require some fundamental changes in the worldview of some health services researchers.

A phantom design and assessment of lesion detectability in PET imaging

NASA Astrophysics Data System (ADS)

Wollenweber, Scott D.; Kinahan, Paul E.; Alessio, Adam M.

2017-03-01

The early detection of abnormal regions with increased tracer uptake in positron emission tomography (PET) is a key driver of imaging system design and optimization as well as choice of imaging protocols. Detectability, however, remains difficult to assess due to the need for realistic objects mimicking the clinical scene, multiple lesion-present and lesion-absent images and multiple observers. Fillable phantoms, with tradeoffs between complexity and utility, provide a means to quantitatively test and compare imaging systems under truth-known conditions. These phantoms, however, often focus on quantification rather than detectability. This work presents extensions to a novel phantom design and analysis techniques to evaluate detectability in the context of realistic, non-piecewise constant backgrounds. The design consists of a phantom filled with small solid plastic balls and a radionuclide solution to mimic heterogeneous background uptake. A set of 3D-printed regular dodecahedral `features' were included at user-defined locations within the phantom to create `holes' within the matrix of chaotically-packed balls. These features fill at approximately 3:1 contrast to the lumpy background. A series of signal-known-present (SP) and signal-known-absent (SA) sub-images were generated and used as input for observer studies. This design was imaged in a head-like 20 cm diameter, 20 cm long cylinder and in a body-like 36 cm wide by 21 cm tall by 40 cm long tank. A series of model observer detectability indices were compared across scan conditions (count levels, number of scan replicates), PET image reconstruction methods (with/without TOF and PSF) and between PET/CT scanner system designs using the same phantom imaged on multiple systems. The detectability index was further compared to the noise-equivalent count (NEC) level to characterize the relationship between NEC and observer SNR.

Simulating and stimulating performance: introducing distributed simulation to enhance musical learning and performance.

PubMed

Williamon, Aaron; Aufegger, Lisa; Eiholzer, Hubert

2014-01-01

Musicians typically rehearse far away from their audiences and in practice rooms that differ significantly from the concert venues in which they aspire to perform. Due to the high costs and inaccessibility of such venues, much current international music training lacks repeated exposure to realistic performance situations, with students learning all too late (or not at all) how to manage performance stress and the demands of their audiences. Virtual environments have been shown to be an effective training tool in the fields of medicine and sport, offering practitioners access to real-life performance scenarios but with lower risk of negative evaluation and outcomes. The aim of this research was to design and test the efficacy of simulated performance environments in which conditions of "real" performance could be recreated. Advanced violin students (n = 11) were recruited to perform in two simulations: a solo recital with a small virtual audience and an audition situation with three "expert" virtual judges. Each simulation contained back-stage and on-stage areas, life-sized interactive virtual observers, and pre- and post-performance protocols designed to match those found at leading international performance venues. Participants completed a questionnaire on their experiences of using the simulations. Results show that both simulated environments offered realistic experience of performance contexts and were rated particularly useful for developing performance skills. For a subset of 7 violinists, state anxiety and electrocardiographic data were collected during the simulated audition and an actual audition with real judges. Results display comparable levels of reported state anxiety and patterns of heart rate variability in both situations, suggesting that responses to the simulated audition closely approximate those of a real audition. The findings are discussed in relation to their implications, both generalizable and individual-specific, for performance training.

Simulating and stimulating performance: introducing distributed simulation to enhance musical learning and performance

PubMed Central

Williamon, Aaron; Aufegger, Lisa; Eiholzer, Hubert

2014-01-01

Musicians typically rehearse far away from their audiences and in practice rooms that differ significantly from the concert venues in which they aspire to perform. Due to the high costs and inaccessibility of such venues, much current international music training lacks repeated exposure to realistic performance situations, with students learning all too late (or not at all) how to manage performance stress and the demands of their audiences. Virtual environments have been shown to be an effective training tool in the fields of medicine and sport, offering practitioners access to real-life performance scenarios but with lower risk of negative evaluation and outcomes. The aim of this research was to design and test the efficacy of simulated performance environments in which conditions of “real” performance could be recreated. Advanced violin students (n = 11) were recruited to perform in two simulations: a solo recital with a small virtual audience and an audition situation with three “expert” virtual judges. Each simulation contained back-stage and on-stage areas, life-sized interactive virtual observers, and pre- and post-performance protocols designed to match those found at leading international performance venues. Participants completed a questionnaire on their experiences of using the simulations. Results show that both simulated environments offered realistic experience of performance contexts and were rated particularly useful for developing performance skills. For a subset of 7 violinists, state anxiety and electrocardiographic data were collected during the simulated audition and an actual audition with real judges. Results display comparable levels of reported state anxiety and patterns of heart rate variability in both situations, suggesting that responses to the simulated audition closely approximate those of a real audition. The findings are discussed in relation to their implications, both generalizable and individual-specific, for performance training. PMID:24550856

Survey of Approaches to Generate Realistic Synthetic Graphs

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

Lim, Seung-Hwan; Lee, Sangkeun; Powers, Sarah S

A graph is a flexible data structure that can represent relationships between entities. As with other data analysis tasks, the use of realistic graphs is critical to obtaining valid research results. Unfortunately, using the actual ("real-world") graphs for research and new algorithm development is difficult due to the presence of sensitive information in the data or due to the scale of data. This results in practitioners developing algorithms and systems that employ synthetic graphs instead of real-world graphs. Generating realistic synthetic graphs that provide reliable statistical confidence to algorithmic analysis and system evaluation involves addressing technical hurdles in a broadmore » set of areas. This report surveys the state of the art in approaches to generate realistic graphs that are derived from fitted graph models on real-world graphs.« less

A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic.

PubMed

Cheung, Winston K; Myburgh, John; Seppelt, Ian M; Parr, Michael J; Blackwell, Nikki; Demonte, Shannon; Gandhi, Kalpesh; Hoyling, Larissa; Nair, Priya; Passer, Melissa; Reynolds, Claire; Saunders, Nicholas M; Saxena, Manoj K; Thanakrishnan, Govindasamy

2012-08-06

To determine the increase in intensive care unit (ICU) bed availability that would result from the use of the New South Wales and Ontario Health Plan for an Influenza Pandemic (OHPIP) triage protocols. Prospective evaluation study conducted in eight Australian, adult, general ICUs, between September 2009 and May 2010. All patients who were admitted to the ICU, excluding those who had elective surgery, were prospectively evaluated using the two triage protocols, simulating a pandemic situation. Both protocols were originally developed to determine which patients should be excluded from accessing ICU resources during an influenza pandemic. Increase in ICU bed availability. At admission, the increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 3.5%, 14.7% and 22.7%, respectively, and 52.8% using the OHPIP triage protocol (P < 0.001). Re-evaluation of patients at 12 hours after admission using Tiers 1, 2 and 3 of the NSW triage protocol incrementally increased ICU bed availability by 19.2%, 16.1% and 14.1%, respectively (P < 0.001). The maximal cumulative increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 23.7%, 31.6% and 37.5%, respectively, at 72 hours (P < 0.001), and 65.0% using the OHPIP triage protocol, at 120 hours (P < 0.001). Both triage protocols resulted in increases in ICU bed availability, but the OHPIP protocol provided the greatest increase overall. With the NSW triage protocol, ICU bed availability increased as the protocol was escalated.

A comparative study of routing protocols of heterogeneous wireless sensor networks.

PubMed

Han, Guangjie; Jiang, Xu; Qian, Aihua; Rodrigues, Joel J P C; Cheng, Long

2014-01-01

Recently, heterogeneous wireless sensor network (HWSN) routing protocols have drawn more and more attention. Various HWSN routing protocols have been proposed to improve the performance of HWSNs. Among these protocols, hierarchical HWSN routing protocols can improve the performance of the network significantly. In this paper, we will evaluate three hierarchical HWSN protocols proposed recently--EDFCM, MCR, and EEPCA--together with two previous classical routing protocols--LEACH and SEP. We mainly focus on the round of the first node dies (also called the stable period) and the number of packets sent to sink, which is an important aspect to evaluate the monitoring ability of a protocol. We conduct a lot of experiments and simulations on Matlab to analyze the performance of the five routing protocols.

Evaluation of the University of Florida lomustine, vincristine, procarbazine, and prednisone chemotherapy protocol for the treatment of relapsed lymphoma in dogs: 33 cases (2003-2009).

PubMed

Fahey, Christine E; Milner, Rowan J; Barabas, Karri; Lurie, David; Kow, Kelvin; Parfitt, Shannon; Lyles, Sarah; Clemente, Monica

2011-07-15

To evaluate the toxicity and efficacy of a modification of a previously evaluated combination of lomustine, vincristine, procarbazine, and prednisone (LOPP) as a rescue protocol for refractory lymphoma in dogs. Retrospective case series. Animals-33 dogs with a cytologic or histologic diagnosis of lymphoma that developed resistance to their induction chemotherapy protocol. Lomustine was administered on day 0 of the protocol. Vincristine was administered on day 0 and again 1 time on day 14. Procarbazine and prednisone were administered on days 0 through 13 of the protocol. This cycle was repeated every 28 days. Median time from initiation to discontinuation of the University of Florida LOPP protocol was 84 days (range, 10 to 308 days). Overall median survival time was 290 days (range, 51 to 762 days). Overall response rate with this protocol was 61% (20/33), with 36% (12) having a complete response and 24% (8) having a partial response. Toxicosis rates were lower than for the previously published LOPP protocol. The University of Florida LOPP protocol may be an acceptable alternative to the mechlorethamine, vincristine, procarbazine, and prednisone protocol as a rescue protocol for dogs with lymphoma.

The SMART personalised self-management system for congestive heart failure: results of a realist evaluation.

PubMed

Bartlett, Yvonne K; Haywood, Annette; Bentley, Claire L; Parker, Jack; Hawley, Mark S; Mountain, Gail A; Mawson, Susan

2014-11-25

Technology has the potential to provide support for self-management to people with congestive heart failure (CHF). This paper describes the results of a realist evaluation of the SMART Personalised Self-Management System (PSMS) for CHF. The PSMS was used, at home, by seven people with CHF. Data describing system usage and usability as well as questionnaire and interview data were evaluated in terms of the context, mechanism and outcome hypotheses (CMOs) integral to realist evaluation. The CHF PSMS improved heart failure related knowledge in those with low levels of knowledge at baseline, through providing information and quizzes. Furthermore, participants perceived the self-regulatory aspects of the CHF PSMS as being useful in encouraging daily walking. The CMOs were revised to describe the context of use, and how this influences both the mechanisms and the outcomes. Participants with CHF engaged with the PSMS despite some technological problems. Some positive effects on knowledge were observed as well as the potential to assist with changing physical activity behaviour. Knowledge of CHF and physical activity behaviour change are important self-management targets for CHF, and this study provides evidence to direct the further development of a technology to support these targets.

Sensitivity comparison of sequential monadic and side-by-side presentation protocols in affective consumer testing.

PubMed

Colyar, Jessica M; Eggett, Dennis L; Steele, Frost M; Dunn, Michael L; Ogden, Lynn V

2009-09-01

The relative sensitivity of side-by-side and sequential monadic consumer liking protocols was compared. In the side-by-side evaluation, all samples were presented at once and evaluated together 1 characteristic at a time. In the sequential monadic evaluation, 1 sample was presented and evaluated on all characteristics, then returned before panelists received and evaluated another sample. Evaluations were conducted on orange juice, frankfurters, canned chili, potato chips, and applesauce. Five commercial brands, having a broad quality range, were selected as samples for each product category to assure a wide array of consumer liking scores. Without their knowledge, panelists rated the same 5 retail brands by 1 protocol and then 3 wk later by the other protocol. For 3 of the products, both protocols yielded the same order of overall liking. Slight differences in order of overall liking for the other 2 products were not significant. Of the 50 pairwise overall liking comparisons, 44 were in agreement. The different results obtained by the 2 protocols in order of liking and significance of paired comparisons were due to the experimental variation and differences in sensitivity. Hedonic liking scores were subjected to statistical power analyses and used to calculate minimum number of panelists required to achieve varying degrees of sensitivity when using side-by-side and sequential monadic protocols. In most cases, the side-by-side protocol was more sensitive, thus providing the same information with fewer panelists. Side-by-side protocol was less sensitive in cases where sensory fatigue was a factor.

Efficient quantum state transfer in an engineered chain of quantum bits

NASA Astrophysics Data System (ADS)

Sandberg, Martin; Knill, Emanuel; Kapit, Eliot; Vissers, Michael R.; Pappas, David P.

2016-03-01

We present a method of performing quantum state transfer in a chain of superconducting quantum bits. Our protocol is based on engineering the energy levels of the qubits in the chain and tuning them all simultaneously with an external flux bias. The system is designed to allow sequential adiabatic state transfers, resulting in on-demand quantum state transfer from one end of the chain to the other. Numerical simulations of the master equation using realistic parameters for capacitive nearest-neighbor coupling, energy relaxation, and dephasing show that fast, high-fidelity state transfer should be feasible using this method.

Chapter 6: Residential Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Dimetrosky, Scott; Parkinson, Katie

Given new regulations, increased complexity in the market, and the general shift from CFLs to LEDs, this evaluation protocol was updated in 2017 to shift the focus of the protocols toward LEDs and away from CFLs and to resolve evaluation uncertainties affecting residential lighting incentive programs.

EVALUATION OF THE PROTOCOL FOR THE NATURAL ATTENUATION OF CHLORINATED SOLVENTS: CASE STUDY AT THE TWIN CITIES ARMY AMMUNITION PLANT

EPA Science Inventory

At the request of staff in the EPA Regions, EPA?s Office of Research and Development carried out an independent evaluation of the Technical Protocol for Evaluating Natural Attenuation of Chlorinated Solvents in Ground Water (EPA/600/R-98/128). The Protocol was developed around c...

Field validation of protocols developed to evaluate in-line mastitis detection systems.

PubMed

Kamphuis, C; Dela Rue, B T; Eastwood, C R

2016-02-01

This paper reports on a field validation of previously developed protocols for evaluating the performance of in-line mastitis-detection systems. The protocols outlined 2 requirements of these systems: (1) to detect cows with clinical mastitis (CM) promptly and accurately to enable timely and appropriate treatment and (2) to identify cows with high somatic cell count (SCC) to manage bulk milk SCC levels. Gold standard measures, evaluation tests, performance measures, and performance targets were proposed. The current study validated the protocols on commercial dairy farms with automated in-line mastitis-detection systems using both electrical conductivity (EC) and SCC sensor systems that both monitor at whole-udder level. The protocol for requirement 1 was applied on 3 commercial farms. For requirement 2, the protocol was applied on 6 farms; 3 of them had low bulk milk SCC (128×10(3) cells/mL) and were the same farms as used for field evaluation of requirement 1. Three farms with high bulk milk SCC (270×10(3) cells/mL) were additionally enrolled. The field evaluation methodology and results were presented at a workshop including representation from 7 international suppliers of in-line mastitis-detection systems. Feedback was sought on the acceptance of standardized performance evaluation protocols and recommended refinements to the protocols. Although the methodology for requirement 1 was relatively labor intensive and required organizational skills over an extended period, no major issues were encountered during the field validation of both protocols. The validation, thus, proved the protocols to be practical. Also, no changes to the data collection process were recommended by the technology supplier representatives. However, 4 recommendations were made to refine the protocols: inclusion of an additional analysis that ignores small (low-density) clot observations in the definition of CM, extension of the time window from 4 to 5 milkings for timely alerts for CM, setting a maximum number of 10 milkings for the time window to detect a CM episode, and presentation of sensitivity for a larger range of false alerts per 1,000 milkings replacing minimum performance targets. The recommended refinements are discussed with suggested changes to the original protocols. The information presented is intended to inform further debate toward achieving international agreement on standard protocols to evaluate performance of in-line mastitis-detection systems. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Usability of a mobile electronic medical record prototype: a verbal protocol analysis.

PubMed

Wu, Robert C; Orr, M Scott; Chignell, Mark; Straus, Sharon E

2008-06-01

Point of care access to electronic medical records may provide clinicians with the information they want when they need it and may in turn improve patient safety. Yet providing an electronic medical record on handheld devices presents many usability challenges, and it is unclear whether clinicians will use them. An iterative design process for the development and evaluation of a prototype of a mobile electronic medical record was performed. Usability sessions were conducted in which physicians were asked to 'think aloud' while working through clinical scenarios using the prototype. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts from the sessions and common themes were extracted. Usability sessions were held with five family physicians and four internists with varying levels of computer expertise. Physicians were able to use the device to complete 52 of 54 required tasks. Users commented that it was intuitive (9/9), would increase accessibility (5/9) but for them to use it, it would need the system to be fast and time-saving (5/9). Users had difficulty entering information (5/9) and reading the screen (4/9). In terms of functionality, users had concerns about completeness of information (6/9), details of ordering (5/9) and desired billing functionality (5/9) and integration with other systems (4/9). While physicians can use mobile electronic medical records in realistic scenarios, certain requirements likely need to be met including a fast system with easy data selection, easy data entry and improved display before widespread adoption occurs.

Template-based protein-protein docking exploiting pairwise interfacial residue restraints.

PubMed

Xue, Li C; Rodrigues, João P G L M; Dobbs, Drena; Honavar, Vasant; Bonvin, Alexandre M J J

2017-05-01

Although many advanced and sophisticated ab initio approaches for modeling protein-protein complexes have been proposed in past decades, template-based modeling (TBM) remains the most accurate and widely used approach, given a reliable template is available. However, there are many different ways to exploit template information in the modeling process. Here, we systematically evaluate and benchmark a TBM method that uses conserved interfacial residue pairs as docking distance restraints [referred to as alpha carbon-alpha carbon (CA-CA)-guided docking]. We compare it with two other template-based protein-protein modeling approaches, including a conserved non-pairwise interfacial residue restrained docking approach [referred to as the ambiguous interaction restraint (AIR)-guided docking] and a simple superposition-based modeling approach. Our results show that, for most cases, the CA-CA-guided docking method outperforms both superposition with refinement and the AIR-guided docking method. We emphasize the superiority of the CA-CA-guided docking on cases with medium to large conformational changes, and interactions mediated through loops, tails or disordered regions. Our results also underscore the importance of a proper refinement of superimposition models to reduce steric clashes. In summary, we provide a benchmarked TBM protocol that uses conserved pairwise interface distance as restraints in generating realistic 3D protein-protein interaction models, when reliable templates are available. The described CA-CA-guided docking protocol is based on the HADDOCK platform, which allows users to incorporate additional prior knowledge of the target system to further improve the quality of the resulting models. © The Author 2016. Published by Oxford University Press.

Zoom Reconstruction Tool: Evaluation of Image Quality and Influence on the Diagnosis of Root Fracture.

PubMed

Queiroz, Polyane Mazucatto; Santaella, Gustavo Machado; Capelozza, Ana Lúcia Alvares; Rosalen, Pedro Luiz; Freitas, Deborah Queiroz; Haiter-Neto, Francisco

2018-04-01

This study evaluated the image quality and the diagnosis of root fractures when using the Zoom Reconstruction tool (J Morita, Kyoto, Japan). A utility wax phantom with a metal sample inside was used for objective evaluation, and a mandible with 27 single-rooted teeth (with and without obturation and with and without vertical or horizontal fractures) was used for diagnostic evaluation. The images were acquired in 3 protocols: protocol 1, field of view (FOV) of 4 × 4 cm and a voxel size of 0.08 mm; protocol 2, FOV of 10 × 10 cm and a voxel size of 0.2 mm; and protocol 3, Zoom Reconstruction of images from protocol 2 (FOV of 4 × 4 cm and a voxel size of 0.08 mm). The objective evaluation was achieved by measuring the image noise, and the diagnosis of fractures was performed by 3 evaluators. The area under the receiver operating characteristic curve was used to calculate accuracy, and analysis of variance compared the accuracy and image quality of the protocols. Regarding quality, protocol 1 was superior to protocol 2 (P < .0001) and Zoom Reconstruction (P < .0001). Additionally, images of protocol 2 presented less noise than the Zoom Reconstruction image (P < .0001); however, for diagnosis, Zoom Reconstruction was superior in relation to protocol 2 (P = .011) and did not differ from protocol 1 (P = .228) for the diagnosis of a vertical root fracture in filled teeth. The Zoom Reconstruction tool allows better accuracy for vertical root fracture detection in filled teeth, making it possible to obtain a higher-resolution image from a lower-resolution examination without having to expose the patient to more radiation. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Interprofessional education in a student-led emergency department: A realist evaluation.

PubMed

Ericson, Anne; Löfgren, Susanne; Bolinder, Gunilla; Reeves, Scott; Kitto, Simon; Masiello, Italo

2017-03-01

This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

Job and Work Evaluation: A Literature Review.

ERIC Educational Resources Information Center

Heneman, Robert L.

2003-01-01

Describes advantages and disadvantages of work evaluation methods: ranking, market pricing, banding, classification, single-factor, competency, point-factor, and factor comparison. Compares work evaluation perspectives: traditional, realist, market advocate, strategist, organizational development, social reality, contingency theory, competency,…

Quantum computation with realistic magic-state factories

NASA Astrophysics Data System (ADS)

O'Gorman, Joe; Campbell, Earl T.

2017-03-01

Leading approaches to fault-tolerant quantum computation dedicate a significant portion of the hardware to computational factories that churn out high-fidelity ancillas called magic states. Consequently, efficient and realistic factory design is of paramount importance. Here we present the most detailed resource assessment to date of magic-state factories within a surface code quantum computer, along the way introducing a number of techniques. We show that the block codes of Bravyi and Haah [Phys. Rev. A 86, 052329 (2012), 10.1103/PhysRevA.86.052329] have been systematically undervalued; we track correlated errors both numerically and analytically, providing fidelity estimates without appeal to the union bound. We also introduce a subsystem code realization of these protocols with constant time and low ancilla cost. Additionally, we confirm that magic-state factories have space-time costs that scale as a constant factor of surface code costs. We find that the magic-state factory required for postclassical factoring can be as small as 6.3 million data qubits, ignoring ancilla qubits, assuming 10-4 error gates and the availability of long-range interactions.

BeatBox-HPC simulation environment for biophysically and anatomically realistic cardiac electrophysiology.

PubMed

Antonioletti, Mario; Biktashev, Vadim N; Jackson, Adrian; Kharche, Sanjay R; Stary, Tomas; Biktasheva, Irina V

2017-01-01

The BeatBox simulation environment combines flexible script language user interface with the robust computational tools, in order to setup cardiac electrophysiology in-silico experiments without re-coding at low-level, so that cell excitation, tissue/anatomy models, stimulation protocols may be included into a BeatBox script, and simulation run either sequentially or in parallel (MPI) without re-compilation. BeatBox is a free software written in C language to be run on a Unix-based platform. It provides the whole spectrum of multi scale tissue modelling from 0-dimensional individual cell simulation, 1-dimensional fibre, 2-dimensional sheet and 3-dimensional slab of tissue, up to anatomically realistic whole heart simulations, with run time measurements including cardiac re-entry tip/filament tracing, ECG, local/global samples of any variables, etc. BeatBox solvers, cell, and tissue/anatomy models repositories are extended via robust and flexible interfaces, thus providing an open framework for new developments in the field. In this paper we give an overview of the BeatBox current state, together with a description of the main computational methods and MPI parallelisation approaches.

Balancing student/trainee learning with the delivery of patient care in the healthcare workplace: a protocol for realist synthesis.

PubMed

Sholl, Sarah; Ajjawi, Rola; Allbutt, Helen; Butler, Jane; Jindal-Snape, Divya; Morrison, Jill; Rees, Charlotte

2016-04-26

A national survey was recently conducted to explore medical education research priorities in Scotland. The identified themes and underlying priority areas can be linked to current medical education drivers in the UK. The top priority area rated by stakeholders was: 'Understanding how to balance service and training conflicts'. Despite its perceived importance, a preliminary scoping exercise revealed the least activity with respect to published literature reviews. This protocol has therefore been developed so as to understand how patient care, other service demands and student/trainee learning can be simultaneously facilitated within the healthcare workplace. The review will identify key interventions designed to balance patient care and student/trainee learning, to understand how and why such interventions produce their effects. Our research questions seek to address how identified interventions enable balanced patient care-trainee learning within the healthcare workplace, for whom, why and under what circumstances. Pawson's five stages for undertaking a realist review underpin this protocol. These stages may progress in a non-linear fashion due to the iterative nature of the review process. We will: (1) clarify the scope of the review, identifying relevant interventions and existing programme theories, understanding how interventions act to produce their intended outcomes; (2) search journal articles and grey literature for empirical evidence from 1998 (introduction of the European Working Time Directive) on the UK multidisciplinary team working concerning these interventions, theories and outcomes, using databases such as ERIC, Scopus and CINAHL; (3) assess study quality; (4) extract data; and (5) synthesise data, drawing conclusions. A formal ethical review is not required. These findings should provide an important understanding of how workplace-based interventions influence the balance of trainee learning and service provision. They should benefit various stakeholders involved in workplace-based learning interventions, and inform the medical education research agenda in the UK. 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/

Chapter 23: Combined Heat and Power Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W.; Simons, George; Barsun, Stephan

The main focus of most evaluations is to determine the energy-savings impacts of the installed measure. This protocol defines a combined heat and power (CHP) measure as a system that sequentially generates both electrical energy and useful thermal energy from one fuel source at a host customer's facility or residence. This protocol is aimed primarily at regulators and administrators of ratepayer-funded CHP programs; however, project developers may find the protocol useful to understand how CHP projects are evaluated.

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

Liu, Derek; Mutanga, Theodore

Purpose: An end-to-end testing methodology was designed to evaluate the overall SRS treatment fidelity, incorporating all steps in the linac-based frameless radiosurgery treatment delivery process. The study details our commissioning experience of the Steev (CIRS, Norfolk, VA) stereotactic anthropomorphic head phantom including modification, test design, and baseline measurements. Methods: Repeated MR and CT scans were performed with interchanging inserts. MR-CT fusion accuracy was evaluated and the insert spatial coincidence was verified on CT. Five non-coplanar arcs delivered a prescription dose to a 15 mm spherical CTV with 2 mm PTV margin. Following setup, CBCT-based shifts were applied as per protocol.more » Sequential measurements were performed by interchanging inserts without disturbing the setup. Spatial and dosimetric accuracy was assessed by a combination of CBCT hidden target, radiochromic film, and ion chamber measurements. To facilitate film registration, the film insert was modified in-house by etching marks. Results: MR fusion error and insert spatial coincidences were within 0.3 mm. Both CBCT and film measurements showed spatial displacements of 1.0 mm in similar directions. Both coronal and sagittal films reported 2.3 % higher target dose relative to the treatment plan. The corrected ion chamber measurement was similarly greater by 1.0 %. The 3 %/2 mm gamma pass rate was 99% for both films Conclusions: A comprehensive end-to-end testing methodology was implemented for our SRS QA program. The Steev phantom enabled realistic evaluation of the entire treatment process. Overall spatial and dosimetric accuracy of the delivery were 1 mm and 3 % respectively.« less

Usability testing of Avoiding Diabetes Thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record

PubMed Central

Chrimes, Dillon; Kushniruk, Andre; Kitos, Nicole R.

2014-01-01

Purpose Usability testing can be used to evaluate human computer interaction (HCI) and communication in shared decision making (SDM) for patient-provider behavioral change and behavioral contracting. Traditional evaluations of usability using scripted or mock patient scenarios with think-aloud protocol analysis provide a to identify HCI issues. In this paper we describe the application of these methods in the evaluation of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) tool, and test the usability of the tool to support the ADAPT framework for integrated care counseling of pre-diabetes. The think-aloud protocol analysis typically does not provide an assessment of how patient-provider interactions are effected in “live” clinical workflow or whether a tool is successful. Therefore, “Near-live” clinical simulations involving applied simulation methods were used to compliment the think-aloud results. This complementary usability technique was used to test the end-user HCI and tool performance by more closely mimicking the clinical workflow and capturing interaction sequences along with assessing the functionality of computer module prototypes on clinician workflow. We expected this method to further complement and provide different usability findings as compared to think-aloud analysis. Together, this mixed method evaluation provided comprehensive and realistic feedback for iterative refinement of the ADAPT system prior to implementation. Methods The study employed two phases of testing of a new interactive ADAPT tool that embedded an evidence-based shared goal setting component into primary care workflow for dealing with pre-diabetes counseling within a commercial physician office electronic health record (EHR). Phase I applied usability testing that involved “think-aloud” protocol analysis of 8 primary care providers interacting with several scripted clinical scenarios. Phase II used “near-live” clinical simulations of 5 providers interacting with standardized trained patient actors enacting the clinical scenario of counseling for pre-diabetes, each of whom had a pedometer that recorded the number of steps taken over a week. In both phases, all sessions were audio-taped and motion screen-capture software was activated for onscreen recordings. Transcripts were coded using iterative qualitative content analysis methods. Results In Phase I, the impact of the components and layout of ADAPT on user’s Navigation, Understandability, and Workflow were associated with the largest volume of negative comments (i.e. approximately 80% of end-user commentary), while Usability and Content of ADAPT were representative of more positive than negative user commentary. The heuristic category of Usability had a positive-to-negative comment ratio of 2.1, reflecting positive perception of the usability of the tool, its functionality, and overall co-productive utilization of ADAPT. However, there were mixed perceptions about content (i.e., how the information was displayed, organized and described in the tool). In Phase II, the duration of patient encounters was approximately 10 minutes with all of the Patient Instructions (prescriptions) and behavioral contracting being activated at the end of each visit. Upon activation, providers accepted the pathway prescribed by the tool 100% of the time and completed all the fields in the tool in the simulation cases. Only 14% of encounter time was spent using the functionality of the ADAPT tool in terms of keystrokes and entering relevant data. The rest of the time was spent on communication and dialogue to populate the patient instructions. In all cases, the interaction sequence of reviewing and discussing exercise and diet of the patient was linked to the functionality of the ADAPT tool in terms of monitoring, response-efficacy, self-efficacy, and negotiation in the patient-provider dialogue. There was a change from one-way dialogue to two-way dialogue and negotiation that ended in a behavioral contract. This change demonstrated the tool’s sequence, which supported recording current exercise and diet followed by a diet and exercise goal setting procedure to reduce the risk of diabetes onset. Conclusions This study demonstrated that “think-aloud” protocol analysis with “near-live” clinical simulations provided a successful usability evaluation of a new primary care pre-diabetes shared goal setting tool. Each phase of the study provided complementary observations on problems with the new onscreen tool and was used to show the influence of the ADAPT framework on the usability, workflow integration, and communication between the patient and provider. The think-aloud tests with the provider showed the tool can be used according to the ADAPT framework (exercise-to-diet behavior change and tool utilization), while the clinical simulations revealed the ADAPT framework to realistically support patient-provider communication to obtain behavioral change contract. SDM interactions and mechanisms affecting protocol-based care can be more completely captured by combining “near-live” clinical simulations with traditional “think-aloud analysis” which augments clinician utilization. More analysis is required to verify if the rich communication actions found in Phase II compliment clinical workflows. PMID:24981988

Usability testing of Avoiding Diabetes Thru Action Plan Targeting (ADAPT) decision support for integrating care-based counseling of pre-diabetes in an electronic health record.

PubMed

Chrimes, Dillon; Kitos, Nicole R; Kushniruk, Andre; Mann, Devin M

2014-09-01

Usability testing can be used to evaluate human-computer interaction (HCI) and communication in shared decision making (SDM) for patient-provider behavioral change and behavioral contracting. Traditional evaluations of usability using scripted or mock patient scenarios with think-aloud protocol analysis provide a way to identify HCI issues. In this paper we describe the application of these methods in the evaluation of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) tool, and test the usability of the tool to support the ADAPT framework for integrated care counseling of pre-diabetes. The think-aloud protocol analysis typically does not provide an assessment of how patient-provider interactions are effected in "live" clinical workflow or whether a tool is successful. Therefore, "Near-live" clinical simulations involving applied simulation methods were used to compliment the think-aloud results. This complementary usability technique was used to test the end-user HCI and tool performance by more closely mimicking the clinical workflow and capturing interaction sequences along with assessing the functionality of computer module prototypes on clinician workflow. We expected this method to further complement and provide different usability findings as compared to think-aloud analysis. Together, this mixed method evaluation provided comprehensive and realistic feedback for iterative refinement of the ADAPT system prior to implementation. The study employed two phases of testing of a new interactive ADAPT tool that embedded an evidence-based shared goal setting component into primary care workflow for dealing with pre-diabetes counseling within a commercial physician office electronic health record (EHR). Phase I applied usability testing that involved "think-aloud" protocol analysis of eight primary care providers interacting with several scripted clinical scenarios. Phase II used "near-live" clinical simulations of five providers interacting with standardized trained patient actors enacting the clinical scenario of counseling for pre-diabetes, each of whom had a pedometer that recorded the number of steps taken over a week. In both phases, all sessions were audio-taped and motion screen-capture software was activated for onscreen recordings. Transcripts were coded using iterative qualitative content analysis methods. In Phase I, the impact of the components and layout of ADAPT on user's Navigation, Understandability, and Workflow were associated with the largest volume of negative comments (i.e. approximately 80% of end-user commentary), while Usability and Content of ADAPT were representative of more positive than negative user commentary. The heuristic category of Usability had a positive-to-negative comment ratio of 2.1, reflecting positive perception of the usability of the tool, its functionality, and overall co-productive utilization of ADAPT. However, there were mixed perceptions about content (i.e., how the information was displayed, organized and described in the tool). In Phase II, the duration of patient encounters was approximately 10 min with all of the Patient Instructions (prescriptions) and behavioral contracting being activated at the end of each visit. Upon activation, providers accepted the pathway prescribed by the tool 100% of the time and completed all the fields in the tool in the simulation cases. Only 14% of encounter time was spent using the functionality of the ADAPT tool in terms of keystrokes and entering relevant data. The rest of the time was spent on communication and dialog to populate the patient instructions. In all cases, the interaction sequence of reviewing and discussing exercise and diet of the patient was linked to the functionality of the ADAPT tool in terms of monitoring, response-efficacy, self-efficacy, and negotiation in the patient-provider dialog. There was a change from one-way dialog to two-way dialog and negotiation that ended in a behavioral contract. This change demonstrated the tool's sequence, which supported recording current exercise and diet followed by a diet and exercise goal setting procedure to reduce the risk of diabetes onset. This study demonstrated that "think-aloud" protocol analysis with "near-live" clinical simulations provided a successful usability evaluation of a new primary care pre-diabetes shared goal setting tool. Each phase of the study provided complementary observations on problems with the new onscreen tool and was used to show the influence of the ADAPT framework on the usability, workflow integration, and communication between the patient and provider. The think-aloud tests with the provider showed the tool can be used according to the ADAPT framework (exercise-to-diet behavior change and tool utilization), while the clinical simulations revealed the ADAPT framework to realistically support patient-provider communication to obtain behavioral change contract. SDM interactions and mechanisms affecting protocol-based care can be more completely captured by combining "near-live" clinical simulations with traditional "think-aloud analysis" which augments clinician utilization. More analysis is required to verify if the rich communication actions found in Phase II compliment clinical workflows. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Usefulness of multiqubit W-type states in quantum information processing

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

Singh, P.; Adhikari, S.; Kumar, A., E-mail: atulk@iitj.ac.in

We analyze the efficiency of multiqubit W-type states as resources for quantum information. For this, we identify and generalize four-qubit W-type states. Our results show that these states can be used as resources for deterministic quantum information processing. The utility of results, however, is limited by the availability of experimental setups to perform and distinguish multiqubit measurements. We therefore emphasize protocols where two users want to establish an optimal bipartite entanglement using the partially entangled W-type states. We find that for such practical purposes, four-qubit W-type states can be a better resource in comparison to three-qubit W-type states. For amore » dense coding protocol, our states can be used deterministically to send two bits of classical message by locally manipulating a single qubit. In addition, we also propose a realistic experimental method to prepare the four-qubit W-type states using standard unitary operations and weak measurements.« less

Unforgeable noise-tolerant quantum tokens

PubMed Central

Pastawski, Fernando; Yao, Norman Y.; Jiang, Liang; Lukin, Mikhail D.; Cirac, J. Ignacio

2012-01-01

The realization of devices that harness the laws of quantum mechanics represents an exciting challenge at the interface of modern technology and fundamental science. An exemplary paragon of the power of such quantum primitives is the concept of “quantum money” [Wiesner S (1983) ACM SIGACT News 15:78–88]. A dishonest holder of a quantum bank note will invariably fail in any counterfeiting attempts; indeed, under assumptions of ideal measurements and decoherence-free memories such security is guaranteed by the no-cloning theorem. In any practical situation, however, noise, decoherence, and operational imperfections abound. Thus, the development of secure “quantum money”-type primitives capable of tolerating realistic infidelities is of both practical and fundamental importance. Here, we propose a novel class of such protocols and demonstrate their tolerance to noise; moreover, we prove their rigorous security by determining tight fidelity thresholds. Our proposed protocols require only the ability to prepare, store, and measure single quantum bit memories, making their experimental realization accessible with current technologies.

Positivism and Realism in the Writings of Moritz Schlick

NASA Astrophysics Data System (ADS)

Lewis, Joia A.

1990-01-01

Moritz Schlick, the founder of the Vienna Circle, is best known for his logical positivist writings of the late 20's and early 30's. He is traditionally seen as having dropped his earlier realist views for an anti-realist positivism. This picture obscures both the complexity and profundity of Schlick's own philosophical development, as well as important issues in understanding positivist and realist assumptions in current debates among philosophers of science. This dissertation seeks to contribute to the contemporary debates through an analysis of Schlick's early as well as his later work, through an examination and evaluation of the principles and motives upon which Schlick based his claims.

SearchLight: a freely available web-based quantitative spectral analysis tool (Conference Presentation)

NASA Astrophysics Data System (ADS)

Prabhat, Prashant; Peet, Michael; Erdogan, Turan

2016-03-01

In order to design a fluorescence experiment, typically the spectra of a fluorophore and of a filter set are overlaid on a single graph and the spectral overlap is evaluated intuitively. However, in a typical fluorescence imaging system the fluorophores and optical filters are not the only wavelength dependent variables - even the excitation light sources have been changing. For example, LED Light Engines may have a significantly different spectral response compared to the traditional metal-halide lamps. Therefore, for a more accurate assessment of fluorophore-to-filter-set compatibility, all sources of spectral variation should be taken into account simultaneously. Additionally, intuitive or qualitative evaluation of many spectra does not necessarily provide a realistic assessment of the system performance. "SearchLight" is a freely available web-based spectral plotting and analysis tool that can be used to address the need for accurate, quantitative spectral evaluation of fluorescence measurement systems. This tool is available at: http://searchlight.semrock.com/. Based on a detailed mathematical framework [1], SearchLight calculates signal, noise, and signal-to-noise ratio for multiple combinations of fluorophores, filter sets, light sources and detectors. SearchLight allows for qualitative and quantitative evaluation of the compatibility of filter sets with fluorophores, analysis of bleed-through, identification of optimized spectral edge locations for a set of filters under specific experimental conditions, and guidance regarding labeling protocols in multiplexing imaging assays. Entire SearchLight sessions can be shared with colleagues and collaborators and saved for future reference. [1] Anderson, N., Prabhat, P. and Erdogan, T., Spectral Modeling in Fluorescence Microscopy, http://www.semrock.com (2010).

Efficiency Improvement in a Busy Radiology Practice: Determination of Musculoskeletal Magnetic Resonance Imaging Protocol Using Deep-Learning Convolutional Neural Networks.

PubMed

Lee, Young Han

2018-04-04

The purposes of this study are to evaluate the feasibility of protocol determination with a convolutional neural networks (CNN) classifier based on short-text classification and to evaluate the agreements by comparing protocols determined by CNN with those determined by musculoskeletal radiologists. Following institutional review board approval, the database of a hospital information system (HIS) was queried for lists of MRI examinations, referring department, patient age, and patient gender. These were exported to a local workstation for analyses: 5258 and 1018 consecutive musculoskeletal MRI examinations were used for the training and test datasets, respectively. The subjects for pre-processing were routine or tumor protocols and the contents were word combinations of the referring department, region, contrast media (or not), gender, and age. The CNN Embedded vector classifier was used with Word2Vec Google news vectors. The test set was tested with each classification model and results were output as routine or tumor protocols. The CNN determinations were evaluated using the receiver operating characteristic (ROC) curves. The accuracies were evaluated by a radiologist-confirmed protocol as the reference protocols. The optimal cut-off values for protocol determination between routine protocols and tumor protocols was 0.5067 with a sensitivity of 92.10%, a specificity of 95.76%, and an area under curve (AUC) of 0.977. The overall accuracy was 94.2% for the ConvNet model. All MRI protocols were correct in the pelvic bone, upper arm, wrist, and lower leg MRIs. Deep-learning-based convolutional neural networks were clinically utilized to determine musculoskeletal MRI protocols. CNN-based text learning and applications could be extended to other radiologic tasks besides image interpretations, improving the work performance of the radiologist.

3D MRI Modeling of Thin and Spatially Complex Soft Tissue Structures without Shrinkage: Lamprey Myosepta as an Example.

PubMed

Wood, Bradley M; Jia, Guang; Carmichael, Owen; McKlveen, Kevin; Homberger, Dominique G

2018-05-12

3D imaging techniques enable the non-destructive analysis and modeling of complex structures. Among these, MRI exhibits good soft tissue contrast, but is currently less commonly used for non-clinical research than x-ray CT, even though the latter requires contrast-staining that shrinks and distorts soft tissues. When the objective is the creation of a realistic and complete 3D model of soft tissue structures, MRI data are more demanding to acquire and visualize and require extensive post-processing because they comprise non-cubic voxels with dimensions that represent a trade-off between tissue contrast and image resolution. Therefore, thin soft tissue structures with complex spatial configurations are not always visible in a single MRI dataset, so that standard segmentation techniques are not sufficient for their complete visualization. By using the example of the thin and spatially complex connective tissue myosepta in lampreys, we developed a workflow protocol for the selection of the appropriate parameters for the acquisition of MRI data and for the visualization and 3D modeling of soft tissue structures. This protocol includes a novel recursive segmentation technique for supplementing missing data in one dataset with data from another dataset to produce realistic and complete 3D models. Such 3D models are needed for the modeling of dynamic processes, such as the biomechanics of fish locomotion. However, our methodology is applicable to the visualization of any thin soft tissue structures with complex spatial configurations, such as fasciae, aponeuroses, and small blood vessels and nerves, for clinical research and the further exploration of tensegrity. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

A novel contact assay for testing aryl hydrocarbon receptor (AhR)-mediated toxicity of chemicals and whole sediments in zebrafish (Danio rerio) embryos.

PubMed

Schiwy, Sabrina; Bräunig, Jennifer; Alert, Henriette; Hollert, Henner; Keiter, Steffen H

2015-11-01

The European Water Framework Directive aims to achieve a good ecological and chemical status in surface waters until 2015. Sediment toxicology plays a major role in this intention as sediments can act as a secondary source of pollution. In order to fulfill this legal obligation, there is an urgent need to develop whole-sediment exposure protocols, since sediment contact assays represent the most realistic scenario to simulate in situ exposure conditions. Therefore, in the present study, a vertebrate sediment contact assay to determine aryl hydrocarbon receptor (AhR)-mediated activity of particle-bound pollutants was developed. Furthermore, the activity and the expression of the CYP1 family in early life stages of zebrafish after exposure to freeze-dried sediment samples were investigated. In order to validate the developed protocol, effects of β-naphthoflavone and three selected sediment on zebrafish embryos were investigated. Results documented clearly AhR-mediated toxicity after exposure to β-naphthoflavone (β-NF) and to the sediment from the Vering canal. Upregulation of mRNA levels was observed for all investigated sediment samples. The highest levels of all investigated cyp genes (cyp1a, cyp1b1, cyp1c1, and cyp1c2) were recorded after exposure to the sediment sample of the Vering canal. In conclusion, the newly developed sediment contact assay can be recommended for the investigation of dioxin-like activities of single substances and the bioavailable fraction of complex environmental samples. Moreover, the exposure of whole zebrafish embryos to native (freeze-dried) sediment samples represents a highly realistic and ecologically relevant exposure scenario.

Choosing Healthcare Options by Involving Canada's Elderly: a protocol for the CHOICE realist synthesis project on engaging older persons in healthcare decision-making

PubMed Central

Stolee, Paul; Elliott, Jacobi; McNeil, Heather; Boscart, Veronique; Heckman, George A; Hutchinson, Rebecca; Hedley, Margaret; Glouberman, Sholom; Judd, Maria

2015-01-01

Introduction While patient and citizen engagement has been recognised as a crucial element in healthcare reform, limited attention has been paid to how best to engage seniors—the fastest growing segment of the population and the largest users of the healthcare system. To improve the healthcare services for this population, seniors and their families need to be engaged as active partners in healthcare decision-making, research and planning. This synthesis aims to understand the underlying context and mechanisms needed to achieve meaningful engagement of older adults in healthcare decision-making, research and planning. Methods and analysis The CHOICE Knowledge Synthesis Project: Choosing Healthcare Options by Involving Canada's Elderly aims to address this issue by synthesising current knowledge on patient, family, and caregiver engagement. A realist synthesis will support us to learn from other patient and citizen engagement initiatives, from previous research, and from seniors, families and caregivers themselves. The synthesis will guide development or adaptation of a framework, leading to the development of best practice guidelines and recommendations for engagement of older people and their families and caregivers in clinical decision-making, healthcare delivery, planning and research. Ethics and dissemination The components of this protocol involving consultation with patients or caregivers have received ethics clearance from the University of Waterloo, Office of Research Ethics (ORE#19094). After completion of the project, we will amalgamate the information collected into a knowledge synthesis report which will include best practice guidelines and recommendations for patient, family and caregiver engagement in clinical and health system planning and research contexts. Results Will be further disseminated to citizens, clinicians, researchers and policymakers with the help of our partners. Trial registration number CRD42015024749. PMID:26534730

An Evaluation of Protocol Enhancing Proxies and File Transport Protocols for Satellite Communication

NASA Technical Reports Server (NTRS)

Finch, Patrick Eugene; Sullivan, Donald; Ivancic, William D.

2012-01-01

NASA is utilizing Global Hawk aircraft in high-altitude, long-duration Earth science missions. Communications with the onboard research equipment and sensors (the science payload) is via Ku-Band radio utilizing satellites in geostationary orbits. All payload communications use standard Internet Protocols and routing, and much of the data to be transferred is comprised of very large files. The science community is interested in fully utilizing these communication links to retrieve data as quickly and reliably as possible. A test bed was developed at NASA Ames to evaluate modern transport protocols as well as Protocol Enhancing Proxies (PEPs) to determine what tools best fit the needs of the science community. This paper describes the test bed used, the protocols, the PEPs that were evaluated, the particular tests performed and the results and conclusions.

Local food environment interventions to improve healthy food choice in adults: a systematic review and realist synthesis protocol.

PubMed

Penney, Tarra L; Brown, Helen Elizabeth; Maguire, Eva R; Kuhn, Isla; Monsivais, Pablo

2015-05-03

Local food environments have been linked with dietary intake and obesity in adults. However, overall evidence remains mixed with calls for increased theoretical and conceptual clarity related to how availability of neighbourhood food outlets, and within-outlet food options, influence food purchasing and consumption. The purpose of this work is to develop a programme theory of food availability, supported by empirical evidence from a range of local food environment interventions. A systematic search of the literature will be followed by duplicate screening and quality assessment (using the Effective Public Health Practice Project tool). Realist synthesis will then be conducted according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) publication standards, including transparent appraisal, synthesis and drawing conclusions via consensus. The final synthesis will propose an evidence-based programme theory of food availability, including evidence mapping to demonstrate contextual factors, pathways of influence and potential mechanisms. With the paucity of empirically supported programme theories used in current local food environment interventions to improve food availability, this synthesis may be used to understand how and why interventions work, and thus inform the development of theory-driven, evidence-based interventions to improve healthy food choice and future empirical work. PROSPERO CRD42014009808. 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.

Using Colored Stochastic Petri Net (CS-PN) software for protocol specification, validation, and evaluation

NASA Technical Reports Server (NTRS)

Zenie, Alexandre; Luguern, Jean-Pierre

1987-01-01

The specification, verification, validation, and evaluation, which make up the different steps of the CS-PN software are outlined. The colored stochastic Petri net software is applied to a Wound/Wait protocol decomposable into two principal modules: request or couple (transaction, granule) treatment module and wound treatment module. Each module is specified, verified, validated, and then evaluated separately, to deduce a verification, validation and evaluation of the complete protocol. The colored stochastic Petri nets tool is shown to be a natural extension of the stochastic tool, adapted to distributed systems and protocols, because the color conveniently takes into account the numerous sites, transactions, granules and messages.

Evaluation of Interoperability Protocols in Repositories of Electronic Theses and Dissertations

ERIC Educational Resources Information Center

Hakimjavadi, Hesamedin; Masrek, Mohamad Noorman

2013-01-01

Purpose: The purpose of this study is to evaluate the status of eight interoperability protocols within repositories of electronic theses and dissertations (ETDs) as an introduction to further studies on feasibility of deploying these protocols in upcoming areas of interoperability. Design/methodology/approach: Three surveys of 266 ETD…

Evaluation of critical nuclear power plant electrical cable response to severe thermal fire conditions

NASA Astrophysics Data System (ADS)

Taylor, Gabriel James

The failure of electrical cables exposed to severe thermal fire conditions are a safety concern for operating commercial nuclear power plants (NPPs). The Nuclear Regulatory Commission (NRC) has promoted the use of risk-informed and performance-based methods for fire protection which resulted in a need to develop realistic methods to quantify the risk of fire to NPP safety. Recent electrical cable testing has been conducted to provide empirical data on the failure modes and likelihood of fire-induced damage. This thesis evaluated numerous aspects of the data. Circuit characteristics affecting fire-induced electrical cable failure modes have been evaluated. In addition, thermal failure temperatures corresponding to cable functional failures have been evaluated to develop realistic single point thermal failure thresholds and probability distributions for specific cable insulation types. Finally, the data was used to evaluate the prediction capabilities of a one-dimension conductive heat transfer model used to predict cable failure.

Device independence for two-party cryptography and position verification with memoryless devices

NASA Astrophysics Data System (ADS)

Ribeiro, Jérémy; Thinh, Le Phuc; Kaniewski, Jedrzej; Helsen, Jonas; Wehner, Stephanie

2018-06-01

Quantum communication has demonstrated its usefulness for quantum cryptography far beyond quantum key distribution. One domain is two-party cryptography, whose goal is to allow two parties who may not trust each other to solve joint tasks. Another interesting application is position-based cryptography whose goal is to use the geographical location of an entity as its only identifying credential. Unfortunately, security of these protocols is not possible against an all powerful adversary. However, if we impose some realistic physical constraints on the adversary, there exist protocols for which security can be proven, but these so far relied on the knowledge of the quantum operations performed during the protocols. In this work we improve the device-independent security proofs of Kaniewski and Wehner [New J. Phys. 18, 055004 (2016), 10.1088/1367-2630/18/5/055004] for two-party cryptography (with memoryless devices) and we add a security proof for device-independent position verification (also memoryless devices) under different physical constraints on the adversary. We assess the quality of the devices by observing a Bell violation, and, as for Kaniewski and Wehner [New J. Phys. 18, 055004 (2016), 10.1088/1367-2630/18/5/055004], security can be attained for any violation of the Clauser-Holt-Shimony-Horne inequality.

Cost-effectiveness of wound management in France: pressure ulcers and venous leg ulcers.

PubMed

Meaume, S; Gemmen, E

2002-06-01

This study set out to define realistic protocols of care for the treatment of chronic venous leg ulcers and pressure ulcers in France and, by developing cost-effectiveness models, to compare the different protocols of care for the two ulcer groups, enabling a calculation of direct medical costs per ulcer healed in a typical French health insurance plan. Clinical outcomes and some treatment patterns were obtained from published literature. Validations of different treatment patterns were developed using an expert consensus panel similar to the Delphi approach. Costs were calculated based on national averages and estimates from the UK and Germany. The models were used to measure costs per healed ulcer over a 12-week period. For both the pressure ulcer and venous leg ulcer models, three protocols of care were identified. For pressure ulcers and venous leg ulcers, the hydrocolloid DuoDERM (ConvaTec, also known as Granuflex in the UK and Varihesive in Germany) was most cost-effective in France. The combination of published data and expert consensus opinion is a valid technique, and in this case suggests that treating pressure ulcers and venous leg ulcers with hydrocolloid dressings is more cost-effective than treating them with saline gauze, in spite of the lower unit cost of the latter.

Evaluation of the operator protection factors offered by positive pressure air suits against airborne microbiological challenge.

PubMed

Steward, Jackie A; Lever, Mark S

2012-08-01

Laboratories throughout the world that perform work with Risk Group 4 Pathogens generally adopt one of two approaches within BSL-4 environments: either the use of positive pressure air-fed suits or using Class III microbiological safety cabinets and isolators for animal work. Within the UK at present, all laboratories working with Risk Group 4 agents adopt the use of Class III microbiological safety cabinet lines and isolators. Operator protection factors for the use of microbiological safety cabinets and isolators are available however; there is limited published data on the operator protection factors afforded by the use of positive pressure suits. This study evaluated the operator protection factors provided by positive pressure air suits against a realistic airborne microbiological challenge. The suits were tested, both intact and with their integrity compromised, on an animated mannequin within a stainless steel exposure chamber. The suits gave operator protection in all tests with an intact suit and with a cut in the leg. When compromised by a cut in the glove, a very small ingress of the challenge was seen as far as the wrist. This is likely to be due to the low airflow in the gloves of the suit. In all cases no microbiological penetration of the respiratory tract was observed. These data provide evidence on which to base safety protocols for use of positive pressure suits within high containment laboratories.

Assessing environmental impacts of genetically modified plants on non-target organisms: The relevance of in planta studies.

PubMed

Arpaia, Salvatore; Birch, A Nicholas E; Kiss, Jozsef; van Loon, Joop J A; Messéan, Antoine; Nuti, Marco; Perry, Joe N; Sweet, Jeremy B; Tebbe, Christoph C

2017-04-01

In legal frameworks worldwide, genetically modified plants (GMPs) are subjected to pre-market environmental risk assessment (ERA) with the aim of identifying potential effects on the environment. In the European Union, the EFSA Guidance Document introduces the rationale that GMPs, as well as their newly produced metabolites, represent the potential stressor to be evaluated during ERA. As a consequence, during several phases of ERA for cultivation purposes, it is considered necessary to use whole plants or plant parts in experimental protocols. The importance of in planta studies as a strategy to address impacts of GMPs on non-target organisms is demonstrated, to evaluate both effects due to the intended modification in plant phenotype (e.g. expression of Cry proteins) and effects due to unintended modifications in plant phenotype resulting from the transformation process (e.g. due to somaclonal variations or pleiotropic effects). In planta tests are also necessary for GMPs in which newly expressed metabolites cannot easily be studied in vitro. This paper reviews the scientific literature supporting the choice of in planta studies as a fundamental tool in ERA of GMPs in cultivation dossiers; the evidence indicates they can realistically mimic the ecological relationships occurring in their receiving environments and provide important insights into the biology and sustainable management of GMPs. Copyright © 2017 Elsevier B.V. All rights reserved.

The "ComPAS Trial" combined treatment model for acute malnutrition: study protocol for the economic evaluation.

PubMed

Lelijveld, Natasha; Bailey, Jeanette; Mayberry, Amy; Trenouth, Lani; N'Diaye, Dieynaba S; Haghparast-Bidgoli, Hassan; Puett, Chloe

2018-04-24

Acute malnutrition is currently divided into severe (SAM) and moderate (MAM) based on level of wasting. SAM and MAM currently have separate treatment protocols and products, managed by separate international agencies. For SAM, the dose of treatment is allocated by the child's weight. A combined and simplified protocol for SAM and MAM, with a standardised dose of ready-to-use therapeutic food (RUTF), is being trialled for non-inferior recovery rates and may be more cost-effective than the current standard protocols for treating SAM and MAM. This is the protocol for the economic evaluation of the ComPAS trial, a cluster-randomised controlled, non-inferiority trial that compares a novel combined protocol for treating uncomplicated acute malnutrition compared to the current standard protocol in South Sudan and Kenya. We will calculate the total economic costs of both protocols from a societal perspective, using accounting data, interviews and survey questionnaires. The incremental cost of implementing the combined protocol will be estimated, and all costs and outcomes will be presented as a cost-consequence analysis. Incremental cost-effectiveness ratio will be calculated for primary and secondary outcome, if statistically significant. We hypothesise that implementing the combined protocol will be cost-effective due to streamlined logistics at clinic level, reduced length of treatment, especially for MAM, and reduced dosages of RUTF. The findings of this economic evaluation will be important for policymakers, especially given the hypothesised non-inferiority of the main health outcomes. The publication of this protocol aims to improve rigour of conduct and transparency of data collection and analysis. It is also intended to promote inclusion of economic evaluation in other nutrition intervention studies, especially for MAM, and improve comparability with other studies. ISRCTN 30393230 , date: 16/03/2017.

PROPEL: implementation of an evidence based pelvic floor muscle training intervention for women with pelvic organ prolapse: a realist evaluation and outcomes study protocol.

PubMed

Maxwell, Margaret; Semple, Karen; Wane, Sarah; Elders, Andrew; Duncan, Edward; Abhyankar, Purva; Wilkinson, Joyce; Tincello, Douglas; Calveley, Eileen; MacFarlane, Mary; McClurg, Doreen; Guerrero, Karen; Mason, Helen; Hagen, Suzanne

2017-12-22

Pelvic Organ Prolapse (POP) is estimated to affect 41%-50% of women aged over 40. Findings from the multi-centre randomised controlled "Pelvic Organ Prolapse PhysiotherapY" (POPPY) trial showed that individualised pelvic floor muscle training (PFMT) was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. However, provision of PFMT for prolapse continues to vary across the UK, with limited numbers of women's health physiotherapists specialising in its delivery. Implementation of this robust evidence from the POPPY trial will require attention to different models of delivery (e.g. staff skill mix) to fit with differing care environments. A Realist Evaluation (RE) of implementation and outcomes of PFMT delivery in contrasting NHS settings will be conducted using multiple case study sites. Involving substantial local stakeholder engagement will permit a detailed exploration of how local sites make decisions on how to deliver PFMT and how these lead to service change. The RE will track how implementation is working; identify what influences outcomes; and, guided by the RE-AIM framework, will collect robust outcomes data. This will require mixed methods data collection and analysis. Qualitative data will be collected at four time-points across each site to understand local contexts and decisions regarding options for intervention delivery and to monitor implementation, uptake, adherence and outcomes. Patient outcome data will be collected at baseline, six months and one year follow-up for 120 women. Primary outcome will be the Pelvic Organ Prolapse Symptom Score (POP-SS). An economic evaluation will assess the costs and benefits associated with different delivery models taking account of further health care resource use by the women. Cost data will be combined with the primary outcome in a cost effectiveness analysis, and the EQ-5D-5L data in a cost utility analysis for each of the different models of delivery. Study of the implementation of varying models of service delivery of PFMT across contrasting sites combined with outcomes data and a cost effectiveness analysis will provide insight into the implementation and value of different models of PFMT service delivery and the cost benefits to the NHS in the longer term.

Investigating the organisational impacts of quality improvement: a protocol for a realist evaluation of improvement approaches drawing on the Resource Based View of the Firm.

PubMed

Burton, Christopher R; Rycroft Malone, Jo; Robert, Glenn; Willson, Alan; Hopkins, Angela

2014-07-31

Little is understood about the role of quality improvement in enabling health organisations to survive and thrive in the contemporary context of financial and economic challenges. We will draw on the theoretical foundations of the 'Resource Based View of the Firm' (RBV) to develop insights into why health organisations engage in improvement work, how impacts are conceptualised, and 'what works' in delivering these impacts. Specifically, RBV theorises that the mix and use of resources across different organisations may explain differences in performance. Whether improvement work influences these resources is unclear. Case study research will be conducted across health organisations participating in four approaches to improvement, including: a national improvement programme; a multiorganisational partnership around implementation; an organisational strategy for quality improvement; and a coproduction project designed to enhance the experience of a clinical service from the perspective of patients. Data will comprise in-depth interviews with key informants, observation of key events and documents; analysed within and then across cases. Adopting a realist perspective, the core tenets of RBV will be evaluated as a programme theory, focusing on the interplay between organisational conditions and behavioural or resource responses that are reported through engagement in improvement. The study has been approved by Bangor University Ethics Committee. The investigation will not judge the relative merits of different approaches to healthcare quality improvement. Rather, we will develop unique insights into the organisational consequences, and dependencies of quality improvement, providing an opportunity to add to the explanatory potential of RBV in this and other contexts. In addition to scientific and lay reports of the study findings, research outputs will include a framework for constructing the economic impacts of quality improvement and practical guidance for health service managers that maximises the impacts of investment in quality improvement. 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.

Recognising the differences in the nurse consultant role across context: a study protocol

PubMed Central

2014-01-01

Background The advanced practice role of the Nurse Consultant is unique in its capacity to provide clinical leadership across a range of contexts. However, the Nurse Consultant role has been plagued with confusion due to lack of clarity over function and appropriateness for purpose within health organisations across contexts. Changing health service delivery models are driving the emergence of new nursing roles, further clouding the waters related to role positioning and purpose. There is an urgent need for evidence of impact and demonstration of how Nurse Consultants contribute to health care outcomes. This study aims to gain a clearer understanding of the Nurse Consultant role and its impact in metropolitan and rural New South Wales (NSW) Australia. Design The proposed study employs a sequential mixed method design, underpinned by Realistic Evaluation, to explore how Nurse Consultants contribute to organisational outcomes. The ‘context – mechanism – outcome’ approach of realistic evaluation provides a sound framework to examine the complex, diverse and multifaceted nature of the Nurse Consultant’s role. Method Participants will be stakeholders, recruited across a large Local Health District in NSW, comprising rural and metropolitan services. A modified and previously validated survey will be used providing information related to role characteristics, patterns and differences across health context. Focus groups with Nurse Consultant’s explore issues highlighted in the survey data. Focus groups with other clinicians, policy makers and managers will help to achieve understanding of how the role is viewed and enacted across a range of groups and contexts. Discussion Lack of role clarity is highlighted extensively in international and Australian studies examining the role of the Nurse Consultant. Previous studies failed to adequately examine the role in the context of integrated and complex health services or to examine the role in detail. Such examination is critical in order to understand the significance of the role and to ascertain how Nurse Consultants can be most effective as members of the health care team. This is the first Australian study to include extensive stakeholder perspectives in order to understand the relational and integrated nature and impact of the role across metropolitan and rural context. PMID:25320563

Beyond the realist turn: a socio-material analysis of heart failure self-care.

PubMed

McDougall, Allan; Kinsella, Elizabeth Anne; Goldszmidt, Mark; Harkness, Karen; Strachan, Patricia; Lingard, Lorelei

2018-01-01

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body of HF studies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' in HF self-care. Realist evaluation and realist interventions emphasise that the relationship between self-care interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts of HF self-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advanced HF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influence HF self-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality. © 2018 Foundation for the Sociology of Health & Illness.

Evolution of Natural Attenuation Evaluation Protocols

EPA Science Inventory

Traditionally the evaluation of the efficacy of natural attenuation was based on changes in contaminant concentrations and mass reduction. Statistical tools and models such as Bioscreen provided evaluation protocols which now are being approached via other vehicles including m...

10 CFR 960.3-1-5 - Basis for site evaluations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... comparative evaluations of sites in terms of the capabilities of the natural barriers for waste isolation and.... Comparative site evaluations shall place primary importance on the natural barriers of the site. In such... only to the extent necessary to obtain realistic source terms for comparative site evaluations based on...

10 CFR 960.3-1-5 - Basis for site evaluations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... comparative evaluations of sites in terms of the capabilities of the natural barriers for waste isolation and.... Comparative site evaluations shall place primary importance on the natural barriers of the site. In such... only to the extent necessary to obtain realistic source terms for comparative site evaluations based on...

10 CFR 960.3-1-5 - Basis for site evaluations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... comparative evaluations of sites in terms of the capabilities of the natural barriers for waste isolation and.... Comparative site evaluations shall place primary importance on the natural barriers of the site. In such... only to the extent necessary to obtain realistic source terms for comparative site evaluations based on...

10 CFR 960.3-1-5 - Basis for site evaluations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... comparative evaluations of sites in terms of the capabilities of the natural barriers for waste isolation and.... Comparative site evaluations shall place primary importance on the natural barriers of the site. In such... only to the extent necessary to obtain realistic source terms for comparative site evaluations based on...

10 CFR 960.3-1-5 - Basis for site evaluations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... comparative evaluations of sites in terms of the capabilities of the natural barriers for waste isolation and.... Comparative site evaluations shall place primary importance on the natural barriers of the site. In such... only to the extent necessary to obtain realistic source terms for comparative site evaluations based on...

The OSSE Framework at the NASA Global Modeling and Assimilation Office (GMAO)

NASA Astrophysics Data System (ADS)

Moradi, I.; Prive, N.; McCarty, W.; Errico, R. M.; Gelaro, R.

2017-12-01

This abstract summarizes the OSSE framework developed at the Global Modeling and Assimilation Office at the National Aeronautics and Space Administration (NASA/GMAO). Some of the OSSE techniques developed at GMAO including simulation of realistic observations, e.g., adding errors to simulated observations, are now widely used by the community to evaluate the impact of new observations on the weather forecasts. This talk presents some of the recent progresses and challenges in simulating realistic observations, radiative transfer modeling support for the GMAO OSSE activities, assimilation of OSSE observations into data assimilation systems, and evaluating the impact of simulated observations on the forecast skills.

The OSSE Framework at the NASA Global Modeling and Assimilation Office (GMAO)

NASA Technical Reports Server (NTRS)

Moradi, Isaac; Prive, Nikki; McCarty, Will; Errico, Ronald M.; Gelaro, Ron

2017-01-01

This abstract summarizes the OSSE framework developed at the Global Modeling and Assimilation Office at the National Aeronautics and Space Administration (NASA/GMAO). Some of the OSSE techniques developed at GMAO including simulation of realistic observations, e.g., adding errors to simulated observations, are now widely used by the community to evaluate the impact of new observations on the weather forecasts. This talk presents some of the recent progresses and challenges in simulating realistic observations, radiative transfer modeling support for the GMAO OSSE activities, assimilation of OSSE observations into data assimilation systems, and evaluating the impact of simulated observations on the forecast skills.

Temporal and spatiotemporal correlation functions for trapped Bose gases

NASA Astrophysics Data System (ADS)

Kohnen, M.; Nyman, R. A.

2015-03-01

Density correlations unambiguously reveal the quantum nature of matter. Here, we study correlations between measurements of density in cold-atom clouds at different times at one position, and also at two separated positions. We take into account the effects of finite-size and -duration measurements made by light beams passing through the atom cloud. We specialize to the case of Bose gases in harmonic traps above critical temperature, for weakly perturbative measurements. For overlapping measurement regions, shot-noise correlations revive after a trap oscillation period. For nonoverlapping regions, bosonic correlations dominate at long times, and propagate at finite speeds. Finally, we give a realistic measurement protocol for performing such experiments.

A universal quantum frequency converter via four-wave-mixing processes

NASA Astrophysics Data System (ADS)

Cheng, Mingfei; Fang, Jinghuai

2016-06-01

We present a convenient and flexible way to realize a universal quantum frequency converter by using nondegenerate four-wave-mixing processes in the ladder-type three-level atomic system. It is shown that quantum state exchange between two fields with large frequency difference can be readily achieved, where one corresponds to the atomic resonant transition in the visible spectral region for quantum memory and the other to the telecommunication range wavelength (1550 nm) for long-distance transmission over optical fiber. This method would bring great facility in realistic quantum information processing protocols with atomic ensembles as quantum memory and low-loss optical fiber as transmission channel.

A multigear protocol for sampling crayfish assemblages in Gulf of Mexico coastal streams

Treesearch

William R. Budnick; William E. Kelso; Susan B. Adams; Michael D. Kaller

2018-01-01

Identifying an effective protocol for sampling crayfish in streams that vary in habitat and physical/chemical characteristics has proven problematic. We evaluated an active, combined-gear (backpack electrofishing and dipnetting) sampling protocol in 20 Coastal Plain streams in Louisiana. Using generalized linear models and rarefaction curves, we evaluated environmental...

Semi-Structured Interview Protocol for Constructing Logic Models

ERIC Educational Resources Information Center

Gugiu, P. Cristian; Rodriguez-Campos, Liliana

2007-01-01

This paper details a semi-structured interview protocol that evaluators can use to develop a logic model of a program's services and outcomes. The protocol presents a series of questions, which evaluators can ask of specific program informants, that are designed to: (1) identify key informants basic background and contextual information, (2)…

The Evaluation of Vocational Programming in Secondary School Settings: A Suggested Protocol

ERIC Educational Resources Information Center

George, Jennifer C.; Seruya, Francine M.

2018-01-01

The primary purpose of this project was to determine if a therapist-created protocol to develop a prevocational program provided sufficient information for a practitioner to implement a vocational program within another high school setting. The developed protocol was evaluated on feasibility and efficacy for replication within another setting by…

Developing an evidence-based practice protocol: implications for midwifery practice.

PubMed

Carr, K C

2000-01-01

Evidence-based practice is defined and its importance to midwifery practice is presented. Guidelines are provided for the development of an evidence-based practice protocol. These include: identifying the clinical question, obtaining the evidence, evaluating the validity and importance of the evidence, synthesizing the evidence and applying it to the development of a protocol or clinical algorithm, and, finally, developing an evaluation plan or measurement strategy to see if the new protocol is effective.

Evaluation of the clinical protocol quality for family planning services of people living with HIV/AIDS.

PubMed

Brasil, Raquel Ferreira Gomes; Silva, Maria Josefina da; Moura, Escolástica Rejane Ferreira

2018-01-01

To evaluate the quality of a clinical protocol for family planning care for people living with HIV/AIDS. An evaluative study based on the six domains of the Appraisal of Guidelines for Research & Evaluation II and on Pearson's Coefficient of Variation. The protocol reached between 88.8% and 100.0% quality in the domains of the Appraisal of Guidelines for Research & Evaluation II and 93.3% in the overall evaluation. The obtained Pearson's coefficient of variation was between zero and 18.6. Considering that a minimum percentage of 70.0% was adopted for the quality attributed by the evaluators, quality has been achieved for all domains of the Appraisal of Guidelines for Research & Evaluation II. As a coefficient for all domains was less than 25%, we can infer that the scores attributed by the evaluators were linear or homogeneous, meaning high agreement between them. The protocol was evaluated as a quality instrument, recommended for use by health professionals who deal with family planning for people living with HIV/AIDS.

Benchmarking Ligand-Based Virtual High-Throughput Screening with the PubChem Database

PubMed Central

Butkiewicz, Mariusz; Lowe, Edward W.; Mueller, Ralf; Mendenhall, Jeffrey L.; Teixeira, Pedro L.; Weaver, C. David; Meiler, Jens

2013-01-01

With the rapidly increasing availability of High-Throughput Screening (HTS) data in the public domain, such as the PubChem database, methods for ligand-based computer-aided drug discovery (LB-CADD) have the potential to accelerate and reduce the cost of probe development and drug discovery efforts in academia. We assemble nine data sets from realistic HTS campaigns representing major families of drug target proteins for benchmarking LB-CADD methods. Each data set is public domain through PubChem and carefully collated through confirmation screens validating active compounds. These data sets provide the foundation for benchmarking a new cheminformatics framework BCL::ChemInfo, which is freely available for non-commercial use. Quantitative structure activity relationship (QSAR) models are built using Artificial Neural Networks (ANNs), Support Vector Machines (SVMs), Decision Trees (DTs), and Kohonen networks (KNs). Problem-specific descriptor optimization protocols are assessed including Sequential Feature Forward Selection (SFFS) and various information content measures. Measures of predictive power and confidence are evaluated through cross-validation, and a consensus prediction scheme is tested that combines orthogonal machine learning algorithms into a single predictor. Enrichments ranging from 15 to 101 for a TPR cutoff of 25% are observed. PMID:23299552

Vehicular Visible Light Networks for Urban Mobile Crowd Sensing

PubMed Central

2018-01-01

Crowd sensing is a powerful tool to map and predict interests and events. In the future, it could be boosted by an increasing number of connected vehicles sharing information and intentions. This will be made available by on board wireless connected devices able to continuously communicate with other vehicles and with the environment. Among the enabling technologies, visible light communication (VLC) represents a low cost solution in the short term. In spite of the fact that vehicular communications cannot rely on the sole VLC due to the limitation provided by the light which allows communications in visibility only, VLC can however be considered to complement other wireless communication technologies which could be overloaded in dense scenarios. In this paper we evaluate the performance of VLC connected vehicles when urban crowd sensing is addressed and we compare the performance of sole vehicular visible light networks with that of VLC as a complementary technology of IEEE 802.11p. Results, obtained through a realistic simulation tool taking into account both the roadmap constraints and the technologies protocols, help to understand when VLC provides the major improvement in terms of delivered data varying the number and position of RSUs and the FOV of the receiver. PMID:29649149

Improving risk assessments for manufactured gas plant soils by measuring PAH availability.

PubMed

Stroo, Hans F; Nakles, David V; Kreitinger, Joseph P; Loehr, Raymond C; Hawthorne, Steven B; Luthy, Richard G; Holman, Hoi-Ying; LaPierre, Adrienne

2005-07-01

Remediation of soils at oil-gas manufactured gas plant (MGP) sites is driven primarily by the human health risks posed by the carcinogenic polycyclic aromatic hydrocarbons (PAHs), particularly benzo[a]pyrene (BaP), that are associated with lampblack residues. Although PAHs on lampblack are tightly sorbed, risk assessments do not account for this reduced availability. A multi-investigator study of 7 oil-gas MGP site soil samples demonstrated that the dermal and ingestion absorption factors are far lower than current default assumptions used in risk assessments. Using these sample-specific absorption factors in standard risk assessment equations increased risk-based cleanup levels by a factor of 72 on average (with a range from 23 to 142 times the default level). The rapidly released fraction of the BaP in each sample, as measured by supercritical fluid extraction, was closely correlated (r2 = 0.96) to these calculated cleanup levels. The weight of evidence developed during this research indicates that the risks posed by PAHs on lampblack are far less than assumed when using default absorption factors and that a tiered evaluation protocol employing chemical analyses, chemical release data, and in vitro bioassays can be used to establish more realistic site-specific criteria.

A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.

PubMed

Hsiao, Angela; Glickman, Gerald; He, Jianing

2009-11-01

Bisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy. Thirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols. In the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05). The results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.

EVALUATION OF AMMONIUM PERCHLORATE IN THE ENDOCRINE DISRUPTOR SCREENING AND TESTING PROGRAM'S MALE PUBERTAL PROTOCOL: ABILITY TO DETECT EFFECTS OF THYROID ENDPOINTS.

EPA Science Inventory

The U.S EPA Endocrine Disruptor Screening Program Tier 1 male pubertal protocol was designed to detect reproductive development and thyroid function. One purpose of this in vivo protocol is to detect thyrotoxicants via a number of different mechanisms of action. Here we evaluate ...

Implementation of a timed, electronic, assessment-driven potassium-replacement protocol.

PubMed

Zielenski, Christopher; Crabtree, Adam; Le, Tien; Marlatt, Alyse; Ng, Dana; Tran, Alan

2017-06-15

The adherence to and effectiveness and safety of a timed, electronic, assessment-driven potassium-replacement protocol (TARP) were compared with an electronic nurse-driven replacement protocol (NRP) are reported. A retrospective observational study was conducted in a community hospital evaluating protocol adherence, effectiveness, and safety for 2 potassium-replacement protocols. All adults on medical units with an order for potassium replacement per protocol during the 3-month trial periods were reviewed. All patients requiring potassium replacement per protocol were included in the analysis. Adherence to the protocol was assessed by evaluating the dose of potassium administered and performance of reassessments. Effectiveness of the protocol was assessed by evaluating the time to achieve target potassium levels. Safety was assessed by evaluating the route of administration and occurrence of hyperkalemia. A total of 300 patients treated using potassium-replacement protocols required potassium replacement during the study period, with 148 patients in the NRP group requiring 491 instances of potassium replacement. In the TARP group a total of 564 instances requiring potassium replacement corresponded to 152 patients. Of the 491 instances requiring replacement in the NRP group, the correct dose was administered and reassessment performed 117 times (23.8%). Overall adherence ( p < 0.05), correct dose given ( p < 0.05), average time from blood draw to potassium replacement ( p < 0.0001), use of oral replacement ( p < 0.05), and time to achieve target potassium level within 12 hours ( p < 0.05) were significantly improved in the TARP group. The TARP improved the effectiveness and safety of potassium-replacement therapy over the traditional NRP without negatively affecting timeliness of care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

A pragmatic randomized control trial and realist evaluation on the implementation and effectiveness of an internet application to support self-management among individuals seeking specialized mental health care: a study protocol.

PubMed

Hensel, Jennifer M; Shaw, Jay; Jeffs, Lianne; Ivers, Noah M; Desveaux, Laura; Cohen, Ashley; Agarwal, Payal; Wodchis, Walter P; Tepper, Joshua; Larsen, Darren; McGahan, Anita; Cram, Peter; Mukerji, Geetha; Mamdani, Muhammad; Yang, Rebecca; Wong, Ivy; Onabajo, Nike; Jamieson, Trevor; Bhatia, R Sacha

2016-10-18

Mental illness is a substantial and rising contributor to the global burden of disease. Access to and utilization of mental health care, however, is limited by structural barriers such as specialist availability, time, out-of-pocket costs, and attitudinal barriers including stigma. Innovative solutions like virtual care are rapidly entering the health care domain. The advancement and adoption of virtual care for mental health, however, often occurs in the absence of rigorous evaluation and adequate planning for sustainability and spread. A pragmatic randomized controlled trial with a nested comparative effectiveness arm, and concurrent realist process evaluation to examine acceptability, effectiveness, and cost-effectiveness of the Big White Wall (BWW) online platform for mental health self-management and peer support among individuals aged 16 and older who are accessing mental health services in Ontario, Canada. Participants will be randomized to 3 months of BWW or treatment as usual. At the end of the 3 months, participants in the intervention group will have the opportunity to opt-in to an intervention extension arm. Those who opt-in will be randomized to receive an additional 3 months of BWW or no additional intervention. The primary outcome is recovery at 3 months as measured by the Recovery Assessment Scale-revised (RAS-r). Secondary outcomes include symptoms of depression and anxiety measured with the Personal Health Questionnaire-9 item (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 item (GAD-7) respectively, quality of life measured with the EQ-5D-5L, and community integration assessed with the Community Integration Questionnaire. Cost-effectiveness evaluations will account for the cost of the intervention and direct health care costs. Qualitative interviews with participants and stakeholders will be conducted throughout. Understanding the impact of virtual strategies, such as BWW, on patient outcomes and experience, and health system costs is essential for informing whether and how health system decision-makers can support these strategies system-wide. This requires clear evidence of effectiveness and an understanding of how the intervention works, for whom, and under what circumstances. This study will produce such effectiveness data for BWW, while simultaneously exploring the characteristics and experiences of users for whom this and similar online interventions could be helpful. Clinicaltrials.gov NCT02896894 . Registered on 31 August 2016 (retrospectively registered).

Strategies for research engagement of clinicians in allied health (STRETCH): a mixed methods research protocol.

PubMed

Mickan, Sharon; Wenke, Rachel; Weir, Kelly; Bialocerkowski, Andrea; Noble, Christy

2017-09-11

Allied health professionals (AHPs) report positive attitudes to using research evidence in clinical practice, yet often lack time, confidence and skills to use, participate in and conduct research. A range of multifaceted strategies including education, mentoring and guidance have been implemented to increase AHPs' use of and participation in research. Emerging evidence suggests that knowledge brokering activities have the potential to support research engagement, but it is not clear which knowledge brokering strategies are most effective and in what contexts they work best to support and maintain clinicians' research engagement. This protocol describes an exploratory concurrent mixed methods study that is designed to understand how allied health research fellows use knowledge brokering strategies within tailored evidence-based interventions, to facilitate research engagement by allied health clinicians. Simultaneously, a realist approach will guide a systematic process evaluation of the research fellows' pattern of use of knowledge brokering strategies within each case study to build a programme theory explaining which knowledge brokering strategies work best, in what contexts and why. Learning and behavioural theories will inform this critical explanation. An explanation of how locally tailored evidence-based interventions improve AHPs use of, participation in and leadership of research projects will be summarised and shared with all participating clinicians and within each case study. It is expected that local recommendations will be developed and shared with medical and nursing professionals in and beyond the health service, to facilitate building research capacity in a systematic and effective way. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Translational cognitive endocrinology: Designing rodent experiments with the goal to ultimately enhance cognitive health in women

PubMed Central

Mennenga, S.E.; Bimonte-Nelson, H.A.

2014-01-01

Understanding the cognitive impact of endogenously derived, and exogenously administered, hormone alterations is necessary for developing hormone treatments to support healthy brain function in women, especially during aging. The increasing number of studies in the burgeoning area of translational cognitive neuroendocrinology has revealed numerous factors that influence the extent and direction of female steroid effects on cognition. Here, we discuss the decision processes underlying the design of rodent hormone manipulation experiments evaluating learning and memory. It is noted that even when beginning with a clear hypothesis-driven question, there are numerous factors to consider in order to solidify a sound experimental design that will yield clean, interpretable results. Decisions and considerations include: age of animals at hormone administration and test, ovariectomy implementation, when to administer hormones relative to ovarian hormone loss, how and whether to monitor the estrous cycle if animals are ovary-intact, dose of hormone, administration route of hormone, hormone treatment confirmation protocols, handling procedures required for hormone administration and treatment confirmation, cognitive domains to be tested and which mazes should be utilized to test these cognitive domains, and control measures to be used. A balanced view of optimal design and realistic experimental practice and protocol is presented. The emerging results from translational cognitive neuroendocrinology studies have been diverse, but also enlightening and exciting as we realize the broad scope and powerful nature of ovarian hormone effects on the brain and its function. We must design, implement, and interpret hormone and cognition experiments with sensitivity to these tenets, acknowledging and respecting the breadth and depth of the impact gonadal hormones have on brain functioning and its rich plasticity. PMID:23391594

Evaluation of a single-scan protocol for radiochromic film dosimetry.

PubMed

Shimohigashi, Yoshinobu; Araki, Fujio; Maruyama, Masato; Nakaguchi, Yuji; Kuwahara, Satoshi; Nagasue, Nozomu; Kai, Yudai

2015-03-08

The purpose of this study was to evaluate a single-scan protocol using Gafchromic EBT3 film (EBT3) by comparing it with the commonly used 24-hr measurement protocol for radiochromic film dosimetry. Radiochromic film is generally scanned 24 hr after film exposure (24-hr protocol). The single-scan protocol enables measurement results within a short time using only the verification film, one calibration film, and unirradiated film. The single-scan protocol was scanned 30 min after film irradiation. The EBT3 calibration curves were obtained with the multichannel film dosimetry method. The dose verifications for each protocol were performed with the step pattern, pyramid pattern, and clinical treatment plans for intensity-modulated radiation therapy (IMRT). The absolute dose distributions for each protocol were compared with those calculated by the treatment planning system (TPS) using gamma evaluation at 3% and 3 mm. The dose distribution for the single-scan protocol was within 2% of the 24-hr protocol dose distribution. For the step pattern, the absolute dose discrepancies between the TPS for the single-scan and 24-hr protocols were 2.0 ± 1.8 cGy and 1.4 ± 1.2 cGy at the dose plateau, respectively. The pass rates were 96.0% for the single-scan protocol and 95.9% for the 24-hr protocol. Similarly, the dose discrepancies for the pyramid pattern were 3.6 ± 3.5cGy and 2.9 ± 3.3 cGy, respectively, while the pass rates for the pyramid pattern were 95.3% and 96.4%, respectively. The average pass rates for the four IMRT plans were 96.7% ± 1.8% for the single-scan protocol and 97.3% ± 1.4% for the 24-hr protocol. Thus, the single-scan protocol measurement is useful for dose verification of IMRT, based on its accuracy and efficiency.

Evaluation of a single‐scan protocol for radiochromic film dosimetry

PubMed Central

Araki, Fujio; Maruyama, Masato; Nakaguchi, Yuji; Kuwahara, Satoshi; Nagasue, Nozomu; Kai, Yudai

2015-01-01

The purpose of this study was to evaluate a single‐scan protocol using Gafchromic EBT3 film (EBT3) by comparing it with the commonly used 24‐hr measurement protocol for radiochromic film dosimetry. Radiochromic film is generally scanned 24 hr after film exposure (24‐hr protocol). The single‐scan protocol enables measurement results within a short time using only the verification film, one calibration film, and unirradiated film. The single‐scan protocol was scanned 30 min after film irradiation. The EBT3 calibration curves were obtained with the multichannel film dosimetry method. The dose verifications for each protocol were performed with the step pattern, pyramid pattern, and clinical treatment plans for intensity‐modulated radiation therapy (IMRT). The absolute dose distributions for each protocol were compared with those calculated by the treatment planning system (TPS) using gamma evaluation at 3% and 3 mm. The dose distribution for the single‐scan protocol was within 2% of the 24‐hr protocol dose distribution. For the step pattern, the absolute dose discrepancies between the TPS for the single‐scan and 24‐hr protocols were 2.0±1.8 cGy and 1.4±1.2 cGy at the dose plateau, respectively. The pass rates were 96.0% for the single‐scan protocol and 95.9% for the 24‐hr protocol. Similarly, the dose discrepancies for the pyramid pattern were 3.6±3.5 cGy and 2.9±3.3 cGy, respectively, while the pass rates for the pyramid pattern were 95.3% and 96.4%, respectively. The average pass rates for the four IMRT plans were 96.7%±1.8% for the single‐scan protocol and 97.3%±1.4% for the 24‐hr protocol. Thus, the single‐scan protocol measurement is useful for dose verification of IMRT, based on its accuracy and efficiency. PACS number: 87.55.Qr PMID:26103194

A review on transport layer protocol performance for delivering video on an adhoc network

NASA Astrophysics Data System (ADS)

Suherman; Suwendri; Al-Akaidi, Marwan

2017-09-01

The transport layer protocol is responsible for the end to end data transmission. Transmission control protocol (TCP) provides a reliable connection and user datagram protocol (UDP) offers fast but unguaranteed data transfer. Meanwhile, the 802.11 (wireless fidelity/WiFi) networks have been widely used as internet hotspots. This paper evaluates TCP, TCP variants and UDP performances for video transmission on an adhoc network. The transport protocol - medium access cross-layer is proposed by prioritizing TCP acknowledgement to reduce delay. The NS-2 evaluations show that the average delays increase linearly for all the evaluated protocols and the average packet losses grow logarithmically. UDP produces the lowest transmission delay; 5.4% and 5.8% lower than TCP and TCP variant, but experiences the highest packet loss. Both TCP and TCP Vegas maintain packet loss as low as possible. The proposed cross-layer successfully decreases TCP and TCP Vegas delay about 0.12 % and 0.15%, although losses remain similar.

Enhanced just-in-time plus protocol for optical burst switching networks

NASA Astrophysics Data System (ADS)

Rodrigues, Joel J. P. C.; Gregório, José M. B.; Vasilakos, Athanasios V.

2010-07-01

We propose a new one-way resource reservation protocol for optical burst switching (OBS) networks, called Enhanced Just-in-Time Plus (E-JIT+). The protocol is described in detail, and its formal specification is presented, following an extended finite state machine approach. The performance evaluation of E-JIT+ is analyzed in comparison with other proposed OBS protocols (JIT+ and E-JIT) for the following network topologies: rings; degree-two, degree-three, and degree-four chordal rings; mesh-torus; NSFNET; ARPANET; FCCN-NET; and the European Optical Network. We evaluate and compare the performance of the different protocols in terms of burst loss probability, taking into account the most important OBS network parameters. It was shown that E-JIT+ performs better than available one-way resource reservation protocols for all the evaluated network topologies. Moreover, the scalability of E-JIT+ was observed, and when the network traffic increases, the burst loss probability also increases, leading to a worse network performance.

Developing the Fourth Evaluation Dimension: A Protocol for Evaluation of Video From the Patient's Perspective During Major Incident Exercises.

PubMed

Haverkort, J J Mark; Leenen, Luke P H

2017-10-01

Presently used evaluation techniques rely on 3 traditional dimensions: reports from observers, registration system data, and observational cameras. Some of these techniques are observer-dependent and are not reproducible for a second review. This proof-of-concept study aimed to test the feasibility of extending evaluation to a fourth dimension, the patient's perspective. Footage was obtained during a large, full-scale hospital trauma drill. Two mock victims were equipped with point-of-view cameras filming from the patient's head. Based on the Major Incident Hospital's first experience during the drill, a protocol was developed for a prospective, standardized method to evaluate a hospital's major incident response from the patient's perspective. The protocol was then tested in a second drill for its feasibility. New insights were gained after review of the footage. The traditional observer missed some of the evaluation points, which were seen on the point-of-view cameras. The information gained from the patient's perspective proved to be implementable into the designed protocol. Use of point-of-view camera recordings from a mock patient's perspective is a valuable addition to traditional evaluation of trauma drills and trauma care. Protocols should be designed to optimize and objectify judgement of such footage. (Disaster Med Public Health Preparedness. 2017;11:594-599).

A lightweight neighbor-info-based routing protocol for no-base-station taxi-call system.

PubMed

Zhu, Xudong; Wang, Jinhang; Chen, Yunchao

2014-01-01

Since the quick topology change and short connection duration, the VANET has had unstable routing and wireless signal quality. This paper proposes a kind of lightweight routing protocol-LNIB for call system without base station, which is applicable to the urban taxis. LNIB maintains and predicts neighbor information dynamically, thus finding the reliable path between the source and the target. This paper describes the protocol in detail and evaluates the performance of this protocol by simulating under different nodes density and speed. The result of evaluation shows that the performance of LNIB is better than AODV which is a classic protocol in taxi-call scene.

Design and Evaluation of a Protocol to Assess Electronic Travel Aids for Persons Who Are Visually Impaired

ERIC Educational Resources Information Center

Havik, Else M.; Steyvers, Frank J. J. M.; van der Velde, Hanneke; Pinkster, J. Christiaan; Kooijman, Aart C.

2010-01-01

This study evaluated a protocol that was developed to assess how beneficial electronic travel aids are for persons who are visually impaired. Twenty persons with visual impairments used an electronic travel device (Trekker) for six weeks to conform to the protocol, which proved useful in identifying successful users of the device. (Contains 2…

Dynamic heart phantom with functional mitral and aortic valves

NASA Astrophysics Data System (ADS)

Vannelli, Claire; Moore, John; McLeod, Jonathan; Ceh, Dennis; Peters, Terry

2015-03-01

Cardiac valvular stenosis, prolapse and regurgitation are increasingly common conditions, particularly in an elderly population with limited potential for on-pump cardiac surgery. NeoChord©, MitraClipand numerous stent-based transcatheter aortic valve implantation (TAVI) devices provide an alternative to intrusive cardiac operations; performed while the heart is beating, these procedures require surgeons and cardiologists to learn new image-guidance based techniques. Developing these visual aids and protocols is a challenging task that benefits from sophisticated simulators. Existing models lack features needed to simulate off-pump valvular procedures: functional, dynamic valves, apical and vascular access, and user flexibility for different activation patterns such as variable heart rates and rapid pacing. We present a left ventricle phantom with these characteristics. The phantom can be used to simulate valvular repair and replacement procedures with magnetic tracking, augmented reality, fluoroscopy and ultrasound guidance. This tool serves as a platform to develop image-guidance and image processing techniques required for a range of minimally invasive cardiac interventions. The phantom mimics in vivo mitral and aortic valve motion, permitting realistic ultrasound images of these components to be acquired. It also has a physiological realistic left ventricular ejection fraction of 50%. Given its realistic imaging properties and non-biodegradable composition—silicone for tissue, water for blood—the system promises to reduce the number of animal trials required to develop image guidance applications for valvular repair and replacement. The phantom has been used in validation studies for both TAVI image-guidance techniques1, and image-based mitral valve tracking algorithms2.

Realistic Simulation for Body Area and Body-To-Body Networks

PubMed Central

Alam, Muhammad Mahtab; Ben Hamida, Elyes; Ben Arbia, Dhafer; Maman, Mickael; Mani, Francesco; Denis, Benoit; D’Errico, Raffaele

2016-01-01

In this paper, we present an accurate and realistic simulation for body area networks (BAN) and body-to-body networks (BBN) using deterministic and semi-deterministic approaches. First, in the semi-deterministic approach, a real-time measurement campaign is performed, which is further characterized through statistical analysis. It is able to generate link-correlated and time-varying realistic traces (i.e., with consistent mobility patterns) for on-body and body-to-body shadowing and fading, including body orientations and rotations, by means of stochastic channel models. The full deterministic approach is particularly targeted to enhance IEEE 802.15.6 proposed channel models by introducing space and time variations (i.e., dynamic distances) through biomechanical modeling. In addition, it helps to accurately model the radio link by identifying the link types and corresponding path loss factors for line of sight (LOS) and non-line of sight (NLOS). This approach is particularly important for links that vary over time due to mobility. It is also important to add that the communication and protocol stack, including the physical (PHY), medium access control (MAC) and networking models, is developed for BAN and BBN, and the IEEE 802.15.6 compliance standard is provided as a benchmark for future research works of the community. Finally, the two approaches are compared in terms of the successful packet delivery ratio, packet delay and energy efficiency. The results show that the semi-deterministic approach is the best option; however, for the diversity of the mobility patterns and scenarios applicable, biomechanical modeling and the deterministic approach are better choices. PMID:27104537

Realistic Simulation for Body Area and Body-To-Body Networks.

PubMed

Alam, Muhammad Mahtab; Ben Hamida, Elyes; Ben Arbia, Dhafer; Maman, Mickael; Mani, Francesco; Denis, Benoit; D'Errico, Raffaele

2016-04-20

In this paper, we present an accurate and realistic simulation for body area networks (BAN) and body-to-body networks (BBN) using deterministic and semi-deterministic approaches. First, in the semi-deterministic approach, a real-time measurement campaign is performed, which is further characterized through statistical analysis. It is able to generate link-correlated and time-varying realistic traces (i.e., with consistent mobility patterns) for on-body and body-to-body shadowing and fading, including body orientations and rotations, by means of stochastic channel models. The full deterministic approach is particularly targeted to enhance IEEE 802.15.6 proposed channel models by introducing space and time variations (i.e., dynamic distances) through biomechanical modeling. In addition, it helps to accurately model the radio link by identifying the link types and corresponding path loss factors for line of sight (LOS) and non-line of sight (NLOS). This approach is particularly important for links that vary over time due to mobility. It is also important to add that the communication and protocol stack, including the physical (PHY), medium access control (MAC) and networking models, is developed for BAN and BBN, and the IEEE 802.15.6 compliance standard is provided as a benchmark for future research works of the community. Finally, the two approaches are compared in terms of the successful packet delivery ratio, packet delay and energy efficiency. The results show that the semi-deterministic approach is the best option; however, for the diversity of the mobility patterns and scenarios applicable, biomechanical modeling and the deterministic approach are better choices.

Randomness Amplification under Minimal Fundamental Assumptions on the Devices

NASA Astrophysics Data System (ADS)

Ramanathan, Ravishankar; Brandão, Fernando G. S. L.; Horodecki, Karol; Horodecki, Michał; Horodecki, Paweł; Wojewódka, Hanna

2016-12-01

Recently, the physically realistic protocol amplifying the randomness of Santha-Vazirani sources producing cryptographically secure random bits was proposed; however, for reasons of practical relevance, the crucial question remained open regarding whether this can be accomplished under the minimal conditions necessary for the task. Namely, is it possible to achieve randomness amplification using only two no-signaling components and in a situation where the violation of a Bell inequality only guarantees that some outcomes of the device for specific inputs exhibit randomness? Here, we solve this question and present a device-independent protocol for randomness amplification of Santha-Vazirani sources using a device consisting of two nonsignaling components. We show that the protocol can amplify any such source that is not fully deterministic into a fully random source while tolerating a constant noise rate and prove the composable security of the protocol against general no-signaling adversaries. Our main innovation is the proof that even the partial randomness certified by the two-party Bell test [a single input-output pair (u* , x* ) for which the conditional probability P (x*|u*) is bounded away from 1 for all no-signaling strategies that optimally violate the Bell inequality] can be used for amplification. We introduce the methodology of a partial tomographic procedure on the empirical statistics obtained in the Bell test that ensures that the outputs constitute a linear min-entropy source of randomness. As a technical novelty that may be of independent interest, we prove that the Santha-Vazirani source satisfies an exponential concentration property given by a recently discovered generalized Chernoff bound.

Decision Support for Environmental Management of Industrial ...

EPA Pesticide Factsheets

Non-hazardous solid materials from industrial processes, once regarded as waste and disposed in landfills, offer numerous environmental and economic advantages when put to beneficial uses (BUs). Proper management of these industrial non-hazardous secondary materials (INSM) requires estimates of their probable environmental impacts among disposal as well as BU options. The U.S. Environmental Protection Agency (EPA) has recently approved new analytical methods (EPA Methods 1313–1316) to assess leachability of constituents of potential concern in these materials. These new methods are more realistic for many disposal and BU options than historical methods, such as the toxicity characteristic leaching protocol. Experimental data from these new methods are used to parameterize a chemical fate and transport (F&T) model to simulate long-term environmental releases from flue gas desulfurization gypsum (FGDG) when disposed of in an industrial landfill or beneficially used as an agricultural soil amendment. The F&T model is also coupled with optimization algorithms, the Beneficial Use Decision Support System (BUDSS), under development by EPA to enhance INSM management. The objective of this paper is to demonstrate the methodologies and encourage similar applications to improve environmental management and BUs of INSM through F&T simulation coupled with optimization, using realistic model parameterization.

A telemedicine instrument for remote evaluation of tremor: design and initial applications in fatigue and patients with Parkinson's Disease

PubMed Central

2011-01-01

Introduction A novel system that combines a compact mobile instrument and Internet communications is presented in this paper for remote evaluation of tremors. The system presents a high potential application in Parkinson's disease and connects to the Internet through a TCP/IP protocol. Tremor transduction is carried out by accelerometers, and the data processing, presentation and storage were obtained by a virtual instrument. The system supplies the peak frequency (fp), the amplitude (Afp) and power in this frequency (Pfp), the total power (Ptot), and the power in low (1-4 Hz) and high (4-7 Hz) frequencies (Plf and Phf, respectively). Methods The ability of the proposed system to detect abnormal tremors was initially demonstrated by a fatigue study in normal subjects. In close agreement with physiological fundamentals, the presence of fatigue increased fp, Afp, Pfp and Pt (p < 0.05), while the removal of fatigue reduced all the mentioned parameters (p < 0.05). The system was also evaluated in a preliminary in vivo test in parkinsonian patients. Afp, Pfp, Ptot, Plf and Phf were the most accurate parameters in the detection of the adverse effects of this disease (Se = 100%, Sp = 100%), followed by fp (Se = 100%, Sp = 80%). Tests for Internet transmission that realistically simulated clinical conditions revealed adequate acquisition and analysis of tremor signals and also revealed that the user could adequately receive medical recommendations. Conclusions The proposed system can be used in a wide spectrum of telemedicine scenarios, enabling the home evaluation of tremor occurrence under specific medical treatments and contributing to reduce the costs of the assistance offered to these patients. PMID:21306628

Rapid virtual H&E histology of breast tissue specimens using a compact fluorescence nonlinear microscope

PubMed Central

Cahill, Lucas C.; Giacomelli, Michael G.; Yoshitake, Tadayuki; Vardeh, Hilde; Faulkner-Jones, Beverly E.; Connolly, James L.; Sun, Chi-Kuang; Fujimoto, James G.

2017-01-01

Up to 40% of patients undergoing breast conserving surgery for breast cancer require repeat surgeries due to close to or positive margins. The lengthy processing required for evaluating surgical margins by standard paraffin embedded histology precludes its use during surgery and therefore, technologies for rapid evaluation of surgical pathology could improve the treatment of breast cancer by reducing the number of surgeries required. We demonstrate real-time histological evaluation of breast cancer surgical specimens by staining specimens with acridine orange (AO) and sulforhodamine 101 (SR101) analogously to hematoxylin and eosin (H&E) and then imaging the specimens with fluorescence nonlinear microscopy (NLM) using a compact femtosecond fiber laser. A video-rate computational light absorption model was used to produce realistic virtual H&E images of tissue in real time and in three dimensions. NLM imaging could be performed to depths of 100 µm below the tissue surface, which is important since many surgical specimens require subsurface evaluation due to artifacts on the tissue surface from electrocautery, surgical ink or debris from specimen handling. We validate this method by expert review of NLM images compared to formalin fixed, paraffin embedded (FFPE) H&E histology. Diagnostically important features such as normal terminal ductal lobular units, fibrous and adipose stromal parenchyma, inflammation, invasive carcinoma, and in-situ lobular and ductal carcinoma were present in NLM images associated with pathologies identified on standard FFPE H&E histology. We demonstrate that AO and SR101 were extracted to undetectable levels after FFPE processing and fluorescence in situ hybridization (FISH) HER2 amplification status was unaffected by the NLM imaging protocol. This method potentially enables cost-effective, real-time histological guidance of surgical resections. PMID:29131161

Biomechanical testing simulation of a cadaver spine specimen: development and evaluation study.

PubMed

Ahn, Hyung Soo; DiAngelo, Denis J

2007-05-15

This article describes a computer model of the cadaver cervical spine specimen and virtual biomechanical testing. To develop a graphics-oriented, multibody model of a cadaver cervical spine and to build a virtual laboratory simulator for the biomechanical testing using physics-based dynamic simulation techniques. Physics-based computer simulations apply the laws of physics to solid bodies with defined material properties. This technique can be used to create a virtual simulator for the biomechanical testing of a human cadaver spine. An accurate virtual model and simulation would complement tissue-based in vitro studies by providing a consistent test bed with minimal variability and by reducing cost. The geometry of cervical vertebrae was created from computed tomography images. Joints linking adjacent vertebrae were modeled as a triple-joint complex, comprised of intervertebral disc joints in the anterior region, 2 facet joints in the posterior region, and the surrounding ligament structure. A virtual laboratory simulation of an in vitro testing protocol was performed to evaluate the model responses during flexion, extension, and lateral bending. For kinematic evaluation, the rotation of motion segment unit, coupling behaviors, and 3-dimensional helical axes of motion were analyzed. The simulation results were in correlation with the findings of in vitro tests and published data. For kinetic evaluation, the forces of the intervertebral discs and facet joints of each segment were determined and visually animated. This methodology produced a realistic visualization of in vitro experiment, and allowed for the analyses of the kinematics and kinetics of the cadaver cervical spine. With graphical illustrations and animation features, this modeling technique has provided vivid and intuitive information.

A generic framework to simulate realistic lung, liver and renal pathologies in CT imaging

NASA Astrophysics Data System (ADS)

Solomon, Justin; Samei, Ehsan

2014-11-01

Realistic three-dimensional (3D) mathematical models of subtle lesions are essential for many computed tomography (CT) studies focused on performance evaluation and optimization. In this paper, we develop a generic mathematical framework that describes the 3D size, shape, contrast, and contrast-profile characteristics of a lesion, as well as a method to create lesion models based on CT data of real lesions. Further, we implemented a technique to insert the lesion models into CT images in order to create hybrid CT datasets. This framework was used to create a library of realistic lesion models and corresponding hybrid CT images. The goodness of fit of the models was assessed using the coefficient of determination (R2) and the visual appearance of the hybrid images was assessed with an observer study using images of both real and simulated lesions and receiver operator characteristic (ROC) analysis. The average R2 of the lesion models was 0.80, implying that the models provide a good fit to real lesion data. The area under the ROC curve was 0.55, implying that the observers could not readily distinguish between real and simulated lesions. Therefore, we conclude that the lesion-modeling framework presented in this paper can be used to create realistic lesion models and hybrid CT images. These models could be instrumental in performance evaluation and optimization of novel CT systems.

Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care.

PubMed

Sanello, Ashley; Gausche-Hill, Marianne; Mulkerin, William; Sporer, Karl A; Brown, John F; Koenig, Kristi L; Rudnick, Eric M; Salvucci, Angelo A; Gilbert, Gregory H

2018-05-01

In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Protocols for patients with AMS vary widely across the State of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

Development of a neuro early mobilisation protocol for use in a neuroscience intensive care unit.

PubMed

Brissie, Megan A; Zomorodi, Meg; Soares-Sardinha, Sharmila; Jordan, J Dedrick

2017-10-01

Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of an adult insulin infusion protocol at an academic medical center.

PubMed

Petrov, Katerina I; Burns, Tammy L; Drincic, Andjela

2012-05-01

Acknowledging evidence of possible detrimental effects of tightly controlled blood glucose levels, the American Association of Clinical Endocrinologists and the American Diabetes Association published a consensus statement recommending less strict control for most diabetic patients. As a result of these recommendations, our academic center at Creighton University Medical Center revised its adult insulin infusion protocol to target blood glucose levels ranging from 120 to 180 mg/dL for regular (standard) glycemic control and 80 to 120 mg/dL for tight control; previous targets had ranged from 80 to 180 mg/dL and 70 to 110 mg/dL, respectively. The primary objective was to evaluate the time that blood glucose values were within the target range for patients receiving the new protocol, compared with patients receiving the previous protocol. Our study was designed to evaluate the effectiveness and safety of the revised protocol. Using a retrospective chart review, we collected data for 4 months from patients on the old insulin protocol (May to August 2009) and for 4 months from patients on the new protocol (September to December 2009). Secondary endpoints included the number of hypoglycemic episodes (blood glucose below 70 mg/dL) and severe hypoglycemic episodes (blood glucose 40 mg/dL or lower) experienced by patients receiving the new insulin protocol compared with those receiving the former protocol. Patient characteristics were similar at baseline. Blood glucose values stayed within the target range for a significantly shorter time with the new protocol than with the former protocol (44.6% vs. 56.8%, respectively; P < 0.001), probably because of the narrower target range in the revised protocol. No statistically significant differences in hypoglycemia were observed after the protocol was changed. Hypoglycemia occurred in 31% of the former-protocol patients compared with 18% of the revised-protocol patients. Severe hypoglycemia was experienced by 2.1% of patients on the old protocol and by 3.1% of patients on the new protocol. Rates of severe hypoglycemia were low (2.6%) with the original protocol. Patients' blood glucose levels were within the target range for a shorter time with the new protocol. Fewer episodes of hypoglycemia were recorded with the new protocol, but rates of severe hypoglycemia were similar with both protocols.

Influence of basis images and skull position on evaluation of cortical bone thickness in cone beam computed tomography.

PubMed

Nascimento, Monikelly do Carmo Chagas; Boscolo, Solange Maria de Almeida; Haiter-Neto, Francisco; Santos, Emanuela Carla Dos; Lambrichts, Ivo; Pauwels, Ruben; Jacobs, Reinhilde

2017-06-01

The aim of this study was to assess the influence of the number of basis images and the orientation of the skull on the evaluation of cortical alveolar bone in cone beam computed tomography (CBCT). Eleven skulls with a total of 59 anterior teeth were selected. CBCT images were acquired by using 4 protocols, by varying the rotation of the tube-detector arm and the orientation of the skull (protocol 1: 360°/0°; protocol 2: 180°/0°; protocol 3: 180°/90°; protocol 4: 180°/180°). Observers evaluated cortical bone as absent, thin, or thick. Direct observation of the skulls was used as the gold standard. Intra- and interobserver agreement, as well as agreement of scoring between the 3 bone thickness classifications, were calculated by using the κ statistic. The Wilcoxon signed-rank test was used to compare the 4 protocols. For lingual cortical bone, protocol 1 showed no statistical difference from the gold standard. Higher reliability was found in protocol 3 for absent (κ = 0.80) and thin (κ = 0.47) cortices, whereas for thick cortical bone, protocol 2 was more consistent (κ = 0.60). In buccal cortical bone, protocol 1 obtained the highest agreement for absent cortices (κ = 0.61), whereas protocol 4 was better for thin cortical plates (κ = 0.38) and protocol 2 for thick cortical plates (κ = 0.40). No consistent effect of the number of basis images or head orientation for visual detection of alveolar bone was detected, except for lingual cortical bone, for which full rotation scanning showed improved visualization. Copyright © 2017 Elsevier Inc. All rights reserved.

MANEMO Routing in Practice: Protocol Selection, Expected Performance, and Experimental Evaluation

NASA Astrophysics Data System (ADS)

Tazaki, Hajime; van Meter, Rodney; Wakikawa, Ryuji; Wongsaardsakul, Thirapon; Kanchanasut, Kanchana; Dias de Amorim, Marcelo; Murai, Jun

Motivated by the deployment of post-disaster MANEMO (MANET for NEMO) composed of mobile routers and stations, we evaluate two candidate routing protocols through network simulation, theoretical performance analysis, and field experiments. The first protocol is the widely adopted Optimized Link State Routing protocol (OLSR) and the second is the combination of the Tree Discovery Protocol (TDP) with Network In Node Advertisement (NINA). To the best of our knowledge, this is the first time that these two protocols are compared in both theoretical and practical terms. We focus on the control overhead generated when mobile routers perform a handover. Our results confirm the correctness and operational robustness of both protocols. More interestingly, although in the general case OLSR leads to better results, TDP/NINA outperforms OLSR both in the case of sparse networks and in highly mobile networks, which correspond to the operation point of a large set of post-disaster scenarios.

Evaluation of a discharge education protocol for pediatric patients with gastrostomy tubes.

PubMed

Schweitzer, Michelle; Aucoin, Julia; Docherty, Sharron L; Rice, Henry E; Thompson, Julie; Sullivan, Dori Taylor

2014-01-01

To evaluate the impact of a preprocedure education protocol for children who receive a gastrostomy tube (GT). A preintervention-postintervention design, using surveys and comparison between preprotocol and postprotocol cohorts, was used to evaluate the effect of implementation of a standardized GT education protocol with 26 subjects on caregiver, patient, and provider outcomes. The use of a preprocedure education protocol resulted in improved patient outcomes and increased caregiver knowledge and confidence and was considered a positive change by the providers. Often education is a forgotten part of a medical procedure, and the importance of education is typically only recognized after an adverse event occurs. Establishing a standardized evidence-based education protocol for GT care improves overall care and satisfaction. Use of a systematic and family-centered interdisciplinary approach markedly improves patient care. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Realistic continuous-variable quantum teleportation with non-Gaussian resources

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

Dell'Anno, F.; De Siena, S.; CNR-INFM Coherentia, Napoli, Italy, and CNISM and INFN Sezione di Napoli, Gruppo Collegato di Salerno, Baronissi, SA

2010-01-15

We present a comprehensive investigation of nonideal continuous-variable quantum teleportation implemented with entangled non-Gaussian resources. We discuss in a unified framework the main decoherence mechanisms, including imperfect Bell measurements and propagation of optical fields in lossy fibers, applying the formalism of the characteristic function. By exploiting appropriate displacement strategies, we compute analytically the success probability of teleportation for input coherent states and two classes of non-Gaussian entangled resources: two-mode squeezed Bell-like states (that include as particular cases photon-added and photon-subtracted de-Gaussified states), and two-mode squeezed catlike states. We discuss the optimization procedure on the free parameters of the non-Gaussian resourcesmore » at fixed values of the squeezing and of the experimental quantities determining the inefficiencies of the nonideal protocol. It is found that non-Gaussian resources enhance significantly the efficiency of teleportation and are more robust against decoherence than the corresponding Gaussian ones. Partial information on the alphabet of input states allows further significant improvement in the performance of the nonideal teleportation protocol.« less

Atomic entanglement purification and concentration using coherent state input-output process in low-Q cavity QED regime.

PubMed

Cao, Cong; Wang, Chuan; He, Ling-Yan; Zhang, Ru

2013-02-25

We investigate an atomic entanglement purification protocol based on the coherent state input-output process by working in low-Q cavity in the atom-cavity intermediate coupling region. The information of entangled states are encoded in three-level configured single atoms confined in separated one-side optical micro-cavities. Using the coherent state input-output process, we design a two-qubit parity check module (PCM), which allows the quantum nondemolition measurement for the atomic qubits, and show its use for remote parities to distill a high-fidelity atomic entangled ensemble from an initial mixed state ensemble nonlocally. The proposed scheme can further be used for unknown atomic states entanglement concentration. Also by exploiting the PCM, we describe a modified scheme for atomic entanglement concentration by introducing ancillary single atoms. As the coherent state input-output process is robust and scalable in realistic applications, and the detection in the PCM is based on the intensity of outgoing coherent state, the present protocols may be widely used in large-scaled and solid-based quantum repeater and quantum information processing.

Simulation of mixture microstructures via particle packing models and their direct comparison with real mixtures

NASA Astrophysics Data System (ADS)

Gulliver, Eric A.

The objective of this thesis to identify and develop techniques providing direct comparison between simulated and real packed particle mixture microstructures containing submicron-sized particles. This entailed devising techniques for simulating powder mixtures, producing real mixtures with known powder characteristics, sectioning real mixtures, interrogating mixture cross-sections, evaluating and quantifying the mixture interrogation process and for comparing interrogation results between mixtures. A drop and roll-type particle-packing model was used to generate simulations of random mixtures. The simulated mixtures were then evaluated to establish that they were not segregated and free from gross defects. A powder processing protocol was established to provide real mixtures for direct comparison and for use in evaluating the simulation. The powder processing protocol was designed to minimize differences between measured particle size distributions and the particle size distributions in the mixture. A sectioning technique was developed that was capable of producing distortion free cross-sections of fine scale particulate mixtures. Tessellation analysis was used to interrogate mixture cross sections and statistical quality control charts were used to evaluate different types of tessellation analysis and to establish the importance of differences between simulated and real mixtures. The particle-packing program generated crescent shaped pores below large particles but realistic looking mixture microstructures otherwise. Focused ion beam milling was the only technique capable of sectioning particle compacts in a manner suitable for stereological analysis. Johnson-Mehl and Voronoi tessellation of the same cross-sections produced tessellation tiles with different the-area populations. Control charts analysis showed Johnson-Mehl tessellation measurements are superior to Voronoi tessellation measurements for detecting variations in mixture microstructure, such as altered particle-size distributions or mixture composition. Control charts based on tessellation measurements were used for direct, quantitative comparisons between real and simulated mixtures. Four sets of simulated and real mixtures were examined. Data from real mixture was matched with simulated data when the samples were well mixed and the particle size distributions and volume fractions of the components were identical. Analysis of mixture components that occupied less than approximately 10 vol% of the mixture was not practical unless the particle size of the component was extremely small and excellent quality high-resolution compositional micrographs of the real sample are available. These methods of analysis should allow future researchers to systematically evaluate and predict the impact and importance of variables such as component volume fraction and component particle size distribution as they pertain to the uniformity of powder mixture microstructures.

Performance Evaluation of a Routing Protocol in Wireless Sensor Network

DTIC Science & Technology

2005-12-01

OF A ROUTING PROTOCOL IN WIRELESS SENSOR NETWORKS by Cheng Kiat Amos, Teo December 2005 Thesis Advisors: Gurminder Singh John C...Evaluation of a Routing Protocol in Wireless Sensor Network 6. AUTHOR(S) Cheng Kiat Amos, Teo 5. FUNDING NUMBERS 7. PERFORMING ORGANIZATION NAME(S...need to be strategically positioned and have topologies engineered. As such, recent research into wireless sensor networks has attracted great

Multitask protocols to evaluate activities of daily living performance in people with COPD: a systematic review.

PubMed

Paes, Thaís; Machado, Felipe Vilaça Cavallari; Cavalheri, Vinícius; Pitta, Fabio; Hernandes, Nidia Aparecida

2017-07-01

People with chronic obstructive pulmonary disease (COPD) present symptoms such as dyspnea and fatigue, which hinder their performance in activities of daily living (ADL). A few multitask protocols have been developed to assess ADL performance in this population, although measurement properties of such protocols were not yet systematically reviewed. Areas covered: Studies were included if an assessment of the ability to perform ADL was conducted in people with COPD using a (objective) performance-based protocol. The search was conducted in the following databases: Pubmed, EMBASE, Cochrane Library, PEDro, CINAHL and LILACS. Furthermore, hand searches were conducted. Expert commentary: Up to this moment, only three protocols had measurement properties described: the Glittre ADL Test, the Monitored Functional Task Evaluation and the Londrina ADL Protocol were shown to be valid and reliable whereas only the Glittre ADL Test was shown to be responsive to change after pulmonary rehabilitation. These protocols can be used in laboratory settings and clinical practice to evaluate ADL performance in people with COPD, although there is need for more in-depth information on their validity, reliability and especially responsiveness due to the growing interest in the accurate assessment of ADL performance in this population.

Feasibility of dietary assessment methods, other tools and procedures for a pan-European food consumption survey among infants, toddlers and children.

PubMed

Ocké, Marga; Brants, Henny; Dofkova, Marcela; Freisling, Heinz; van Rossum, Caroline; Ruprich, Jiri; Slimani, Nadia; Temme, Elisabeth; Trolle, Ellen; Vandevijvere, Stefanie; Huybrechts, Inge; de Boer, Evelien

2015-08-01

To test the feasibility of tools and procedures for a pan-European food consumption survey among children 0-10 years and to recommend one of two tested dietary assessment methods. Two pilot studies including 378 children were conducted in Belgium and the Czech Republic in the Pilot studies for Assessment of Nutrient intake and food Consumption among Kids in Europe. One protocol included a 3-day food diary which was checked with a parent, and data were entered afterwards using EPIC-Soft. The alternative protocol consisted of two non-consecutive 1-day food diaries followed by EPIC-Soft completion interviews. Both protocols included general and food propensity questionnaires and anthropometric measurements. The protocols were compared using evaluation questionnaires among the participating parents and study personnel. The parents found the questionnaires and instructions for filling in the food diaries understandable. Food description and food quantification was evaluated as problematic by 29 and 15% of the participants for the 3-day diaries versus 15 and 12% for the 1-day diaries. The protocol with 1-day food diaries was evaluated as less burdensome by the parents and logistically more challenging by the interviewers. Both dietary assessment methods with related tools and administration protocols were evaluated as feasible. The administration protocol with two 1-day food diaries with completion interviews offers more advantages for the future pan-European survey in children 0-10 years. The positive evaluation of feasibility of tools and materials is an important step towards harmonised food consumption data at European level among the younger age groups.

Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)--a realist synthesis.

PubMed

Maidment, Ian; Booth, Andrew; Mullan, Judy; McKeown, Jane; Bailey, Sylvia; Wong, Geoffrey

2017-07-03

Medication-related adverse events have been estimated to be responsible for 5700 deaths and cost the UK £750 million annually. This burden falls disproportionately on older people. Outcomes from interventions to optimise medication management are caused by multiple context-sensitive mechanisms. The MEdication Management in Older people: REalist Approaches BAsed on Literature and Evaluation (MEMORABLE) project uses realist synthesis to understand how, why, for whom and in what context interventions, to improve medication management in older people on complex medication regimes residing in the community, work. This realist synthesis uses secondary data and primary data from interviews to develop the programme theory. A realist logic of analysis will synthesise data both within and across the two data sources to inform the design of a complex intervention(s) to help improve medication management in older people. 1. Literature review The review (using realist synthesis) contains five stages to develop an initial programme theory to understand why processes are more or less successful and under which situations: focussing of the research question; developing the initial programme theory; developing the search strategy; selection and appraisal based on relevance and rigour; and data analysis/synthesis to develop and refine the programme theory and context, intervention and mechanism configurations. 2. Realist interviews Realist interviews will explore and refine our understanding of the programme theory developed from the realist synthesis. Up to 30 older people and their informal carers (15 older people with multi-morbidity, 10 informal carers and 5 older people with dementia), and 20 care staff will be interviewed. 3. Developing framework for the intervention(s) Data from the realist synthesis and interviews will be used to refine the programme theory for the intervention(s) to identify: the mechanisms that need to be 'triggered', and the contexts related to these mechanisms. Intervention strategies that change the contexts so the mechanisms are triggered to produce desired outcomes will be developed. Feedback on these strategies will be obtained. This realist synthesis aims to develop a framework (underpinned by our programme theory) for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens. PROSPERO CRD42016043506.

Potential of dynamic spectrum allocation in LTE macro networks

NASA Astrophysics Data System (ADS)

Hoffmann, H.; Ramachandra, P.; Kovács, I. Z.; Jorguseski, L.; Gunnarsson, F.; Kürner, T.

2015-11-01

In recent years Mobile Network Operators (MNOs) worldwide are extensively deploying LTE networks in different spectrum bands and utilising different bandwidth configurations. Initially, the deployment is coverage oriented with macro cells using the lower LTE spectrum bands. As the offered traffic (i.e. the requested traffic from the users) increases the LTE deployment evolves with macro cells expanded with additional capacity boosting LTE carriers in higher frequency bands complemented with micro or small cells in traffic hotspot areas. For MNOs it is crucial to use the LTE spectrum assets, as well as the installed network infrastructure, in the most cost efficient way. The dynamic spectrum allocation (DSA) aims at (de)activating the available LTE frequency carriers according to the temporal and spatial traffic variations in order to increase the overall LTE system performance in terms of total network capacity by reducing the interference. This paper evaluates the DSA potential of achieving the envisaged performance improvement and identifying in which system and traffic conditions the DSA should be deployed. A self-optimised network (SON) DSA algorithm is also proposed and evaluated. The evaluations have been carried out in a hexagonal and a realistic site-specific urban macro layout assuming a central traffic hotspot area surrounded with an area of lower traffic with a total size of approximately 8 × 8 km2. The results show that up to 47 % and up to 40 % possible DSA gains are achievable with regards to the carried system load (i.e. used resources) for homogenous traffic distribution with hexagonal layout and for realistic site-specific urban macro layout, respectively. The SON DSA algorithm evaluation in a realistic site-specific urban macro cell deployment scenario including realistic non-uniform spatial traffic distribution shows insignificant cell throughput (i.e. served traffic) performance gains. Nevertheless, in the SON DSA investigations, a gain of up to 25 % has been observed when analysing the resource utilisation in the non-hotspot cells.

[Enhanced Recovery after Surgery from Theory to Practice
What do We Need to Do?

PubMed

Che, Guowei; Liu, Lunxu; Zhou, Qinghua

2017-04-20

Enhanced recovery after surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes, shorter length of hospital stay and cost savings. But the current ERAS either by application of breadth or depth is not enough, why? The main reason is the lack of "operability, evaluation, repetition" ERAS protocol and suitable for clinical extensive application protocol. How to form the clinical available protocol? Operational mainly refers to the clinical scheme is simple and feasible, and protocol compliance is good; Evaluate refers to the methods used before, during and after are the objective evaluation criteria and plan; Repeatable is clinical scheme repeatability in the process of single or multiple center.

Cognitive therapy for performance anxiety.

PubMed

Rodebaugh, Thomas L; Chambless, Dianne L

2004-08-01

We present and illustrate the major components of cognitive therapy for performance anxiety, focusing on the performance fears of a client treated with a protocol designed for social phobia. The basic supposition of cognitive theory is that a client's thoughts and beliefs about situations maintain distressing feelings, such as anxiety. Changing these beliefs involves detection and disputation of anxiety-provoking thoughts, as well as testing of these thoughts through exposure to feared situations. Through a process of identifying existing beliefs about performance situations and challenging these beliefs, clients can gain a more realistic and less anxiety-producing perspective on performance tasks. Specific techniques, along with common difficulties and potential solutions, are presented in a detailed case study. Copyright 2004 Wiley Periodicals, Inc.

Phonon Networks with Silicon-Vacancy Centers in Diamond Waveguides

NASA Astrophysics Data System (ADS)

Lemonde, M.-A.; Meesala, S.; Sipahigil, A.; Schuetz, M. J. A.; Lukin, M. D.; Loncar, M.; Rabl, P.

2018-05-01

We propose and analyze a novel realization of a solid-state quantum network, where separated silicon-vacancy centers are coupled via the phonon modes of a quasi-one-dimensional diamond waveguide. In our approach, quantum states encoded in long-lived electronic spin states can be converted into propagating phonon wave packets and be reabsorbed efficiently by a distant defect center. Our analysis shows that under realistic conditions, this approach enables the implementation of high-fidelity, scalable quantum communication protocols within chip-scale spin-qubit networks. Apart from quantum information processing, this setup constitutes a novel waveguide QED platform, where strong-coupling effects between solid-state defects and individual propagating phonons can be explored at the quantum level.

A Method for Decentralised Optimisation in Networks

NASA Astrophysics Data System (ADS)

Saramäki, Jari

2005-06-01

We outline a method for distributed Monte Carlo optimisation of computational problems in networks of agents, such as peer-to-peer networks of computers. The optimisation and messaging procedures are inspired by gossip protocols and epidemic data dissemination, and are decentralised, i.e. no central overseer is required. In the outlined method, each agent follows simple local rules and seeks for better solutions to the optimisation problem by Monte Carlo trials, as well as by querying other agents in its local neighbourhood. With proper network topology, good solutions spread rapidly through the network for further improvement. Furthermore, the system retains its functionality even in realistic settings where agents are randomly switched on and off.

Phonon Networks with Silicon-Vacancy Centers in Diamond Waveguides.

PubMed

Lemonde, M-A; Meesala, S; Sipahigil, A; Schuetz, M J A; Lukin, M D; Loncar, M; Rabl, P

2018-05-25

We propose and analyze a novel realization of a solid-state quantum network, where separated silicon-vacancy centers are coupled via the phonon modes of a quasi-one-dimensional diamond waveguide. In our approach, quantum states encoded in long-lived electronic spin states can be converted into propagating phonon wave packets and be reabsorbed efficiently by a distant defect center. Our analysis shows that under realistic conditions, this approach enables the implementation of high-fidelity, scalable quantum communication protocols within chip-scale spin-qubit networks. Apart from quantum information processing, this setup constitutes a novel waveguide QED platform, where strong-coupling effects between solid-state defects and individual propagating phonons can be explored at the quantum level.

Evolution equation for quantum entanglement

NASA Astrophysics Data System (ADS)

Konrad, Thomas; de Melo, Fernando; Tiersch, Markus; Kasztelan, Christian; Aragão, Adriano; Buchleitner, Andreas

2008-02-01

Quantum information technology largely relies on a precious and fragile resource, quantum entanglement, a highly non-trivial manifestation of the coherent superposition of states of composite quantum systems. However, our knowledge of the time evolution of this resource under realistic conditions-that is, when corrupted by environment-induced decoherence-is so far limited, and general statements on entanglement dynamics in open systems are scarce. Here we prove a simple and general factorization law for quantum systems shared by two parties, which describes the time evolution of entanglement on passage of either component through an arbitrary noisy channel. The robustness of entanglement-based quantum information processing protocols is thus easily and fully characterized by a single quantity.

Apples to apples: the origin and magnitude of differences in asbestos cancer risk estimates derived using varying protocols.

PubMed

Berman, D Wayne

2011-08-01

Given that new protocols for assessing asbestos-related cancer risk have recently been published, questions arise concerning how they compare to the "IRIS" protocol currently used by regulators. The newest protocols incorporate findings from 20 additional years of literature. Thus, differences between the IRIS and newer Berman and Crump protocols are examined to evaluate whether these protocols can be reconciled. Risks estimated by applying these protocols to real exposure data from both laboratory and field studies are also compared to assess the relative health protectiveness of each protocol. The reliability of risks estimated using the two protocols are compared by evaluating the degree with which each potentially reproduces the known epidemiology study risks. Results indicate that the IRIS and Berman and Crump protocols can be reconciled; while environment-specific variation within fiber type is apparently due primarily to size effects (not addressed by IRIS), the 10-fold (average) difference between amphibole asbestos risks estimated using each protocol is attributable to an arbitrary selection of the lowest of available mesothelioma potency factors in the IRIS protocol. Thus, the IRIS protocol may substantially underestimate risk when exposure is primarily to amphibole asbestos. Moreover, while the Berman and Crump protocol is more reliable than the IRIS protocol overall (especially for predicting amphibole risk), evidence is presented suggesting a new fiber-size-related adjustment to the Berman and Crump protocol may ultimately succeed in reconciling the entire epidemiology database. However, additional data need to be developed before the performance of the adjusted protocol can be fully validated. © 2011 Society for Risk Analysis.

Chapter 19: HVAC Controls (DDC/EMS/BAS) Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W.; Romberger, Jeff

The HVAC Controls Evaluation Protocol is designed to address evaluation issues for direct digital controls/energy management systems/building automation systems (DDC/EMS/BAS) that are installed to control heating, ventilation, and air-conditioning (HVAC) equipment in commercial and institutional buildings. (This chapter refers to the DDC/EMS/BAS measure as HVAC controls.) This protocol may also be applicable to industrial facilities such as clean rooms and labs, which have either significant HVAC equipment or spaces requiring special environmental conditions.

Automating Security Protocol Analysis

DTIC Science & Technology

2004-03-01

language that allows easy representation of pattern interaction. Using CSP, Lowe tests whether a protocol achieves authentication. In the case of...only to correctly code whatever protocol they intend to evaluate. The tool, OCaml 3.04 [1], translates the protocol into Horn clauses and then...model protocol transactions. One example of automated modeling software is Maude [19]. Maude was the intended language for this research, but Java

Clinical Simulation: A Protocol for Evaluation of Mobile Technology.

PubMed

Mather, Carey; Jensen, Sanne; Cummings, Elizabeth

2017-01-01

For mobile technology to be accepted at point of care in healthcare environments there is a need to demonstrate benefits whilst ameliorating the risks and challenges. To provide a standardised approach to evaluation of mobile technology a simulation protocol was developed to provide guidance for its use in healthcare environments. Simulated conditions provide the opportunity to assess intended and unintended consequences and identify potential workarounds when using technology. The protocol can also be used to demonstrate the importance of the development of digital professionalism by end-users prior to students entering the clinical practice setting. The mobile technology protocol was adapted from a health information systems protocol developed and used at the ITX Lab, Denmark for use in other simulation laboratories. Use case scenarios were developed to enable evaluation of mobile technology for mobile learning of nurses, nurse supervisors, students and patients. The scenarios can be used in a range of simulated environments including hospital bedside, outpatient clinic or community settings. A case study exemplar of a nurse and patient is included to demonstrate how the mobile technology protocol can be applied.

Optimization of 64-MDCT urography: effect of dual-phase imaging with furosemide on collecting system opacification and radiation dose.

PubMed

Portnoy, Orith; Guranda, Larisa; Apter, Sara; Eiss, David; Amitai, Marianne Michal; Konen, Eli

2011-11-01

The purpose of this study was to compare opacification of the urinary collecting system and radiation dose associated with three-phase 64-MDCT urographic protocols and those associated with a split-bolus dual-phase protocol including furosemide. Images from 150 CT urographic examinations performed with three scanning protocols were retrospectively evaluated. Group A consisted of 50 sequentially registered patients who underwent a three-phase protocol with saline infusion. Group B consisted of 50 sequentially registered patients who underwent a reduced-radiation three-phase protocol with saline. Group C consisted of 50 sequentially registered patients who underwent a dual-phase split-bolus protocol that included a low-dose furosemide injection. Opacification of the urinary collecting system was evaluated with segmental binary scoring. Contrast artifacts were evaluated, and radiation doses were recorded. Results were compared by analysis of variance. A significant reduction in mean effective radiation dose was found between groups A and B (p < 0.001) and between groups B and C (p < 0.001), resulting in 65% reduction between groups A and C (p < 0.001). This reduction did not significantly affect opacification score in any of the 12 urinary segments (p = 0.079). In addition, dense contrast artifacts overlying the renal parenchyma observed with the three-phase protocols (groups A and B) were avoided with the dual-phase protocol (group C) (p < 0.001). A dual-phase protocol with furosemide injection is the preferable technique for CT urography. In comparison with commonly used three-phase protocols, the dual-phase protocol significantly reduces radiation exposure dose without reduction in image quality.

Evaluation of Protocol Uniformity Concerning Laparoscopic Cholecystectomy in The Netherlands

PubMed Central

Goossens, Richard H. M.; van Eijk, Daan J.; Lange, Johan F.

2008-01-01

Background Iatrogenic bile duct injury remains a current complication of laparoscopic cholecystectomy. One uniform and standardized protocol, based on the “critical view of safety” concept of Strasberg, should reduce the incidence of this complication. Furthermore, owing to the rapid development of minimally invasive surgery, technicians are becoming more frequently involved. To improve communication between the operating team and technicians, standardized actions should also be defined. The aim of this study was to compare existing protocols for laparoscopic cholecystectomy from various Dutch hospitals. Methods Fifteen Dutch hospitals were contacted for evaluation of their protocols for laparoscopic cholecystectomy. All evaluated protocols were divided into six steps and were compared accordingly. Results In total, 13 hospitals responded—5 academic hospitals, 5 teaching hospitals, 3 community hospitals—of which 10 protocols were usable for comparison. Concerning the trocar positions, only minor differences were found. The concept of “critical view of safety” was represented in just one protocol. Furthermore, the order of clipping and cutting the cystic artery and duct differed. Descriptions of instruments and apparatus were also inconsistent. Conclusions Present protocols differ too much to define a universal procedure among surgeons in The Netherlands. The authors propose one (inter)national standardized protocol, including standardized actions. This uniform standardized protocol has to be officially released and recommended by national scientific associations (e.g., the Dutch Society of Surgery) or international societies (e.g., European Association for Endoscopic Surgery and Society of American Gastrointestinal and Endoscopic Surgeons). The aim is to improve patient safety and professional communication, which are necessary for new developments. PMID:18224485

Evaluation of the use of automatic exposure control and automatic tube potential selection in low-dose cerebrospinal fluid shunt head CT.

PubMed

Wallace, Adam N; Vyhmeister, Ross; Bagade, Swapnil; Chatterjee, Arindam; Hicks, Brandon; Ramirez-Giraldo, Juan Carlos; McKinstry, Robert C

2015-06-01

Cerebrospinal fluid shunts are primarily used for the treatment of hydrocephalus. Shunt complications may necessitate multiple non-contrast head CT scans resulting in potentially high levels of radiation dose starting at an early age. A new head CT protocol using automatic exposure control and automated tube potential selection has been implemented at our institution to reduce radiation exposure. The purpose of this study was to evaluate the reduction in radiation dose achieved by this protocol compared with a protocol with fixed parameters. A retrospective sample of 60 non-contrast head CT scans assessing for cerebrospinal fluid shunt malfunction was identified, 30 of which were performed with each protocol. The radiation doses of the two protocols were compared using the volume CT dose index and dose length product. The diagnostic acceptability and quality of each scan were evaluated by three independent readers. The new protocol lowered the average volume CT dose index from 15.2 to 9.2 mGy representing a 39 % reduction (P < 0.01; 95 % CI 35-44 %) and lowered the dose length product from 259.5 to 151.2 mGy/cm representing a 42 % reduction (P < 0.01; 95 % CI 34-50 %). The new protocol produced diagnostically acceptable scans with comparable image quality to the fixed parameter protocol. A pediatric shunt non-contrast head CT protocol using automatic exposure control and automated tube potential selection reduced patient radiation dose compared with a fixed parameter protocol while producing diagnostic images of comparable quality.

Optimizing Equivalence-Based Instruction: Effects of Training Protocols on Equivalence Class Formation

ERIC Educational Resources Information Center

Fienup, Daniel M.; Wright, Nicole A.; Fields, Lanny

2015-01-01

Two experiments evaluated the effects of the simple-to-complex and simultaneous training protocols on the formation of academically relevant equivalence classes. The simple-to-complex protocol intersperses derived relations probes with training baseline relations. The simultaneous protocol conducts all training trials and test trials in separate…

Sample of Second Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Second grade classroom protocols collected within this volume are examples of the protocols developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

Sample of Fifth Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

ERIC Educational Resources Information Center

Tikunoff, William J.; And Others

Classroom protocols collected within this volume are examples of the protocols from grade 5 developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

The Cost-Income Compenent of Program Evaluation.

ERIC Educational Resources Information Center

Miner, Norris

Cost-income studies are designed to serve two functions in instructional program evaluation. First, they act as the indicator of the economic value of a program. This economic value in conjunction with the other educational values needed in program evaluation allow for the most realistic appraisal of program worth. Second, if the studies show a…

Mathematical modeling in realistic mathematics education

NASA Astrophysics Data System (ADS)

Riyanto, B.; Zulkardi; Putri, R. I. I.; Darmawijoyo

2017-12-01

The purpose of this paper is to produce Mathematical modelling in Realistics Mathematics Education of Junior High School. This study used development research consisting of 3 stages, namely analysis, design and evaluation. The success criteria of this study were obtained in the form of local instruction theory for school mathematical modelling learning which was valid and practical for students. The data were analyzed using descriptive analysis method as follows: (1) walk through, analysis based on the expert comments in the expert review to get Hypothetical Learning Trajectory for valid mathematical modelling learning; (2) analyzing the results of the review in one to one and small group to gain practicality. Based on the expert validation and students’ opinion and answers, the obtained mathematical modeling problem in Realistics Mathematics Education was valid and practical.

Radiation Dosimetry of Whole-Body Dual-Tracer 18F-FDG and 11C-Acetate PET/CT for Hepatocellular Carcinoma.

PubMed

Liu, Dan; Khong, Pek-Lan; Gao, Yiming; Mahmood, Usman; Quinn, Brian; St Germain, Jean; Xu, X George; Dauer, Lawrence T

2016-06-01

Combined whole-body dual-tracer ((18)F-FDG and (11)C-acetate) PET/CT is increasingly used for staging hepatocellular carcinoma, with only limited studies investigating the radiation dosimetry data of these scans. The aim of the study was to characterize the radiation dosimetry of combined whole-body dual-tracer PET/CT protocols. Consecutive adult patients with hepatocellular carcinoma who underwent whole-body dual-tracer PET/CT scans were retrospectively reviewed with institutional review board approval. OLINDA/EXM 1.1 was used to estimate patient-specific internal dose exposure in each organ. Biokinetic models for (18)F-FDG and (11)C-acetate as provided by ICRP (International Commission on Radiological Protection) publication 106 were used. Standard reference phantoms were modified to more closely represent patient-specific organ mass. With patient-specific parameters, organ equivalent doses from each CT series were estimated using VirtualDose. Dosimetry capabilities for tube current modulation protocols were applied by integrating with the latest anatomic realistic models. Effective dose was calculated using ICRP publication 103 tissue-weighting coefficients for adult male and female, respectively. Fourteen scans were evaluated (12 men, 2 women; mean age ± SD, 60 ± 19.48 y). The patient-specific effective dose from (18)F-FDG and (11)C-acetate was 6.08 ± 1.49 and 1.56 ± 0.47 mSv, respectively, for male patients and 6.62 ± 1.38 and 1.79 ± 0.12 mSV, respectively, for female patients. The patient-specific effective dose of the CT component, which comprised 2 noncontrast whole-body scans, to male and female patients was 21.20 ± 8.94 and 14.79 ± 3.35 mSv, respectively. Thus, the total effective doses of the combined whole-body dual-tracer PET/CT studies for male and female patients were 28.84 ± 10.18 and 23.19 ± 4.61 mSv, respectively. Patient-specific parameters allow for more accurate estimation of organ equivalent doses. Considering the substantial radiation dose incurred, judicious medical justification is required with every whole-body dual-tracer PET/CT referral. Although radiation risks may have less impact for the population with cancer because of their reduced life expectancy, the information is of interest and relevant for both justification, to evaluate risk/benefit, and protocol optimization. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Validation of a low dose simulation technique for computed tomography images.

PubMed

Muenzel, Daniela; Koehler, Thomas; Brown, Kevin; Zabić, Stanislav; Fingerle, Alexander A; Waldt, Simone; Bendik, Edgar; Zahel, Tina; Schneider, Armin; Dobritz, Martin; Rummeny, Ernst J; Noël, Peter B

2014-01-01

Evaluation of a new software tool for generation of simulated low-dose computed tomography (CT) images from an original higher dose scan. Original CT scan data (100 mAs, 80 mAs, 60 mAs, 40 mAs, 20 mAs, 10 mAs; 100 kV) of a swine were acquired (approved by the regional governmental commission for animal protection). Simulations of CT acquisition with a lower dose (simulated 10-80 mAs) were calculated using a low-dose simulation algorithm. The simulations were compared to the originals of the same dose level with regard to density values and image noise. Four radiologists assessed the realistic visual appearance of the simulated images. Image characteristics of simulated low dose scans were similar to the originals. Mean overall discrepancy of image noise and CT values was -1.2% (range -9% to 3.2%) and -0.2% (range -8.2% to 3.2%), respectively, p>0.05. Confidence intervals of discrepancies ranged between 0.9-10.2 HU (noise) and 1.9-13.4 HU (CT values), without significant differences (p>0.05). Subjective observer evaluation of image appearance showed no visually detectable difference. Simulated low dose images showed excellent agreement with the originals concerning image noise, CT density values, and subjective assessment of the visual appearance of the simulated images. An authentic low-dose simulation opens up opportunity with regard to staff education, protocol optimization and introduction of new techniques.

Development of a Test Protocol for Spacecraft Post-Fire Atmospheric Cleanup and Monitoring

NASA Technical Reports Server (NTRS)

Zuniga, David; Hornung, Steven D.; Haas, Jon P.; Graf, John C.

2009-01-01

Detecting and extinguishing fires, along with post-fire atmospheric cleaning and monitoring, are vital components of a spacecraft fire response system. Preliminary efforts focused on the technology evaluation of these systems under realistic conditions are described in this paper. While the primary objective of testing is to determine a smoke mitigation filter s performance, supplemental evaluations measuring the smoke-filled chamber handheld commercial off-the-shelf (COTS) atmospheric monitoring devices (combustion product monitors) are also conducted. The test chamber consists of a 1.4 cubic meter (50 cu. ft.) volume containing a smoke generator. The fuel used to generate the smoke is a mixture of polymers in quantities representative of materials involved in a circuit board fire as a typical spacecraft fire. Two fire conditions were examined: no flame and flame. No flame events are produced by pyrolyzing the fuel mixture in a quartz tube furnace with forced ventilation to produce a white, lingering-type smoke. Flame events ignite the smoke at the outlet of the tube furnace producing combustion characterized by a less opaque smoke with black soot. Electrochemical sensor measurements showed carbon monoxide is a major indicator of each fire. Acid gas measurements were recorded, but cross interferents are currently uncharacterized. Electrochemical sensor measurements and sample acquisition techniques from photoacoustic sensors are being improved. Overall, this research shows fire characterization using traditional analytical chemistry techniques is required to verify measurements recorded using COTS atmospheric monitoring devices.

Pilot Study of Sublethal Effects on Fish of Pesticides Currently Used and Proposed for Use on Maine Blueberries

USGS Publications Warehouse

Elskus, Adria A.

2007-01-01

Blueberry pesticides have been detected consistently in some Down East Maine rivers, yet little is known about the sublethal effects of these pesticides on fish early life stages. The Maine blueberry industry is proposing to replace the insecticide ImidanTM (active ingredient phosmet) and the herbicide VelparTM (active ingredient hexazinone), two of the pesticides found in these rivers, with candidate alternatives SpinTor TM (active ingredient spinosad) and Callistso TM (active ingredient mesotrione). Our objective is to evaluate potential sublethal effects of these four formulations before the industry adopts the two candidate alternatives. We exposed zebrafish (Danio rerio) early life stages, from fertilization through larval swim-up, to a range of pesticide concentrations and evaluated their response relative to untreated controls. In this report we provide preliminary data on immune function as well as on parameters in addition to those originally proposed: development and performance fitness. We also provide information on our progress towards optimizing chemical protocols for analyzing the concentration of active ingredient in each of our formulation dosing solutions, another new parameter we added to those originally proposed. Preliminary results indicate that at environmentally realistic concentrations, these pesticides may have no significant effect on innate immunity, development rate or behavior (spontaneous swimming), however further replication is needed to confirm these initial findings. We have also observed some degree of developmental abnormalities in both pesticide-treated and control zebrafish embryos; however, additional replication is underway to determine if these groups differ significantly.

Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W.; Carlson, Stephen

This Commercial and Industrial Lighting Controls Evaluation Protocol (the protocol) describes methods to account for energy savings resulting from programmatic installation of lighting control equipment in large populations of commercial, industrial, government, institutional, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. When lighting controls are installed in conjunction with a lighting retrofit project, the lighting control savings must be calculated parametrically with the lighting retrofit project so savings are not double counted.

Feasibility and limitations of the round robin test for assessment of in vitro chondrogenesis evaluation protocol in a tissue-engineered medical product.

PubMed

Yokoi, Masako; Hattori, Koji; Narikawa, Koichi; Ohgushi, Hajime; Tadokoro, Mika; Hoshi, Kazuto; Takato, Tsuyoshi; Myoui, Akira; Nanno, Katsuhiko; Kato, Yukio; Kanawa, Masami; Sugawara, Katsura; Kobo, Tomoko; Ushida, Takashi

2012-07-01

Tissue-engineered medical products (TEMPs) should be evaluated before implantation. Therefore, it is indispensable to establish evaluation protocols in regenerative medicine. Whether or not such evaluation protocols are reasonable is generally verified through a 'round robin' test. However, the round robin test for TEMPs intrinsically includes a deficiency, because 'identical' specimens can not be prepared for TEMPs. The aim of the study was to assess the feasibility and limitations of the round robin test for TEMPs by using a prepared evaluation protocol. We adopted tissue-engineered cartilage constructs as delivered specimens and a protocol of measuring sGAG content as an evaluation protocol proposed to ISO TC150/SC7, which is an invasive, but usually applied, method, although non-invasive methods are keenly required in evaluating TEMPs. The results showed that: (a) the coefficient of variation (CV) of the measured sGAG contents in intralaboratory tests was ~5% at most; (b) the CV of sGAG content in the scheme where each participating laboratory measured different constructs was comparable with that in the scheme where each participating laboratory measured one half of a construct along with the organizing laboratory; (c) the CV caused by factors other than the specimen was ~15%, comparable to that in reproducible experiments in biomedical fields. Based on these results, the study concludes that a round robin test for a TEMP could be valuable, under the condition that the delivered TEMPs are sufficiently reproducible so that the CV of the measured values is < 5% in the organizing laboratory. Copyright © 2011 John Wiley & Sons, Ltd.

Comparing Voice-Therapy and Vocal-Hygiene Treatments in Dysphonia Using a Limited Multidimensional Evaluation Protocol

ERIC Educational Resources Information Center

Rodriguez-Parra, Maria J.; Adrian, Jose A.; Casado, Juan C.

2011-01-01

Purpose: This study evaluates the effectiveness of two different programs of voice-treatment on a heterogeneous group of dysphonic speakers and the stability of therapeutic progress for longterm follow-up post-treatment period, using a limited multidimensional protocol of evaluation. Method: Forty-two participants with voice disorders were…

Adding Dimension to Evaluative Research Through the Use of Protocol Material.

ERIC Educational Resources Information Center

Tittle, Carol Kehr

A rationale and illustration of the use of original records or protocol materials in an evaluation research report are described. Records of school observations and audiotape transcripts were selected to represent the concepts or categories which were developed in the process of evaluation. These qualitative data were collected in a project which…

METHODS AND ANALYSES FOR IMPLEMENTING NATURAL ATTENUATION PROTOCOLS

EPA Science Inventory

Technical protocols for evaluating natural attenuation at petroleum hydrocarbon and chlorinated solvent contaminated sites specify the analysis of electron acceptors and metabolic by-products for identifying and quantifying natural attenuation processes. However, these protocols ...

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

PubMed

van der Roer, Nicole; van Tulder, Maurits; van Mechelen, Willem; de Vet, Henrica

2008-02-15

Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles. Two studies found a significant reduction in absenteeism for a graded activity program in occupational health care. This program has not yet been evaluated in a primary care physiotherapy setting. Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain. Eligible patients were randomized to either the protocol group or the guideline group. Outcome measures included functional status (Roland Morris Disability Questionnaire), pain intensity (11-point numerical rating scale), general perceived effect and quality of life (EuroQol-5D). Cost data were measured with cost diaries and included direct and indirect costs related to low back pain. After 52 weeks, the direct health care costs were significantly higher for patients in the protocol group, largely due to the costs of the intervention. The mean difference in total costs amounted to [Euro sign] 233 (95% confidence interval: [Euro sign] -2.185; [Euro sign] 2.764). The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups. The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.

Optimal early active mobilisation protocol after extensor tendon repairs in zones V and VI: A systematic review of literature.

PubMed

Collocott, Shirley Jf; Kelly, Edel; Ellis, Richard F

2018-03-01

Early mobilisation protocols after repair of extensor tendons in zone V and VI provide better outcomes than immobilisation protocols. This systematic review investigated different early active mobilisation protocols used after extensor tendon repair in zone V and VI. The purpose was to determine whether any one early active mobilisation protocol provides superior results. An extensive literature search was conducted to identify articles investigating the outcomes of early active mobilisation protocols after extensor tendon repair in zone V and VI. Databases searched were AMED, Embase, Medline, Cochrane and CINAHL. Studies were included if they involved participants with extensor tendon repairs in zone V and VI in digits 2-5 and described a post-operative rehabilitation protocol which allowed early active metacarpophalangeal joint extension. Study designs included were randomised controlled trials, observational studies, cohort studies and case series. The Structured Effectiveness Quality Evaluation Scale was used to evaluate the methodological quality of the included studies. Twelve articles met the inclusion criteria. Two types of early active mobilisation protocols were identified: controlled active motion protocols and relative motion extension splinting protocols. Articles describing relative motion extension splinting protocols were more recent but of lower methodological quality than those describing controlled active motion protocols. Participants treated with controlled active motion and relative motion extension splinting protocols had similar range of motion outcomes, but those in relative motion extension splinting groups returned to work earlier. The evidence reviewed suggested that relative motion extension splinting protocols may allow an earlier return to function than controlled active motion protocols without a greater risk of complication.

Alcohol, Drugs and Driving: Implications for Evaluating Driver Impairment

PubMed Central

Brown, Timothy; Milavetz, Gary; Murry, Daryl J.

2013-01-01

Impaired driving is a significant traffic safety problem, and alcohol and drugs taken before driving contribute substantially to this problem. With the increase in use of prescription medication and the decriminalization of some drugs, it has become increasingly important to understand the manifestation of driver impairment. Building upon previous alcohol research conducted at the National Advanced Driving Simulator (NADS), this study enrolled commercial bus drivers to evaluate the effect of triazolam on driving performance to assess difference between placebo, 0.125, and 0.25 mg doses in a randomized and double-blind design. On each of three randomized visits, subjects drove a simulator scenario that had previously been used to demonstrate effects of alcohol on driving performance. Plasma triazolam levels were obtained before the simulator drive. The protocol included participants receiving study medication and placebo over a 3-week period of time one to two weeks apart. The simulator drives used for this analysis occurred approximately 140 minutes after dosing—after the subjects had completed four bus simulator drives and neuropsychological tests over a 2-hour period of time surrounding dosing. The driving scenario contained representative situations on three types of roadways (urban, freeway, and rural) under nighttime driving conditions. Lane keeping performance (ability to drive straight in the lane) under the three doses of triazolam demonstrates that at the 0.25 mg dose, statistically significant effects on performance are observed, but no effects are found at the 0.125 mg level when testing at this time period after dosing. This differs from the effects of alcohol, which shows impairing effects at a 0.05% blood alcohol concentration (BAC) and a greater effect at 0.10% BAC. These results demonstrate the importance of understanding how different types of drugs affect driving performance in realistic driving environments. Although some compounds may have an effect that correlates linearly to dosage, that is not always the case. An understanding of these differences and how they vary across driving tasks is essential to developing a robust evaluation protocol that can accurately describe the effects of a wide variety of drugs on driver impairment. This information can be used to reduce the risk of deleterious effects of therapeutic medications while ensuring their safe and beneficial use. PMID:24406943

In-situ liquid storage capacity measurement of subsurface wastewater absorption system products.

PubMed

Quisenberry, Virgil; Brown, Philip; Smith, Bill; Hallahan, Dennis F

2006-11-01

A method is presented for measuring the in-situ liquid storage capacity of subsurface wastewater infiltration system (SWIS) products. While these products vary in composition, geometry, and porosity, they all have the same function: to provide a conduit for the flow of effluent from a septic tank to and through a trench so that infiltration into the soil can occur. A functional SWIS must also provide temporary liquid storage. Storage is necessary for periods when discharge from the septic tank exceeds the infiltration rate of the soil. Storage is also important during times when the soil in and around the trench is saturated. Many states now have regulatory requirements pertaining to storage volume, and these requirements commonly establish the traditional gravel-pipe system as the standard for minimally acceptable volume. Raliable comparisons between various alternative products and gravel have been difficult or impossible, because there has been no standard method for measuring storage volume. Some products have been evaluated under realistic field conditions; others have been evaluated under theoretical or ideal conditions. The protocol developed by the study reported here can serve as a common, accurate basis for comparisons. A 3-foot-deep trench was excavated, and the bottom was leveled. Markers (nails or rods) were attached to the products to indicate the invert and full-volume heights. The products were then enclosed in plastic, placed in a trench, and covered with soil. A 4-inch-diameter pipe extended from the product to the surface to allow metered additions of water into the products and precise determinations when the systems had been filled to capacity. Four plastic chambers, three expanded polystyrene (ESP) products, two multipipe arrangements, and a standard gravel-pipe system were evaluated. The standard gravel-pipe system held 10.2 gal/ft Three of the four plastic chambers stored from 100 to 130 percent of what the standard system held. The multipipe systems held 80 and 90 percent of the standard. The ESP bundles held less than 75 percent of the standard, with the most commonly used configuration storing about 60 percent. The rigid products were found to store amounts that agreed with their companies' reported values. The ESP products retained less than company reported values. These differences illustrate the need for a standard protocol for measuring storage volume.

Altered Mental Status: Current Evidence-based Recommendations for Prehospital Care

PubMed Central

Sanello, Ashley; Mulkerin, William; Sporer, Karl A.; Brown, John F.; Koenig, Kristi L.; Rudnick, Eric M.; Salvucci, Angelo A.; Gilbert, Gregory H.

2018-01-01

Introduction In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the AMS protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were patient assessment, point-of-care tests, supplemental oxygen, use of standardized scoring, evaluating for causes of AMS, blood glucose evaluation, toxicological treatment, and pediatric evaluation and management. Results Protocols across 33 EMS agencies in California varied widely. All protocols call for a blood glucose check, 21 (64%) suggest treating adults at <60mg/dL, and half allow for the use of dextrose 10%. All the protocols recommend naloxone for signs of opioid overdose, but only 13 (39%) give specific parameters. Half the agencies (52%) recommend considering other toxicological causes of AMS, often by using the mnemonic AEIOU TIPS. Eight (24%) recommend a 12-lead electrocardiogram; others simply suggest cardiac monitoring. Fourteen (42%) advise supplemental oxygen as needed; only seven (21%) give specific parameters. In terms of considering various etiologies of AMS, 25 (76%) give instructions to consider trauma, 20 (61%) to consider stroke, and 18 (55%) to consider seizure. Twenty-three (70%) of the agencies have separate pediatric AMS protocols; others include pediatric considerations within the adult protocol. Conclusion Protocols for patients with AMS vary widely across the State of California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols. PMID:29760852

Protocol adherence and the ability to achieve target haemoglobin levels in haemodialysis patients.

PubMed

Chan, Kevin; Moran, John; Hlatky, Mark; Lafayette, Richard

2009-06-01

Anemia management remains complicated in patients with endstage renal disease on hemodialysis. We wished to evaluate the effect of protocol adherence to EPO and intravenous iron dosing on achieving the desired range of hemoglobin levels. A cohort of hemodialysis patients was studied to evaluate the rate of adherence to EPO and iron dosing protocols over a 5 month period. A database was completed to evaluate all known comorbidities, demographic factors, and facility issues that might affect hemoglobin levels. A logistic regression model was employed to evaluate the effect of adherence to the anemia protocols on the probability of achieving a hemoglobin level below, within or above the targeted range of 11-12.5 g/dl. Among 2114 patients, we found that adherence to both the EPO and iron dosing protocol resulted in the greatest probability of achieving the target hemoglobin range (56 +/- 5% in anemia protocol adherent patients versus 42 +/- 7% in non adherent patients). This was predominantly due to a lowered risk of having above target hemoglobin levels rather than below. The use of the anemia protocols was associated with lower rates of hospitalization (9 +/- 0.7 visits/100 months in adherent group vs 15 +/- 2 in non adherent group) and lower utilization of both EPO and intravenous iron. Furthermore, patients in the adherent groups had less variability of their hemoglobin levels month by month, at least as judged by standard deviation. Adherence to anemia protocols, as practiced in the dialysis units included in this cohort, may improve hemodialysis patients' ability to achieve target hemoglobin levels, and by avoiding above target hemoglobin values, lower drug utilization and reduce variability of hemoglobin levels.

Robust Multi-unit Auction Protocol against False-name Bids

NASA Astrophysics Data System (ADS)

Yokoo, Makoto; Sakurai, Yuko; Matsubara, Shigeo

This paper presents a new multi-unit auction protocol (IR protocol) that is robust against false-name bids. Internet auctions have become an integral part of Electronic Commerce and a promising field for applying agent and Artificial Intelligence technologies. Although the Internet provides an excellent infrastructure for executing auctions, the possibility of a new type of cheating called false-name bids has been pointed out. A false-name bid is a bid submitted under a fictitious name. A protocol called LDS has been developed for combinatorial auctions of multiple different items and has proven to be robust against false-name bids. Although we can modify the LDS protocol to handle multi-unit auctions, in which multiple units of an identical item are auctioned, the protocol is complicated and requires the auctioneer to carefully pre-determine the combination of bundles to obtain a high social surplus or revenue. For the auctioneer, our newly developed IR protocol is easier to use than the LDS, since the combination of bundles is automatically determined in a flexible manner according to the declared evaluation values of agents. The evaluation results show that the IR protocol can obtain a better social surplus than that obtained by the LDS protocol.

High performance MRI simulations of motion on multi-GPU systems.

PubMed

Xanthis, Christos G; Venetis, Ioannis E; Aletras, Anthony H

2014-07-04

MRI physics simulators have been developed in the past for optimizing imaging protocols and for training purposes. However, these simulators have only addressed motion within a limited scope. The purpose of this study was the incorporation of realistic motion, such as cardiac motion, respiratory motion and flow, within MRI simulations in a high performance multi-GPU environment. Three different motion models were introduced in the Magnetic Resonance Imaging SIMULator (MRISIMUL) of this study: cardiac motion, respiratory motion and flow. Simulation of a simple Gradient Echo pulse sequence and a CINE pulse sequence on the corresponding anatomical model was performed. Myocardial tagging was also investigated. In pulse sequence design, software crushers were introduced to accommodate the long execution times in order to avoid spurious echoes formation. The displacement of the anatomical model isochromats was calculated within the Graphics Processing Unit (GPU) kernel for every timestep of the pulse sequence. Experiments that would allow simulation of custom anatomical and motion models were also performed. Last, simulations of motion with MRISIMUL on single-node and multi-node multi-GPU systems were examined. Gradient Echo and CINE images of the three motion models were produced and motion-related artifacts were demonstrated. The temporal evolution of the contractility of the heart was presented through the application of myocardial tagging. Better simulation performance and image quality were presented through the introduction of software crushers without the need to further increase the computational load and GPU resources. Last, MRISIMUL demonstrated an almost linear scalable performance with the increasing number of available GPU cards, in both single-node and multi-node multi-GPU computer systems. MRISIMUL is the first MR physics simulator to have implemented motion with a 3D large computational load on a single computer multi-GPU configuration. The incorporation of realistic motion models, such as cardiac motion, respiratory motion and flow may benefit the design and optimization of existing or new MR pulse sequences, protocols and algorithms, which examine motion related MR applications.

Of taps and toilets: quasi-experimental protocol for evaluating community-demand-driven projects.

PubMed

Pattanayak, Subhrendu K; Poulos, Christine; Yang, Jui-Chen; Patil, Sumeet R; Wendland, Kelly J

2009-09-01

Sustainable and equitable access to safe water and adequate sanitation are widely acknowledged as vital, yet neglected, development goals. Water supply and sanitation (WSS) policies are justified because of the usual efficiency criteria, but also major equity concerns. Yet, to date there are few scientific impact evaluations showing that WSS policies are effective in delivering social welfare outcomes. This lack of an evaluation culture is partly because WSS policies are characterized by diverse mechanisms, broad goals and the increasing importance of decentralized delivery, and partly because programme administrators are unaware of appropriate methods. We describe a protocol for a quasi-experimental evaluation of a community-demand-driven programme for water and sanitation in rural India, which addresses several evaluation challenges. After briefly reviewing policy and implementation issues in the sector, we describe key features of our protocol, including control group identification, pre-post measurement, programme theory, sample sufficiency and robust indicators. At its core, our protocol proposes to combine propensity score matching and difference-in-difference estimation. We conclude by briefly summarizing how quasi-experimental impact evaluations can address key issues in WSS policy design and when such evaluations are needed.

Chapter 18: Variable Frequency Drive Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Romberger, Jeff

An adjustable-speed drive (ASD) includes all devices that vary the speed of a rotating load, including those that vary the motor speed and linkage devices that allow constant motor speed while varying the load speed. The Variable Frequency Drive Evaluation Protocol presented here addresses evaluation issues for variable-frequency drives (VFDs) installed on commercial and industrial motor-driven centrifugal fans and pumps for which torque varies with speed. Constant torque load applications, such as those for positive displacement pumps, are not covered by this protocol.

Psychological treatment of Comorbid Asthma and Panic Disorder: A Pilot Study

PubMed Central

Lehrer, Paul M.; Karavidas, Maria Katsamanis; Lu, Shou-En; Feldman, Jonathan; Kranitz, Linda; Abraham, Smrithy; Sanderson, William; Reynolds, Russ

2008-01-01

We evaluated two protocols for treating adults with comorbid asthma and panic disorder. The protocols included elements of Barlow’s “panic control therapy” and several asthma education programs, as well as modules designed to teach participants how to differentiate asthma and panic symptoms, and how to apply specific home management strategies for each. Fifty percent of subjects dropped out of a 14-session protocol by the eighth session; however, 83% of patients were retained in an eight-session protocol. Clinical results were mostly equivalent: significant decreases of >50% in panic symptoms, clinically significant decreases in asthma symptoms, improvement in asthma quality of life, and maintenance of clinical stability in asthma. Albuterol use decreased significantly in the 14-session protocol and at a borderline level in the 8-session protocol, while pulmonary function was maintained. A controlled evaluation of this procedure is warranted. PMID:17693054

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

Duan, Sisi; Li, Yun; Levitt, Karl N.

Consensus is a fundamental approach to implementing fault-tolerant services through replication where there exists a tradeoff between the cost and the resilience. For instance, Crash Fault Tolerant (CFT) protocols have a low cost but can only handle crash failures while Byzantine Fault Tolerant (BFT) protocols handle arbitrary failures but have a higher cost. Hybrid protocols enjoy the benefits of both high performance without failures and high resiliency under failures by switching among different subprotocols. However, it is challenging to determine which subprotocols should be used. We propose a moving target approach to switch among protocols according to the existing systemmore » and network vulnerability. At the core of our approach is a formalized cost model that evaluates the vulnerability and performance of consensus protocols based on real-time Intrusion Detection System (IDS) signals. Based on the evaluation results, we demonstrate that a safe, cheap, and unpredictable protocol is always used and a high IDS error rate can be tolerated.« less

Forest, Trees, Dynamics: Results from a Novel Wisconsin Card Sorting Test Variant Protocol for Studying Global-Local Attention and Complex Cognitive Processes

PubMed Central

Cowley, Benjamin; Lukander, Kristian

2016-01-01

Background: Recognition of objects and their context relies heavily on the integrated functioning of global and local visual processing. In a realistic setting such as work, this processing becomes a sustained activity, implying a consequent interaction with executive functions. Motivation: There have been many studies of either global-local attention or executive functions; however it is relatively novel to combine these processes to study a more ecological form of attention. We aim to explore the phenomenon of global-local processing during a task requiring sustained attention and working memory. Methods: We develop and test a novel protocol for global-local dissociation, with task structure including phases of divided (“rule search”) and selective (“rule found”) attention, based on the Wisconsin Card Sorting Task (WCST). We test it in a laboratory study with 25 participants, and report on behavior measures (physiological data was also gathered, but not reported here). We develop novel stimuli with more naturalistic levels of information and noise, based primarily on face photographs, with consequently more ecological validity. Results: We report behavioral results indicating that sustained difficulty when participants test their hypotheses impacts matching-task performance, and diminishes the global precedence effect. Results also show a dissociation between subjectively experienced difficulty and objective dimension of performance, and establish the internal validity of the protocol. Contribution: We contribute an advance in the state of the art for testing global-local attention processes in concert with complex cognition. With three results we establish a connection between global-local dissociation and aspects of complex cognition. Our protocol also improves ecological validity and opens options for testing additional interactions in future work. PMID:26941689

Active SAmpling Protocol (ASAP) to Optimize Individual Neurocognitive Hypothesis Testing: A BCI-Inspired Dynamic Experimental Design.

PubMed

Sanchez, Gaëtan; Lecaignard, Françoise; Otman, Anatole; Maby, Emmanuel; Mattout, Jérémie

2016-01-01

The relatively young field of Brain-Computer Interfaces has promoted the use of electrophysiology and neuroimaging in real-time. In the meantime, cognitive neuroscience studies, which make extensive use of functional exploration techniques, have evolved toward model-based experiments and fine hypothesis testing protocols. Although these two developments are mostly unrelated, we argue that, brought together, they may trigger an important shift in the way experimental paradigms are being designed, which should prove fruitful to both endeavors. This change simply consists in using real-time neuroimaging in order to optimize advanced neurocognitive hypothesis testing. We refer to this new approach as the instantiation of an Active SAmpling Protocol (ASAP). As opposed to classical (static) experimental protocols, ASAP implements online model comparison, enabling the optimization of design parameters (e.g., stimuli) during the course of data acquisition. This follows the well-known principle of sequential hypothesis testing. What is radically new, however, is our ability to perform online processing of the huge amount of complex data that brain imaging techniques provide. This is all the more relevant at a time when physiological and psychological processes are beginning to be approached using more realistic, generative models which may be difficult to tease apart empirically. Based upon Bayesian inference, ASAP proposes a generic and principled way to optimize experimental design adaptively. In this perspective paper, we summarize the main steps in ASAP. Using synthetic data we illustrate its superiority in selecting the right perceptual model compared to a classical design. Finally, we briefly discuss its future potential for basic and clinical neuroscience as well as some remaining challenges.

Inconsistent Strategies to Spin up Models in CMIP5: Implications for Ocean Biogeochemical Model Performance Assessment

NASA Technical Reports Server (NTRS)

Seferian, Roland; Gehlen, Marion; Bopp, Laurent; Resplandy, Laure; Orr, James C.; Marti, Olivier; Dunne, John P.; Christian, James R.; Doney, Scott C.; Ilyina, Tatiana;

Matching the Word Processor to the Job.

ERIC Educational Resources Information Center

Synder, Carin

1982-01-01

The intelligent purchase of school office equipment, specifically word processors, typewriters, calculators, and furniture, requires analysis of present needs and a realistic evaluation of future needs. (MLF)

Realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

PubMed Central

Mogre, Victor; Scherpbier, Albert J J A; Stevens, Fred; Aryee, Paul; Cherry, Mary Gemma; Dornan, Tim

2016-01-01

Objective To determine what, how, for whom, why, and in what circumstances educational interventions improve the delivery of nutrition care by doctors and other healthcare professionals work. Design Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched MEDLINE, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations. Results Over half of the 46 studies from which we extracted data originated from the USA. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included feeling competent, feeling confident and comfortable, having greater self-efficacy, being less inhibited by barriers in healthcare systems and feeling that nutrition care was accepted and recognised. Conclusions These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it. PMID:27797977

How can pharmacists develop patient-pharmacist communication skills? A realist review protocol.

PubMed

Kerr, Aisling; Strawbridge, Judith; Kelleher, Caroline; Mertens, Fien; Pype, Peter; Deveugele, Myriam; Pawlikowska, Teresa

2017-01-23

Good patient-pharmacist communication improves health outcomes. There is, however, room for improving pharmacists' communication skills. These develop through complex interactions during undergraduate pharmacy education, practice-based learning and continuing professional development. Research is needed to determine how best to approach teaching patient-pharmacist communication. The aim of the research is to understand how educational interventions develop patient-pharmacist interpersonal communication skills produce their effects. A realist review approach will be used to synthesise the literature to make sense of the complexities of educational interventions. Our review will iteratively progress through the various stages of clarifying scope, locating existing theories, searching for evidence, appraisal of papers, data extraction and synthesis. A scoping review revealed a number of substantive theories, which will be used to build an initial programme theory. This will be explored through available published evidence, which we will find by searching databases such as Medline, EMBASE, PsychInfo, ERIC, Scopus and Web of Science. Judgements will be made on the relevance and rigour of the retrieved literature and will be taken into consideration during analysis and synthesis. Synthesis, testing and refinement of the theories will describe and explain the links between contexts, mechanisms and outcomes of educational interventions for communication development in pharmacy. The realist review will provide an analysis of what works when, for whom, how and why, for educational interventions for interpersonal patient-pharmacist communication development. We will also explore barriers to successful communications training and acknowledge any limitations. Ultimately, we plan to provide pharmacy educators with evidence for how best to incorporate educational interventions for communications skills development into pharmacy curricula and for life-long learning opportunities for pharmacists.

3D visualization of movements can amplify motor cortex activation during subsequent motor imagery

PubMed Central

Sollfrank, Teresa; Hart, Daniel; Goodsell, Rachel; Foster, Jonathan; Tan, Tele

2015-01-01

A repetitive movement practice by motor imagery (MI) can influence motor cortical excitability in the electroencephalogram (EEG). This study investigated if a realistic visualization in 3D of upper and lower limb movements can amplify motor related potentials during subsequent MI. We hypothesized that a richer sensory visualization might be more effective during instrumental conditioning, resulting in a more pronounced event related desynchronization (ERD) of the upper alpha band (10–12 Hz) over the sensorimotor cortices thereby potentially improving MI based brain-computer interface (BCI) protocols for motor rehabilitation. The results show a strong increase of the characteristic patterns of ERD of the upper alpha band components for left and right limb MI present over the sensorimotor areas in both visualization conditions. Overall, significant differences were observed as a function of visualization modality (VM; 2D vs. 3D). The largest upper alpha band power decrease was obtained during MI after a 3-dimensional visualization. In total in 12 out of 20 tasks the end-user of the 3D visualization group showed an enhanced upper alpha ERD relative to 2D VM group, with statistical significance in nine tasks.With a realistic visualization of the limb movements, we tried to increase motor cortex activation during subsequent MI. The feedback and the feedback environment should be inherently motivating and relevant for the learner and should have an appeal of novelty, real-world relevance or aesthetic value (Ryan and Deci, 2000; Merrill, 2007). Realistic visual feedback, consistent with the participant’s MI, might be helpful for accomplishing successful MI and the use of such feedback may assist in making BCI a more natural interface for MI based BCI rehabilitation. PMID:26347642

Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong.

PubMed

Lam, Winsome; Dawson, Angela; Fowler, Cathrine

2015-04-01

To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level. Yearly, influenza epidemics seriously affect all age groups, particularly those with weakened immune systems, including children. Influenza is transmitted easily from person to person through droplet and direct contact. Maintaining personal hygiene, avoiding close contact with the infected person and proper hand washing are recommended as the most effective means of preventing the transmission of influenza. However, it is not clear what programme-related mechanisms and contexts are crucial to the successful delivery of interventions in the home. This study systematically reviewed published research studies to identify factors influencing the effective delivery of health promotion programmes targeting influenza in a household. Realist review. A realist review methodology was selected to examine what interventions are effective in preventing and managing influenza at the household level and in what circumstances. A structured search of the peer-reviewed primary research literature was undertaken using a defined search protocol. Eight studies were retrieved for the analysis. Mechanisms impacting on intervention delivery were identified, including timing of implementation, programme reach, organisational and healthcare worker involvement, mode and place of delivery, contact with infected person, health practice compliance and sustainability at home. These findings suggest contextual factors that could be identified through ecological approaches to health promotion that are crucial for policymakers to consider when designing interventions. The active involvement of community nurses through an integrated household visiting programme may help to better deliver family-based health promotion interventions to prevent illnesses such as influenza in children. © 2014 John Wiley & Sons Ltd.

3D visualization of movements can amplify motor cortex activation during subsequent motor imagery.

PubMed

Sollfrank, Teresa; Hart, Daniel; Goodsell, Rachel; Foster, Jonathan; Tan, Tele

2015-01-01

A repetitive movement practice by motor imagery (MI) can influence motor cortical excitability in the electroencephalogram (EEG). This study investigated if a realistic visualization in 3D of upper and lower limb movements can amplify motor related potentials during subsequent MI. We hypothesized that a richer sensory visualization might be more effective during instrumental conditioning, resulting in a more pronounced event related desynchronization (ERD) of the upper alpha band (10-12 Hz) over the sensorimotor cortices thereby potentially improving MI based brain-computer interface (BCI) protocols for motor rehabilitation. The results show a strong increase of the characteristic patterns of ERD of the upper alpha band components for left and right limb MI present over the sensorimotor areas in both visualization conditions. Overall, significant differences were observed as a function of visualization modality (VM; 2D vs. 3D). The largest upper alpha band power decrease was obtained during MI after a 3-dimensional visualization. In total in 12 out of 20 tasks the end-user of the 3D visualization group showed an enhanced upper alpha ERD relative to 2D VM group, with statistical significance in nine tasks.With a realistic visualization of the limb movements, we tried to increase motor cortex activation during subsequent MI. The feedback and the feedback environment should be inherently motivating and relevant for the learner and should have an appeal of novelty, real-world relevance or aesthetic value (Ryan and Deci, 2000; Merrill, 2007). Realistic visual feedback, consistent with the participant's MI, might be helpful for accomplishing successful MI and the use of such feedback may assist in making BCI a more natural interface for MI based BCI rehabilitation.

Early years interventions to improve child health and wellbeing: what works, for whom and in what circumstances? Protocol for a realist review.

PubMed

Coles, Emma; Cheyne, Helen; Daniel, Brigid

2015-06-06

Child health and wellbeing is influenced by multiple factors, all of which can impact on early childhood development. Adverse early life experiences can have lasting effects across the life course, sustaining inequalities and resulting in negative consequences for the health and wellbeing of individuals and society. The potential to influence future outcomes via early intervention is widely accepted; there are numerous policy initiatives, programmes and interventions clustered around the early years theme, resulting in a broad and disparate evidence base. Existing reviews have addressed the effectiveness of early years interventions, yet there is a knowledge gap regarding the mechanisms underlying why interventions work in given contexts. This realist review seeks to address the question 'what works, for whom and in what circumstances?' in terms of early years interventions to improve child health and wellbeing. The review will be conducted following Pawson's five-stage iterative realist methodology: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions and (5) disseminate findings. The reviewers will work with stakeholders in the early stages to refine the focus of the review, create a review framework and build programme theory. Searches for primary evidence will be conducted iteratively. Data will be extracted and tested against the programme theory. A review collaboration group will oversee the review process. The review will demonstrate how early years interventions do or do not work in different contexts and with what outcomes and effects. Review findings will be written up following the RAMESES guidelines and will be disseminated via a report, presentations and peer-reviewed publications. PROSPERO CRD42015017832.

Analysis of the Impact of Realistic Wind Size Parameter on the Delft3D Model

NASA Astrophysics Data System (ADS)

Washington, M. H.; Kumar, S.

2017-12-01

The wind size parameter, which is the distance from the center of the storm to the location of the maximum winds, is currently a constant in the Delft3D model. As a result, the Delft3D model's output prediction of the water levels during a storm surge are inaccurate compared to the observed data. To address these issues, an algorithm to calculate a realistic wind size parameter for a given hurricane was designed and implemented using the observed water-level data for Hurricane Matthew. A performance evaluation experiment was conducted to demonstrate the accuracy of the model's prediction of water levels using the realistic wind size input parameter compared to the default constant wind size parameter for Hurricane Matthew, with the water level data observed from October 4th, 2016 to October 9th, 2016 from National Oceanic and Atmospheric Administration (NOAA) as a baseline. The experimental results demonstrate that the Delft3D water level output for the realistic wind size parameter, compared to the default constant size parameter, matches more accurately with the NOAA reference water level data.

Heuristic Evaluation of E-Learning Courses: A Comparative Analysis of Two E-Learning Heuristic Sets

ERIC Educational Resources Information Center

Zaharias, Panagiotis; Koutsabasis, Panayiotis

2012-01-01

Purpose: The purpose of this paper is to discuss heuristic evaluation as a method for evaluating e-learning courses and applications and more specifically to investigate the applicability and empirical use of two customized e-learning heuristic protocols. Design/methodology/approach: Two representative e-learning heuristic protocols were chosen…

A Mandala of Faculty Development: Using Theory-Based Evaluation to Explore Contexts, Mechanisms and Outcomes

ERIC Educational Resources Information Center

Onyura, Betty; Ng, Stella L.; Baker, Lindsay R.; Lieff, Susan; Millar, Barbara-Ann; Mori, Brenda

2017-01-01

Demonstrating the impact of faculty development, is an increasingly mandated and ever elusive goal. Questions have been raised about the adequacy of current approaches. Here, we integrate realist and theory-driven evaluation approaches, to evaluate an intensive longitudinal program. Our aim is to elucidate how faculty development can work to…

Dual-energy CT for the characterization of urinary calculi: In vitro and in vivo evaluation of a low-dose scanning protocol.

PubMed

Thomas, C; Patschan, O; Ketelsen, D; Tsiflikas, I; Reimann, A; Brodoefel, H; Buchgeister, M; Nagele, U; Stenzl, A; Claussen, C; Kopp, A; Heuschmid, M; Schlemmer, H-P

2009-06-01

The efficiency and radiation dose of a low-dose dual-energy (DE) CT protocol for the evaluation of urinary calculus disease were evaluated. A low-dose dual-source DE-CT renal calculi protocol (140 kV, 46 mAs; 80 kV, 210 mAs) was derived from the single-energy (SE) CT protocol used in our institution for the detection of renal calculi (120 kV, 75 mAs). An Alderson-Rando phantom was equipped with thermoluminescence dosimeters and examined by CT with both protocols. The effective doses were calculated. Fifty-one patients with suspected or known urinary calculus disease underwent DE-CT. DE analysis was performed if calculi were detected using a dedicated software tool. Results were compared to chemical analysis after invasive calculus extraction. An effective dose of 3.43 mSv (male) and 5.30 mSv (female) was measured in the phantom for the DE protocol (vs. 3.17/4.57 mSv for the SE protocol). Urinary calculi were found in 34 patients; in 28 patients, calculi were removed and analyzed (23 patients with calcified calculi, three with uric acid calculi, one with 2,8-dihyxdroxyadenine-calculi, one patient with a mixed struvite calculus). DE analysis was able to distinguish between calcified and non-calcified calculi in all cases. In conclusion, dual-energy urinary calculus analysis is effective also with a low-dose protocol. The protocol tested in this study reliably identified calcified urinary calculi in vivo.

Safety and efficacy of an intensive insulin protocol in a burn-trauma intensive care unit.

PubMed

Cochran, Amalia; Davis, Lynn; Morris, Stephen E; Saffle, Jeffrey R

2008-01-01

Aggressive glycemic management in critically ill patients with acute burn injury or life-threatening soft-tissue infections has not been thoroughly evaluated. An intensive insulin protocol with target glucose values of less than 120 mg/dl was implemented in October 2005 in our regional Burn-Trauma intensive care unit. We reviewed our initial experience with this protocol to evaluate the safety and efficacy of aggressive glycemic control in these patient groups. Patients were placed on the intensive insulin protocol based upon the need for glycemic management during their hospitalization for burn or soft-tissue disease. Patient information prospectively collected while on protocol included all measured blood glucose values, total daily insulin use, and incidence of hypoglycemic episodes, defined as serum glucose <60 mg/dl. Thirty patients (17 burns, 13 soft-tissue infections) were placed on the intensive insulin protocol during the first 16 months of use. The mean daily blood glucose level for burn patients was 115.9 mg/dl and for soft-tissue disease patients was 119.5 mg/dl. There was a 5% incidence of hypoglycemic episodes per protocol day. All hypoglycemic episodes were treated by holding the insulin infusion, and no episode had known adverse effects. Hyperglycemia in critically ill patients with burns and extensive soft-tissue disease can be effectively managed with an insulin protocol that targets blood glucose values of less than 120 mg/dl with minimal incidence of hypoglycemia. A multicenter prospective randomized trial would provide the ideal forum for evaluating clinical outcome benefits of using an intensive insulin protocol.

A comparison of the use of bony anatomy and internal markers for offline verification and an evaluation of the potential benefit of online and offline verification protocols for prostate radiotherapy.

PubMed

McNair, Helen A; Hansen, Vibeke N; Parker, Christopher C; Evans, Phil M; Norman, Andrew; Miles, Elizabeth; Harris, Emma J; Del-Acroix, Louise; Smith, Elizabeth; Keane, Richard; Khoo, Vincent S; Thompson, Alan C; Dearnaley, David P

2008-05-01

To evaluate the utility of intraprostatic markers in the treatment verification of prostate cancer radiotherapy. Specific aims were: to compare the effectiveness of offline correction protocols, either using gold markers or bony anatomy; to estimate the potential benefit of online correction protocol's using gold markers; to determine the presence and effect of intrafraction motion. Thirty patients with three gold markers inserted had pretreatment and posttreatment images acquired and were treated using an offline correction protocol and gold markers. Retrospectively, an offline protocol was applied using bony anatomy and an online protocol using gold markers. The systematic errors were reduced from 1.3, 1.9, and 2.5 mm to 1.1, 1.1, and 1.5 mm in the right-left (RL), superoinferior (SI), and anteroposterior (AP) directions, respectively, using the offline correction protocol and gold markers instead of bony anatomy. The subsequent decrease in margins was 1.7, 3.3, and 4 mm in the RL, SI, and AP directions, respectively. An offline correction protocol combined with an online correction protocol in the first four fractions reduced random errors further to 0.9, 1.1, and 1.0 mm in the RL, SI, and AP directions, respectively. A daily online protocol reduced all errors to <1 mm. Intrafraction motion had greater impact on the effectiveness of the online protocol than the offline protocols. An offline protocol using gold markers is effective in reducing the systematic error. The value of online protocols is reduced by intrafraction motion.

An evaluation of the hemiplegic subject based on the Bobath approach. Part II: The evaluation protocol.

PubMed

Corriveau, H; Guarna, F; Dutil, E; Riley, E; Arsenault, A B; Drouin, G

1988-01-01

A protocol of evaluation of the hemiplegic patient based on the Bobath approach to treatment is presented. Six parameters are evaluated: sensorium, muscle tone, reflex activity, active movement, postural reactions and pain. The first and last of these are included because of their possible effects on the motor recovery process of the hemiplegic patient. The other four are directly borrowed from the Bobath modality of treatment. For each of these parameters, the procedures are given for its evaluation along with its respective rating scales. These scales are of an ordinal nature ranging from 0 to 3. It is suggested that this new evaluation protocol is fully compatible with the therapeutic modality developed by Bobath and as well is adequate to quantify patient progress in the principle aspects treated by this well used rehabilitation approach.

Tiered protocol implementation improves treatment of hypoglycaemia in a neurosciences critical care and surgical intensive care unit.

PubMed

Van Berkel, Megan A; MacDermott, Jennifer; Dungan, Kathleen M; Cook, Charles H; Murphy, Claire V

2017-12-01

Although studies demonstrate techniques to limit hypoglycaemia in critically ill patients, there are limited data supporting methods to improve management of existing hypoglycaemia. Assess the impact and sustainability of a computerised, three tiered, nurse driven protocol for hypoglycaemia treatment. Retrospective pre and post protocol study. Neurosciences and surgical intensive care units at a tertiary academic medical centre. Patients with a hypoglycaemic episode were included during a pre-protocol or post-protocol implementation period. An additional six-month cohort was evaluated to assess sustainability. Fifty-four patients were included for evaluation (35 pre- and 19 post-protocol); 122 patients were included in the sustainability cohort. Hypoglycaemia treatment significantly improved in the post-protocol cohort (20% vs. 52.6%, p=0.014); with additional improvement to 79.5% in the sustainability cohort. Time to follow-up blood glucose was decreased after treatment from 122 [Q1-Q3: 46-242] minutes pre-protocol to 25 [Q1-Q3: 9-48] minutes post protocol (p<0.0001). This reduction was maintained in the sustainability cohort [median of 29min (Q1-Q3: 20-51)]. Implementation of a nurse-driven, three-tiered protocol for treatment of hypoglyacemia significantly improved treatment rates, as well as reduced time to recheck blood glucose measurement. These benefits were sustained during a six-month period after protocol implementation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using simulated fluorescence cell micrographs for the evaluation of cell image segmentation algorithms.

PubMed

Wiesmann, Veit; Bergler, Matthias; Palmisano, Ralf; Prinzen, Martin; Franz, Daniela; Wittenberg, Thomas

2017-03-18

Manual assessment and evaluation of fluorescent micrograph cell experiments is time-consuming and tedious. Automated segmentation pipelines can ensure efficient and reproducible evaluation and analysis with constant high quality for all images of an experiment. Such cell segmentation approaches are usually validated and rated in comparison to manually annotated micrographs. Nevertheless, manual annotations are prone to errors and display inter- and intra-observer variability which influence the validation results of automated cell segmentation pipelines. We present a new approach to simulate fluorescent cell micrographs that provides an objective ground truth for the validation of cell segmentation methods. The cell simulation was evaluated twofold: (1) An expert observer study shows that the proposed approach generates realistic fluorescent cell micrograph simulations. (2) An automated segmentation pipeline on the simulated fluorescent cell micrographs reproduces segmentation performances of that pipeline on real fluorescent cell micrographs. The proposed simulation approach produces realistic fluorescent cell micrographs with corresponding ground truth. The simulated data is suited to evaluate image segmentation pipelines more efficiently and reproducibly than it is possible on manually annotated real micrographs.

Application and Evaluation of MODIS LAI, FPAR, and Albedo ...

EPA Pesticide Factsheets

MODIS vegetation and albedo products provide a more realistic representation of surface conditions for input to the WRF/CMAQ modeling system. However, the initial evaluation of ingesting MODIS data into the system showed mixed results, with increased bias and error for 2-m temperature and reduced bias and error for 2-m mixing ratio. Recently, the WRF/CMAQ land surface and boundary laywer processes have been updated. In this study, MODIS vegetation and albedo data are input to the updated WRF/CMAQ meteorology and air quality simulations for 2006 over a North American (NA) 12-km domain. The evaluation of the simulation results shows that the updated WRF/CMAQ system improves 2-m temperature estimates over the pre-update base modeling system estimates. The MODIS vegetation input produces a realistic spring green-up that progresses through time from the south to north. Overall, MODIS input reduces 2-m mixing ration bias during the growing season. The NA west shows larger positive O3 bias during the growing season because of reduced gas phase deposition resulting from lower O3 deposition velocities driven by reduced vegetation cover. The O3 bias increase associated with the realistic vegetation representation indicates that further improvement may be needed in the WRF/CMAQ system. The National Exposure Research Laboratory’s Atmospheric Modeling Division (AMAD) conducts research in support of EPA’s mission to protect human health and the environment. AMAD’s rese

The work is never ending: uncovering teamwork sustainability using realistic evaluation.

PubMed

Frykman, Mandus; von Thiele Schwarz, Ulrica; Muntlin Athlin, Åsa; Hasson, Henna; Mazzocato, Pamela

2017-03-20

Purpose The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork. Design/methodology/approach Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation. Non-participant observation and interview data were used. Findings The teamwork behaviors were not sustained. A substantial fallback in managerial activities in combination with a complex context contributed to reduced direction, opportunity, and motivation. Reduced direction made staff members unclear about how and why they should work in teams. Deterioration of opportunity was evident from the lack of problem-solving resources resulting in accumulated barriers to teamwork. Motivation in terms of management support and feedback was reduced. Practical implications The implementation of complex organizational changes in complex healthcare contexts requires continuous adaption and managerial activities well beyond the initial implementation period. Originality/value By integrating the DCOM® framework with realistic evaluation, this study responds to the call for theoretically based research on behavioral mechanisms that can explain how BCIs interact with context and how this interaction influences sustainability.

Rehand: Realistic electric prosthetic hand created with a 3D printer.

PubMed

Yoshikawa, Masahiro; Sato, Ryo; Higashihara, Takanori; Ogasawara, Tsukasa; Kawashima, Noritaka

2015-01-01

Myoelectric prosthetic hands provide an appearance with five fingers and a grasping function to forearm amputees. However, they have problems in weight, appearance, and cost. This paper reports on the Rehand, a realistic electric prosthetic hand created with a 3D printer. It provides a realistic appearance that is same as the cosmetic prosthetic hand and a grasping function. A simple link mechanism with one linear actuator for grasping and 3D printed parts achieve low cost, light weight, and ease of maintenance. An operating system based on a distance sensor provides a natural operability equivalent to the myoelectric control system. A supporter socket allows them to wear the prosthetic hand easily. An evaluation using the Southampton Hand Assessment Procedure (SHAP) demonstrated that an amputee was able to operate various objects and do everyday activities with the Rehand.

Rapid Bacterial Testing for Spacecraft Water

NASA Technical Reports Server (NTRS)

Lisle, John T.; Pyle, Barry H.; McFeters, Gordon A.

1996-01-01

Evaluations of the fluorogenic stains and probes will continue. E. coli 0157:H7 will be used as the reference strain for optimizing protocols. We anticipate the continued use of the fluorescent antibodies (TRITC and FITC labeled) in conjunction with CTC, Rhl23, DiBAC4(3), DAPI and acridine orange. Chemunex, the manufacturer of the ChemScan analyzer system, also makes a fluorogenic probe, Chemchrome B, which will be incorporated into the suite of probes to evaluate once their system is on site. Regardless of the combination of stains and probes all will be evaluated on membrane filters. Development of a FISH protocol that will be applicable to our conditions will be continued. Complimentary 16s rRNA probes to Ps. aeruginosa and currently in our laboratory will be evaluated first. Once this protocol has been adequately optimized other probes will be ordered for u a select number of other species. Currently, protocols to evaluate the effects of disinfection and the resulting lethality, injury on stain and/or probe specificity and reliability are being developed. E. coli 0157:H7 is the reference strain and chlorine the disinfectant the reference protocol is being developed around. Upon completion of this work, the resulting protocol will be extended to other species and disinfectants (e.g., iodine). Similar disinfectant experiments will then be conducted on the same species after starvation to evaluate the effects of starvation on disinfection resistance and the applicability of the stains and probes. Development of the immunomagnetic separation system will continue. Combined with the rapid methods described above, with enumeration by the ChemScan, we anticipate that this will provide a highly sensitive technique for the detection of specific, active bacteria.

A simplified protocol for molecular identification of Eimeria species in field samples.

PubMed

Haug, Anita; Thebo, Per; Mattsson, Jens G

2007-05-15

This study aimed to find a fast, sensitive and efficient protocol for molecular identification of chicken Eimeria spp. in field samples. Various methods for each of the three steps of the protocol were evaluated: oocyst wall rupturing methods, DNA extraction methods, and identification of species-specific DNA sequences by PCR. We then compared and evaluated five complete protocols. Three series of oocyst suspensions of known number of oocysts from Eimeria mitis, Eimeria praecox, Eimeria maxima and Eimeria tenella were prepared and ground using glass beads or mini-pestle. DNA was extracted from ruptured oocysts using commercial systems (GeneReleaser, Qiagen Stoolkit and Prepman) or phenol-chloroform DNA extraction, followed by identification of species-specific ITS-1 sequences by optimised single species PCR assays. The Stoolkit and Prepman protocols showed insufficient repeatability, and the former was also expensive and relatively time-consuming. In contrast, both the GeneReleaser protocol and phenol-chloroform protocols were robust and sensitive, detecting less than 0.4 oocysts of each species per PCR. Finally, we evaluated our new protocol on 68 coccidia positive field samples. Our data suggests that rupturing the oocysts by mini-pestle grinding, preparing the DNA with GeneReleaser, followed by optimised single species PCR assays, makes a robust and sensitive procedure for identifying chicken Eimeria species in field samples. Importantly, it also provides minimal hands-on-time in the pre-PCR process, lower contamination risk and no handling of toxic chemicals.

Low-Contrast and Low-Radiation Dose Protocol in Cardiac Computed Tomography: Usefulness of Low Tube Voltage and Knowledge-Based Iterative Model Reconstruction Algorithm.

PubMed

Iyama, Yuji; Nakaura, Takeshi; Yokoyama, Koichi; Kidoh, Masafumi; Harada, Kazunori; Oda, Seitaro; Tokuyasu, Shinichi; Yamashita, Yasuyuki

This study aimed to evaluate the feasibility of a low contrast, low-radiation dose protocol of 80-peak kilovoltage (kVp) with prospective electrocardiography-gated cardiac computed tomography (CT) using knowledge-based iterative model reconstruction (IMR). Thirty patients underwent an 80-kVp prospective electrocardiography-gated cardiac CT with low-contrast agent (222-mg iodine per kilogram of body weight) dose. We also enrolled 30 consecutive patients who were scanned with a 120-kVp cardiac CT with filtered back projection using the standard contrast agent dose (370-mg iodine per kilogram of body weight) as a historical control group. We evaluated the radiation dose for the 2 groups. The 80-kVp images were reconstructed with filtered back projection (protocol A), hybrid iterative reconstruction (HIR, protocol B), and IMR (protocol C). We compared CT numbers, image noise, and contrast-to-noise ratio among 120-kVp protocol, protocol A, protocol B, and protocol C. In addition, we compared the noise reduction rate between HIR and IMR. Two independent readers compared image contrast, image noise, image sharpness, unfamiliar image texture, and overall image quality among the 4 protocols. The estimated effective dose (ED) of the 80-kVp protocol was 74% lower than that of the 120-kVp protocol (1.4 vs 5.4 mSv). The contrast-to-noise ratio of protocol C was significantly higher than that of protocol A. The noise reduction rate of IMR was significantly higher than that of HIR (P < 0.01). There was no significant difference in almost all qualitative image quality between 120-kVp protocol and protocol C except for image contrast. A 80-kVp protocol with IMR yields higher image quality with 74% decreased radiation dose and 40% decreased contrast agent dose as compared with a 120-kVp protocol, while decreasing more image noise compared with the 80-kVp protocol with HIR.

A strategy for the study of the interactions between metal-dyes and proteins with QM/MM approaches: the case of iron-gall dye.

PubMed

Jurinovich, Sandro; Degano, Ilaria; Mennucci, Benedetta

2012-11-15

Historical textiles dyed with tannins usually show more extended degradation than fabrics dyed with other coloring materials. In order to shed light on this phenomenon we investigated the molecular interactions between tannin dyes and protein-based textiles using quantum-mechanical tools. In particular, we focused on the iron-gall complex with a fragment of α-helix wool keratin. We developed a step by step protocol which moves from the simplest ternary complexes with free amino acids (all treated quantum mechanically) to the more realistic system of the polypeptide fragment (treated at QM/MM level), passing through an intermediate model of interacting sites to evaluate the local environmental effects. The analysis of the interactions between the iron-gall complexes and free amino acids allowed us to identify possible coordination modes as well as determining their relative geometries. However, we also showed that only with the addition of the proteic environment a detailed picture of the interaction sites and binding modes can be achieved. An important role is in fact played by the microenvironment which can favor specific coordinations with respect to others due to both structural and electronic changes in the possible interaction sites.

Evaluating image reconstruction methods for tumor detection performance in whole-body PET oncology imaging

NASA Astrophysics Data System (ADS)

Lartizien, Carole; Kinahan, Paul E.; Comtat, Claude; Lin, Michael; Swensson, Richard G.; Trebossen, Regine; Bendriem, Bernard

2000-04-01

This work presents initial results from observer detection performance studies using the same volume visualization software tools that are used in clinical PET oncology imaging. Research into the FORE+OSEM and FORE+AWOSEM statistical image reconstruction methods tailored to whole- body 3D PET oncology imaging have indicated potential improvements in image SNR compared to currently used analytic reconstruction methods (FBP). To assess the resulting impact of these reconstruction methods on the performance of human observers in detecting and localizing tumors, we use a non- Monte Carlo technique to generate multiple statistically accurate realizations of 3D whole-body PET data, based on an extended MCAT phantom and with clinically realistic levels of statistical noise. For each realization, we add a fixed number of randomly located 1 cm diam. lesions whose contrast is varied among pre-calibrated values so that the range of true positive fractions is well sampled. The observer is told the number of tumors and, similar to the AFROC method, asked to localize all of them. The true positive fraction for the three algorithms (FBP, FORE+OSEM, FORE+AWOSEM) as a function of lesion contrast is calculated, although other protocols could be compared. A confidence level for each tumor is also recorded for incorporation into later AFROC analysis.

An integrated approach to develop, validate and operate thermo-physiological human simulator for the development of protective clothing.

PubMed

Psikuta, Agnes; Koelblen, Barbara; Mert, Emel; Fontana, Piero; Annaheim, Simon

2017-12-07

Following the growing interest in the further development of manikins to simulate human thermal behaviour more adequately, thermo-physiological human simulators have been developed by coupling a thermal sweating manikin with a thermo-physiology model. Despite their availability and obvious advantages, the number of studies involving these devices is only marginal, which plausibly results from the high complexity of the development and evaluation process and need of multi-disciplinary expertise. The aim of this paper is to present an integrated approach to develop, validate and operate such devices including technical challenges and limitations of thermo-physiological human simulators, their application and measurement protocol, strategy for setting test scenarios, and the comparison to standard methods and human studies including details which have not been published so far. A physical manikin controlled by a human thermoregulation model overcame the limitations of mathematical clothing models and provided a complementary method to investigate thermal interactions between the human body, protective clothing, and its environment. The opportunities of these devices include not only realistic assessment of protective clothing assemblies and equipment but also potential application in many research fields ranging from biometeorology, automotive industry, environmental engineering, and urban climate to clinical and safety applications.

The Creation and Statistical Evaluation of a Deterministic Model of the Human Bronchial Tree from HRCT Images.

PubMed

Montesantos, Spyridon; Katz, Ira; Pichelin, Marine; Caillibotte, Georges

2016-01-01

A quantitative description of the morphology of lung structure is essential prior to any form of predictive modeling of ventilation or aerosol deposition implemented within the lung. The human lung is a very complex organ, with airway structures that span two orders of magnitude and having a multitude of interfaces between air, tissue and blood. As such, current medical imaging protocols cannot provide medical practitioners and researchers with in-vivo knowledge of deeper lung structures. In this work a detailed algorithm for the generation of an individualized 3D deterministic model of the conducting part of the human tracheo-bronchial tree is described. Distinct initial conditions were obtained from the high-resolution computed tomography (HRCT) images of seven healthy volunteers. The algorithm developed is fractal in nature and is implemented as a self-similar space sub-division procedure. The expansion process utilizes physiologically realistic relationships and thresholds to produce an anatomically consistent human airway tree. The model was validated through extensive statistical analysis of the results and comparison of the most common morphological features with previously published morphometric studies and other equivalent models. The resulting trees were shown to be in good agreement with published human lung geometric characteristics and can be used to study, among other things, structure-function relationships in simulation studies.

Effect of biased feedback on motor imagery learning in BCI-teleoperation system.

PubMed

Alimardani, Maryam; Nishio, Shuichi; Ishiguro, Hiroshi

2014-01-01

Feedback design is an important issue in motor imagery BCI systems. Regardless, to date it has not been reported how feedback presentation can optimize co-adaptation between a human brain and such systems. This paper assesses the effect of realistic visual feedback on users' BCI performance and motor imagery skills. We previously developed a tele-operation system for a pair of humanlike robotic hands and showed that BCI control of such hands along with first-person perspective visual feedback of movements can arouse a sense of embodiment in the operators. In the first stage of this study, we found that the intensity of this ownership illusion was associated with feedback presentation and subjects' performance during BCI motion control. In the second stage, we probed the effect of positive and negative feedback bias on subjects' BCI performance and motor imagery skills. Although the subject specific classifier, which was set up at the beginning of experiment, detected no significant change in the subjects' online performance, evaluation of brain activity patterns revealed that subjects' self-regulation of motor imagery features improved due to a positive bias of feedback and a possible occurrence of ownership illusion. Our findings suggest that in general training protocols for BCIs, manipulation of feedback can play an important role in the optimization of subjects' motor imagery skills.

[Apheresis in children: procedures and outcome].

PubMed

Tummolo, Albina; Colella, Vincenzo; Bellantuono, Rosa; Giordano, Mario; Messina, Giovanni; Puteo, Flora; Sorino, Palma; De Palo, Tommaso

2012-01-01

Apheresis procedures are used in children to treat an increasing number of conditions by removing different types of substances from the bloodstream. In a previous study we evaluated the first results of our experience in children, emphasizing the solutions adopted to overcome technical difficulties and to adapt adult apheresis procedures to a pediatric population. The aim of the present study is to present data on a larger number of patients in whom apheresis was the main treatment. Ninety-three children (50 m, 43 f) affected by renal and/or extrarenal diseases were included. They were treated with LDL apheresis, protein A immunoadsorption, or plasma exchange. Our therapeutic protocol was the same as described in the previous study. Renal diseases and immunological disorders remained the most common conditions requiring this therapeutic approach. However, hemolytic uremic syndrome (HUS) was no longer the most frequent renal condition to be treated, as apheresis is currently the first treatment option only in cases of atypical HUS. In this series we also treated small children, showing that low weight should no longer be considered a contraindication to apheresis procedures. The low rate of complications and the overall satisfactory clinical results with increasingly advanced technical procedures make a wider use of apheresis in children realistic in the years to come.

An integrated approach to develop, validate and operate thermo-physiological human simulator for the development of protective clothing

PubMed Central

PSIKUTA, Agnes; KOELBLEN, Barbara; MERT, Emel; FONTANA, Piero; ANNAHEIM, Simon

2017-01-01

Following the growing interest in the further development of manikins to simulate human thermal behaviour more adequately, thermo-physiological human simulators have been developed by coupling a thermal sweating manikin with a thermo-physiology model. Despite their availability and obvious advantages, the number of studies involving these devices is only marginal, which plausibly results from the high complexity of the development and evaluation process and need of multi-disciplinary expertise. The aim of this paper is to present an integrated approach to develop, validate and operate such devices including technical challenges and limitations of thermo-physiological human simulators, their application and measurement protocol, strategy for setting test scenarios, and the comparison to standard methods and human studies including details which have not been published so far. A physical manikin controlled by a human thermoregulation model overcame the limitations of mathematical clothing models and provided a complementary method to investigate thermal interactions between the human body, protective clothing, and its environment. The opportunities of these devices include not only realistic assessment of protective clothing assemblies and equipment but also potential application in many research fields ranging from biometeorology, automotive industry, environmental engineering, and urban climate to clinical and safety applications. PMID:28966294

Simulation of realistic retinoscopic measurement

NASA Astrophysics Data System (ADS)

Tan, Bo; Chen, Ying-Ling; Baker, K.; Lewis, J. W.; Swartz, T.; Jiang, Y.; Wang, M.

2007-03-01

Realistic simulation of ophthalmic measurements on normal and diseased eyes is presented. We use clinical data of ametropic and keratoconus patients to construct anatomically accurate three-dimensional eye models and simulate the measurement of a streak retinoscope with all the optical elements. The results show the clinical observations including the anomalous motion in high myopia and the scissors reflex in keratoconus. The demonstrated technique can be applied to other ophthalmic instruments and to other and more extensively abnormal eye conditions. It provides promising features for medical training and for evaluating and developing ocular instruments.

A seat cushion to provide realistic acceleration cues for aircraft simulators

NASA Technical Reports Server (NTRS)

Ashworth, B. R.

1976-01-01

A seat cushion to provide acceleration cues for aircraft simulator pilots was built, performance tested, and evaluated. The four cell seat, using a thin air cushion with highly responsive pressure control, attempts to reproduce the same events which occur in an aircraft seat under acceleration loading. The pressure controller provides seat cushion responses which are considered adequate for current high performance aircraft simulations. The initial tests of the seat cushions have resulted in excellent pilot opinion of the cushion's ability to provide realistic and useful cues to the simulator pilot.

Verification and large scale clinical evaluation of a national standard protocol for Salmonella spp./Shigella spp. screening using real-time PCR combined with guided culture.

PubMed

Tang, Xi-Jun; Yang, Ze; Chen, Xin-Bin; Tian, Wen-Fang; Tu, Cheng-Ning; Wang, Hai-Bo

2018-02-01

Salmonella spp./Shigella spp. are often associated with food poisoning and fecal-oral transmission of acute gastroenteritis that requires strict monitoring, especially among people who would handle food and water. In 2014, the National Health and Family Planning Commission of the P. R. China issued a national standard protocol (recommendatory) for the screening of Salmonella spp./Shigella spp.. However, its performance has not been fully studied. Whether it was suitable for use in our laboratory was still unknown. In the current study, the new protocol was first verified by various experiments and then its clinical performance was evaluated in about 20,000 stool samples over a three-year period. Verification results showed that the new protocol was highly specific and reproducible. Sensitivity (as defined as the lower limit of detection) of the new protocol at the PCR step was 10 3 CFU/mL and 10 1 CFU/mL for Salmonella spp. and Shigella spp., while that at the guided culture step was 10 4 CFU/mL and 10 3 CFU/mL, respectively. The large scale clinical evaluation indicated that the new protocol could increase the positivity rate by two fold and decrease the workload/median turnaround time significantly. In conclusion, the protocol was verified and evaluated and was proven to be a valuable platform for the rapid, specific, sensitive and high-throughput screening of Salmonella spp./Shigella spp. Copyright © 2017 Elsevier B.V. All rights reserved.

Protocols for the Initial Treatment of Moderately Severe Juvenile Dermatomyositis: Results of a Children's Arthritis and Rheumatology Research Alliance Consensus Conference

PubMed Central

Huber, Adam M.; Giannini, Edward H.; Bowyer, Suzanne L.; Kim, Susan; Lang, Bianca; Lindsley, Carol B.; Pachman, Lauren M.; Pilkington, Clarissa; Reed, Ann M.; Rennebohm, Robert M.; Rider, Lisa G.; Wallace, Carol A.; Feldman, Brian M.

2010-01-01

Objective To use juvenile dermatomyositis (JDM) survey data and expert opinion to develop a small number of consensus treatment protocols which reflect current initial treatment of moderately severe JDM. Methods A consensus meeting was held in Toronto, Ontario, Canada on December 1-2, 2007. Nominal group technique was used to achieve consensus on treatment protocols which represented typical management of moderately severe JDM. Consensus was also reached on which patients these protocols would be applicable to (inclusion and exclusion criteria), initial investigations which should be done prior to initiating one of these protocols, data which should be collected to evaluate these protocols, concomitant interventions that would be required or recommended. Results Three protocols were developed which described the first 2 months of treatment. All protocols included corticosteroids and methotrexate. One protocol also included intravenous gammaglobulin. Consensus was achieved for all issues that were addressed by conference participants, although there were some areas of controversy Conclusions This study shows that it is possible to achieve consensus on the initial treatment of JDM, despite considerable variation in clinical practice. Once these protocols are extended beyond 2 months, these protocols will be available for clinical use. By using methods which account for differences between patients (confounding by indication), the comparative effectiveness of the protocols will be evaluated. In the future, the goal will be to identify the optimal treatment of moderately severe JDM. PMID:20191521

Evaluation of a Modified Pamidronate Protocol for the Treatment of Osteogenesis Imperfecta.

PubMed

Palomo, Telma; Andrade, Maria C; Peters, Barbara S E; Reis, Fernanda A; Carvalhaes, João Tomás A; Glorieux, Francis H; Rauch, Frank; Lazaretti-Castro, Marise

2016-01-01

Intravenous pamidronate is widely used to treat children with osteogenesis imperfecta (OI). In a well-studied protocol ('standard protocol'), pamidronate is given at a daily dose of 1 mg per kg body weight over 4 h on 3 successive days; infusion cycles are repeated every 4 months. Here, we evaluated renal safety of a simpler protocol for intravenous pamidronate infusions (2 mg per kg body weight given in a single infusion over 2 h, repeated every 4 months; 'modified protocol'). Results of 18 patients with OI types I, III, or IV treated with the modified protocol for 12 months were compared to 18 historic controls, treated with standard protocol. In the modified protocol, mild transient post-infusion increases in serum creatinine were found during each infusion but after 12 months serum creatinine remained similar from baseline [0.40 mg/dl (SD: 0.13)] to the end of the study [0.41 mg/dl (SD: 0.11)] (P = 0.79). The two protocols led to similar changes in serum creatinine during the first pamidronate infusion [modified protocol: +2% (SD: 21%); standard protocol: -3% (SD: 8%); P = 0.32]. Areal lumbar spine bone mineral density Z-scores increased from -2.7 (SD: 1.5) to -1.8 (SD: 1.4) with the modified protocol, and from -4.1 (SD: 1.4) to -3.1 (SD: 1.1) with standard protocol (P = 0.68 for group differences in bone density Z-score changes). The modified pamidronate protocol is safe and may have similar effects on bone density as the standard pamidronate protocol. More studies are needed with longer follow-up to prove anti-fracture efficacy.

Computation of Surface Laplacian for tri-polar ring electrodes on high-density realistic geometry head model.

PubMed

Junwei Ma; Han Yuan; Sunderam, Sridhar; Besio, Walter; Lei Ding

2017-07-01

Neural activity inside the human brain generate electrical signals that can be detected on the scalp. Electroencephalograph (EEG) is one of the most widely utilized techniques helping physicians and researchers to diagnose and understand various brain diseases. Due to its nature, EEG signals have very high temporal resolution but poor spatial resolution. To achieve higher spatial resolution, a novel tri-polar concentric ring electrode (TCRE) has been developed to directly measure Surface Laplacian (SL). The objective of the present study is to accurately calculate SL for TCRE based on a realistic geometry head model. A locally dense mesh was proposed to represent the head surface, where the local dense parts were to match the small structural components in TCRE. Other areas without dense mesh were used for the purpose of reducing computational load. We conducted computer simulations to evaluate the performance of the proposed mesh and evaluated possible numerical errors as compared with a low-density model. Finally, with achieved accuracy, we presented the computed forward lead field of SL for TCRE for the first time in a realistic geometry head model and demonstrated that it has better spatial resolution than computed SL from classic EEG recordings.

Developing family planning nurse practitioner protocols.

PubMed

Hawkins, J W; Roberto, D

1984-01-01

This article focuses on the process of development of protocols for family planning nurse practitioners. A rationale for the use of protocols, a definition of the types and examples, and the pros and cons of practice with protocols are presented. A how-to description for the development process follows, including methods and a suggested tool for critique and evaluation. The aim of the article is to assist nurse practitioners in developing protocols for their practice.

Study protocol of a mixed-methods evaluation of a cluster randomized trial to improve the safety of NSAID and antiplatelet prescribing: data-driven quality improvement in primary care.

PubMed

Grant, Aileen; Dreischulte, Tobias; Treweek, Shaun; Guthrie, Bruce

2012-08-28

Trials of complex interventions are criticized for being 'black box', so the UK Medical Research Council recommends carrying out a process evaluation to explain the trial findings. We believe it is good practice to pre-specify and publish process evaluation protocols to set standards and minimize bias. Unlike protocols for trials, little guidance or standards exist for the reporting of process evaluations. This paper presents the mixed-method process evaluation protocol of a cluster randomized trial, drawing on a framework designed by the authors. This mixed-method evaluation is based on four research questions and maps data collection to a logic model of how the data-driven quality improvement in primary care (DQIP) intervention is expected to work. Data collection will be predominately by qualitative case studies in eight to ten of the trial practices, focus groups with patients affected by the intervention and quantitative analysis of routine practice data, trial outcome and questionnaire data and data from the DQIP intervention. We believe that pre-specifying the intentions of a process evaluation can help to minimize bias arising from potentially misleading post-hoc analysis. We recognize it is also important to retain flexibility to examine the unexpected and the unintended. From that perspective, a mixed-methods evaluation allows the combination of exploratory and flexible qualitative work, and more pre-specified quantitative analysis, with each method contributing to the design, implementation and interpretation of the other.As well as strengthening the study the authors hope to stimulate discussion among their academic colleagues about publishing protocols for evaluations of randomized trials of complex interventions. DATA-DRIVEN QUALITY IMPROVEMENT IN PRIMARY CARE TRIAL REGISTRATION: ClinicalTrials.gov: NCT01425502.

Heavy vehicle driver workload assessment. Task 5, workload assessment protocol

DOT National Transportation Integrated Search

This report presents a description of a prescriptive workload assessment protocol for use in evaluating in-cab devices in heavy vehicles. The primary objective of this heavy vehicle driver workload assessment protocol is to identify the components an...

Developing the protocol for the evaluation of the health foundation's 'engaging with quality initiative' – an emergent approach

PubMed Central

Soper, Bryony; Buxton, Martin; Hanney, Stephen; Oortwijn, Wija; Scoggins, Amanda; Steel, Nick; Ling, Tom

2008-01-01

In 2004 a UK charity, The Health Foundation, established the 'Engaging with Quality Initiative' to explore and evaluate the benefits of engaging clinicians in quality improvement in healthcare. Eight projects run by professional bodies or specialist societies were commissioned in various areas of acute care. A developmental approach to the initiative was adopted, accompanied by a two level evaluation: eight project self-evaluations and a related external evaluation. This paper describes how the protocol for the external evaluation was developed. The challenges faced included large variation between and within the projects (in approach, scope and context, and in understanding of quality improvement), the need to support the project teams in their self-evaluations while retaining a necessary objectivity, and the difficulty of evaluating the moving target created by the developmental approach adopted in the initiative. An initial period to develop the evaluation protocol proved invaluable in helping us to explore these issues. PMID:18973650

New approach to enhance and evaluate the performance of vehicle-infrastructure integration and its communication systems, final report.

DOT National Transportation Integrated Search

2010-09-01

Initial research studied the use of wireless local area networks (WLAN) protocols in Inter-Vehicle Communications : (IVC) environments. The protocols performance was evaluated in terms of measuring throughput, jitter time and : delay time. This re...

Evaluation of rapid dual-tracer 62Cu-PTSM + 62Cu-ATSM PET in dogs with spontaneously occurring tumors

NASA Astrophysics Data System (ADS)

Black, Noel F.; McJames, Scott; Rust, Thomas C.; Kadrmas, Dan J.

2008-01-01

We are developing methods for imaging multiple PET tracers in a single scan with staggered injections, where imaging measures for each tracer are separated and recovered using differences in tracer kinetics and radioactive decay. In this work, signal separation performance for rapid dual-tracer 62Cu-PTSM (blood flow) + 62Cu-ATSM (hypoxia) tumor imaging was evaluated in a large animal model. Four dogs with pre-existing tumors received a series of dynamic PET scans with 62Cu-PTSM and 62Cu-ATSM, permitting evaluation of a rapid dual-tracer protocol designed by previous simulation work. Several imaging measures were computed from the dual-tracer data and compared with those from separate, single-tracer imaging. Static imaging measures (e.g. SUV) for each tracer were accurately recovered from dual-tracer data. The wash-in (k1) and wash-out (k2) rate parameters for both tracers were likewise well recovered (r = 0.87-0.99), but k3 was not accurately recovered for PTSM (r = 0.19) and moderately well recovered for ATSM (r = 0.70). Some degree of bias was noted, however, which may potentially be overcome through further refinement of the signal separation algorithms. This work demonstrates that complementary information regarding tumor blood flow and hypoxia can be acquired by a single dual-tracer PET scan, and also that the signal separation procedure works effectively for real physiologic data with realistic levels of kinetic model mismatch. Rapid multi-tracer PET has the potential to improve tumor assessment for image-guide therapy and monitoring, and further investigation with these and other tracers is warranted.

Evaluation of Rapid Dual-Tracer 62Cu-PTSM + 62Cu-ATSM PET in Dogs with Spontaneously-Occurring Tumors

PubMed Central

Black, Noel F.; McJames, Scott; Rust, Thomas C.; Kadrmas, Dan J.

2013-01-01

We are developing methods for imaging multiple PET tracers in a single scan with staggered injections, where imaging measures for each tracer are separated and recovered using differences in tracer kinetics and radioactive decay. In this work, signal-separation performance for rapid dual-tracer 62Cu-PTSM (blood flow) + 62Cu-ATSM (hypoxia) tumor imaging was evaluated in a large animal model. Four dogs with pre-existing tumors received a series of dynamic PET scans with 62Cu-PTSM and 62Cu-ATSM, permitting evaluation of a rapid dual-tracer protocol designed by previous simulation work. Several imaging measures were computed from the dual-tracer data and compared with those from separate, single-tracer imaging. Static imaging measures (e.g. SUV) for each tracer were accurately recovered from dual-tracer data. The wash-in (k1) and wash-out (k2) rate parameters for both tracers were likewise well recovered (r = 0.87 – 0.99), but k3 was not accurately recovered for PTSM (r = 0.19) and moderately well recovered for ATSM (r = 0.70). Some degree of bias was noted, however, which may potentially be overcome through further refinement of the signal-separation algorithms. This work demonstrates that complementary information regarding tumor blood flow and hypoxia can be acquired by a single dual-tracer PET scan, and also that the signal-separation procedure works effectively for real physiologic data with realistic levels of kinetic model-mismatch. Rapid multi-tracer PET has the potential to improve tumor assessment for image-guide therapy and monitoring, and further investigation with these and other tracers is warranted. PMID:18182698

Simulation of plastic surgery and microvascular procedures using perfused fresh human cadavers.

PubMed

Carey, Joseph N; Rommer, Elizabeth; Sheckter, Clifford; Minneti, Michael; Talving, Peep; Wong, Alex K; Garner, Warren; Urata, Mark M

2014-02-01

Surgical simulation models are often limited by their lack of fidelity, which hinders their essential purpose, making a better surgeon. Fresh cadaveric tissue is a superior model of simulation owing to its approximation of live tissue. One major unresolved difference between dead and live tissue is perfusion. Here, we propose a means of enhancing the fidelity of cadaveric simulation through the development of a perfused cadaveric model whereby simulation is further able to approach life-like surgery and teach one of the more technically demanding skills of plastic surgery: microsurgery. Fresh tissue human cadavers were procured according to university protocol. Perfusion was performed via cannulation of large vessels, and arterial and venous pressure was maintained by centrifugal circulation. Skin perfusion was evaluated with incisions in the perfused regions and was evaluated using indocyanine green angiography. Surgical simulations were selected to broadly evaluate applicability to plastic surgical education. Surgical simulation of 38 procedures ranging in complexity from skin excisions to microsurgical cases was performed with high priority given to the accurate simulation of clinical procedures. Flap dissections included perforator flaps, muscle flaps, and fasciocutaneous flaps. Effective perfusion was noted with ICG angiography and notable bleeding vessels. Microsurgical flap transfer was successfully performed. We report the establishment of a high fidelity surgical simulation using a perfused fresh tissue model in a realistic environment akin to the operating room. We anticipate utilization of this model prior to entering the operating room will enhance surgical ability and offer a valuable resource in plastic surgical education. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies.

PubMed

Madill, A; Jordan, A; Shirley, C

2000-02-01

The effect of the individual analyst on research findings can create a credibility problem for qualitative approaches from the perspective of evaluative criteria utilized in quantitative psychology. This paper explicates the ways in which objectivity and reliability are understood in qualitative analysis conducted from within three distinct epistemological frameworks: realism, contextual constructionism, and radical constructionism. It is argued that quality criteria utilized in quantitative psychology are appropriate to the evaluation of qualitative analysis only to the extent that it is conducted within a naive or scientific realist framework. The discussion is illustrated with reference to the comparison of two independent grounded theory analyses of identical material. An implication of this illustration is to identify the potential to develop a radical constructionist strand of grounded theory.

Tropical Cyclones in the 7-km NASA Global Nature Run for Use in Observing System Simulation Experiments

NASA Technical Reports Server (NTRS)

Reale, Oreste; Achuthavarier, Deepthi; Fuentes, Marangelly; Putman, William M.; Partyka, Gary

2017-01-01

The National Aeronautics and Space Administration (NASA) Nature Run (NR), released for use in Observing System Simulation Experiments (OSSEs), is a 2-year long global non-hydrostatic free-running simulation at a horizontal resolution of 7 km, forced by observed sea-surface temperatures (SSTs) and sea ice, and inclusive of interactive aerosols and trace gases. This article evaluates the NR with respect to tropical cyclone (TC) activity. It is emphasized that to serve as a NR, a long-term simulation must be able to produce realistic TCs, which arise out of realistic large-scale forcings. The presence in the NR of the realistic, relevant dynamical features over the African Monsoon region and the tropical Atlantic is confirmed, along with realistic African Easterly Wave activity. The NR Atlantic TC seasons, produced with 2005 and 2006 SSTs, show interannual variability consistent with observations, with much stronger activity in 2005. An investigation of TC activity over all the other basins (eastern and western North Pacific, North and South Indian Ocean, and Australian region), together with relevant elements of the atmospheric circulation, such as, for example, the Somali Jet and westerly bursts, reveals that the model captures the fundamental aspects of TC seasons in every basin, producing realistic number of TCs with realistic tracks, life spans and structures. This confirms that the NASA NR is a very suitable tool for OSSEs targeting TCs and represents an improvement with respect to previous long simulations that have served the global atmospheric OSSE community.

Tropical Cyclones in the 7km NASA Global Nature Run for use in Observing System Simulation Experiments

PubMed Central

Reale, Oreste; Achuthavarier, Deepthi; Fuentes, Marangelly; Putman, William M.; Partyka, Gary

2018-01-01

The National Aeronautics and Space Administration (NASA) Nature Run (NR), released for use in Observing System Simulation Experiments (OSSEs), is a 2-year long global non-hydrostatic free-running simulation at a horizontal resolution of 7 km, forced by observed sea-surface temperatures (SSTs) and sea ice, and inclusive of interactive aerosols and trace gases. This article evaluates the NR with respect to tropical cyclone (TC) activity. It is emphasized that to serve as a NR, a long-term simulation must be able to produce realistic TCs, which arise out of realistic large-scale forcings. The presence in the NR of the realistic, relevant dynamical features over the African Monsoon region and the tropical Atlantic is confirmed, along with realistic African Easterly Wave activity. The NR Atlantic TC seasons, produced with 2005 and 2006 SSTs, show interannual variability consistent with observations, with much stronger activity in 2005. An investigation of TC activity over all the other basins (eastern and western North Pacific, North and South Indian Ocean, and Australian region), together with relevant elements of the atmospheric circulation, such as, for example, the Somali Jet and westerly bursts, reveals that the model captures the fundamental aspects of TC seasons in every basin, producing realistic number of TCs with realistic tracks, life spans and structures. This confirms that the NASA NR is a very suitable tool for OSSEs targeting TCs and represents an improvement with respect to previous long simulations that have served the global atmospheric OSSE community. PMID:29674806

Tropical Cyclones in the 7km NASA Global Nature Run for use in Observing System Simulation Experiments.

PubMed

Reale, Oreste; Achuthavarier, Deepthi; Fuentes, Marangelly; Putman, William M; Partyka, Gary

2017-01-01

The National Aeronautics and Space Administration (NASA) Nature Run (NR), released for use in Observing System Simulation Experiments (OSSEs), is a 2-year long global non-hydrostatic free-running simulation at a horizontal resolution of 7 km, forced by observed sea-surface temperatures (SSTs) and sea ice, and inclusive of interactive aerosols and trace gases. This article evaluates the NR with respect to tropical cyclone (TC) activity. It is emphasized that to serve as a NR, a long-term simulation must be able to produce realistic TCs, which arise out of realistic large-scale forcings. The presence in the NR of the realistic, relevant dynamical features over the African Monsoon region and the tropical Atlantic is confirmed, along with realistic African Easterly Wave activity. The NR Atlantic TC seasons, produced with 2005 and 2006 SSTs, show interannual variability consistent with observations, with much stronger activity in 2005. An investigation of TC activity over all the other basins (eastern and western North Pacific, North and South Indian Ocean, and Australian region), together with relevant elements of the atmospheric circulation, such as, for example, the Somali Jet and westerly bursts, reveals that the model captures the fundamental aspects of TC seasons in every basin, producing realistic number of TCs with realistic tracks, life spans and structures. This confirms that the NASA NR is a very suitable tool for OSSEs targeting TCs and represents an improvement with respect to previous long simulations that have served the global atmospheric OSSE community.

Evaluation of a Sexual Assault Risk Reduction and Self-Defense Program: A Prospective Analysis of a Revised Protocol

ERIC Educational Resources Information Center

Orchowski, Lindsay M.; Gidycz, Christine A.; Raffle, Holly

2008-01-01

The current study extends the development and evaluation of an existing and previously evaluated sexual assault risk reduction program with a self-defense component for college women (N = 300). The program protocol was revised to address psychological barriers to responding assertively to risky dating situations, and a placebo-control group was…

Promoting Digital Change in Higher Education: Evaluating the Curriculum Digitalisation

ERIC Educational Resources Information Center

Coskun, Yelkin Diker

2015-01-01

Technology, which forms part of all educational settings and curricula, is becoming an integral part of higher education too. Therefore, observations and interpretations from inside such settings are needed for a more realistic understanding. This study evaluates the information packages of the undergraduate programs of a university within the…

Application of an Elastic-Plastic Methodology to Structural Integrity Evaluation,

DTIC Science & Technology

The elastic plastic fracture mechanics ( EPFM ) technology has advanced to the point where it can be used to make a realistic assessment of the...concepts of EPFM into a structural stability evaluation. The structure is modeled as a cracked test specimen either in series or parallel with a spring

Application and Evaluation of MODIS LAI, FPAR, and Albedo Products in the WRF/CMAQ System

EPA Science Inventory

MODIS vegetation and albedo products provide a more realistic representation of surface conditions for input to the WRF/CMAQ modeling system. However, the initial evaluation of ingesting MODIS data into the system showed mixed results, with increased bias and error for 2-m temper...

Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

PubMed Central

Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

2014-01-01

Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

An Overview of Chain of Custody Options for LETTERPRESS.

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

Smartt, Heidi A.

2016-11-01

This purpose of this document is to provide an overview of Chain of Custody (CoC) technology options that could be made available for the LETTERPRESS exercise as part of the Quad Working Group. The Quad Working Group comprises five sub-working groups (Management, Protocol, Simulation, Technology, and Training) with members from the U.S., U.K., Norway, and Sweden having the goal of providing a repeatable, realistic arms control exercise (dubbed LETTERPRESS) to be executed in representative facilities and using non-proliferative but representative treaty items. The Technology Working Group is responsible for supporting the technology requirements of the LETTERPRESS exercise and as suchmore » the technologies presented here are possible options to meet those requirements.« less

Chirped self-similar optical pulses in tapered centrosymmetric nonlinear waveguides doped with resonant impurities

NASA Astrophysics Data System (ADS)

He, J. R.; Xu, S. L.; Xue, L.

2017-11-01

Exact chirped self-similar optical pulses propagating in tapered centrosymmetric nonlinear waveguides doped with resonant impurities are reported. The propagation behaviors of the pulses are studied by tailoring of the tapering function. Numerical simulations and stability analysis reveal that the tapering can be used to postpone the wave dispersion and the addition of a small cubic self-focusing term to the governing equation could stabilize the chirped bright pulses. An example of possible experimental protocol that may generate the pulses in realistic waveguides is given. The obtained chirped self-similar optical pulses are particularly useful in the design of amplifying or attenuating pulse compressors for chirped solitary waves in tapered centrosymmetric nonlinear waveguides doped with resonant impurities.

Experimental Measurement-Device-Independent Quantum Key Distribution

NASA Astrophysics Data System (ADS)

Liu, Yang; Chen, Teng-Yun; Wang, Liu-Jun; Liang, Hao; Shentu, Guo-Liang; Wang, Jian; Cui, Ke; Yin, Hua-Lei; Liu, Nai-Le; Li, Li; Ma, Xiongfeng; Pelc, Jason S.; Fejer, M. M.; Peng, Cheng-Zhi; Zhang, Qiang; Pan, Jian-Wei

2013-09-01

Quantum key distribution is proven to offer unconditional security in communication between two remote users with ideal source and detection. Unfortunately, ideal devices never exist in practice and device imperfections have become the targets of various attacks. By developing up-conversion single-photon detectors with high efficiency and low noise, we faithfully demonstrate the measurement-device-independent quantum-key-distribution protocol, which is immune to all hacking strategies on detection. Meanwhile, we employ the decoy-state method to defend attacks on a nonideal source. By assuming a trusted source scenario, our practical system, which generates more than a 25 kbit secure key over a 50 km fiber link, serves as a stepping stone in the quest for unconditionally secure communications with realistic devices.

Experimental measurement-device-independent quantum key distribution.

PubMed

Liu, Yang; Chen, Teng-Yun; Wang, Liu-Jun; Liang, Hao; Shentu, Guo-Liang; Wang, Jian; Cui, Ke; Yin, Hua-Lei; Liu, Nai-Le; Li, Li; Ma, Xiongfeng; Pelc, Jason S; Fejer, M M; Peng, Cheng-Zhi; Zhang, Qiang; Pan, Jian-Wei

2013-09-27

Quantum key distribution is proven to offer unconditional security in communication between two remote users with ideal source and detection. Unfortunately, ideal devices never exist in practice and device imperfections have become the targets of various attacks. By developing up-conversion single-photon detectors with high efficiency and low noise, we faithfully demonstrate the measurement-device-independent quantum-key-distribution protocol, which is immune to all hacking strategies on detection. Meanwhile, we employ the decoy-state method to defend attacks on a nonideal source. By assuming a trusted source scenario, our practical system, which generates more than a 25 kbit secure key over a 50 km fiber link, serves as a stepping stone in the quest for unconditionally secure communications with realistic devices.

Experimental study on discretely modulated continuous-variable quantum key distribution

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

Shen Yong; Zou Hongxin; Chen Pingxing

2010-08-15

We present a discretely modulated continuous-variable quantum key distribution system in free space by using strong coherent states. The amplitude noise in the laser source is suppressed to the shot-noise limit by using a mode cleaner combined with a frequency shift technique. Also, it is proven that the phase noise in the source has no impact on the final secret key rate. In order to increase the encoding rate, we use broadband homodyne detectors and the no-switching protocol. In a realistic model, we establish a secret key rate of 46.8 kbits/s against collective attacks at an encoding rate of 10more » MHz for a 90% channel loss when the modulation variance is optimal.« less

Coupling multiscale X-ray physics and micromechanics for bone tissue composition and elasticity determination from micro-CT data, by example of femora from OVX and sham rats

NASA Astrophysics Data System (ADS)

Hasslinger, Patricia; Vass, Viktoria; Dejaco, Alexander; Blanchard, Romane; Örlygsson, Gissur; Gargiulo, Paolo; Hellmich, Christian

2016-05-01

Due to its high resolution, micro-CT (Computed Tomograph) scanning is the key to assess bone quality of sham and OVX (ovariectomized) rats. Combination of basic X-ray physics, such as the energy- and chemistry-dependence of attenuation coefficients, with results from ashing tests on rat bones, delivers mineral, organic, and water volume fractions within the voxels. Additional use of a microelastic model for bone provides voxel-specific elastic properties. The new method delivers realistic bone mass densities, and reveals that OVX protocols may indeed induce some bone mass loss, while the average composition of the bone tissue remains largely unaltered.

Mobile Virtual Private Networking

NASA Astrophysics Data System (ADS)

Pulkkis, Göran; Grahn, Kaj; Mårtens, Mathias; Mattsson, Jonny

Mobile Virtual Private Networking (VPN) solutions based on the Internet Security Protocol (IPSec), Transport Layer Security/Secure Socket Layer (SSL/TLS), Secure Shell (SSH), 3G/GPRS cellular networks, Mobile IP, and the presently experimental Host Identity Protocol (HIP) are described, compared and evaluated. Mobile VPN solutions based on HIP are recommended for future networking because of superior processing efficiency and network capacity demand features. Mobile VPN implementation issues associated with the IP protocol versions IPv4 and IPv6 are also evaluated. Mobile VPN implementation experiences are presented and discussed.

Comparative evaluation of total RNA extraction methods in Theobroma cacao using shoot apical meristems.

PubMed

Silva, D V; Branco, S M J; Holanda, I S A; Royaert, S; Motamayor, J C; Marelli, J P; Corrêa, R X

2016-03-04

Theobroma cacao is a species of great economic importance with its beans used for chocolate production. The tree has been a target of various molecular studies. It contains many polyphenols, which complicate the extraction of nucleic acids with the extraction protocols requiring a large amount of plant material. These issues, therefore, necessitate the optimization of the protocols. The aim of the present study was to evaluate different methods for extraction of total RNA from shoot apical meristems of T. cacao 'CCN 51' and to assess the influence of storage conditions for the meristems on the extraction. The study also aimed to identify the most efficient protocol for RNA extraction using a small amount of plant material. Four different protocols were evaluated for RNA extraction using one shoot apical meristem per sample. Among these protocols, one that was more efficient was then tested to extract RNA using four different numbers of shoot apical meristems, subjected to three different storage conditions. The best protocol was tested for cDNA amplification using reverse transcription-polymerase chain reaction; the cDNA quality was determined to be satisfactory for molecular analyses. The study revealed that with the best RNA extraction protocol, one shoot apical meristem was sufficient for extraction of high-quality total RNA. The results obtained might enable advances in genetic analyses and molecular studies using reduced amount of plant material.

A Protocol for Evaluating Contextual Design Principles

PubMed Central

Stamps, Arthur

2014-01-01

This paper explains how scientific data can be incorporated into urban design decisions, such as evaluating contextual design principles. The recommended protocols are based on the Cochrane Reviews that have been widely used in medical research. The major concepts of a Cochrane Review are explained, as well as the underlying mathematics. The underlying math is meta-analysis. Data are reported for three applications and seven contextual design policies. It is suggested that use of the Cochrane protocols will be of great assistance to planners by providing scientific data that can be used to evaluate the efficacies of contextual design policies prior to implementing those policies. PMID:25431448

Comparison of two cooling protocols for llama semen: with and without collagenase and seminal plasma in the medium.

PubMed

Carretero, M I; Giuliano, S M; Arraztoa, C C; Santa Cruz, R C; Fumuso, F G; Neild, D M

2017-08-01

Seminal plasma (SP) of South American Camelids could interfere with the interaction of spermatozoa with the extenders; therefore it becomes necessary to improve semen management using enzymatic treatment. Our objective was to compare two cooling protocols for llama semen. Twelve ejaculates were incubated in 0.1% collagenase and then were divided into two aliquots. One was extended in lactose and egg yolk (LEY) (Protocol A: collagenase and SP present). The other aliquot was centrifuged, and the pellet was resuspended in LEY (Protocol B: collagenase and SP absent). Both samples were maintained at 5°C during 24 hr. Routine and DNA evaluations were carried out in raw and cooled semen. Both cooling protocols maintained sperm viability, membrane function and DNA fragmentation, with Protocol A showing a significantly lowered total and progressive motility (p < .05) and Protocol B showing a significant increase in chromatin decondensation (p < .05). Protocol A avoids centrifugation, reducing processing times and making application in the field simpler. However, as neither protocol showed a significant superiority over the other, studies should be carried out in vivo to evaluate the effect on pregnancy rates of the presence of collagenase and SP in semen samples prior to either cooling or freeze-thawing. © 2016 Blackwell Verlag GmbH.

A False-name-Proof Double Auction Protocol for Arbitrary Evaluation Values

NASA Astrophysics Data System (ADS)

Sakurai, Yuko; Yokoo, Makoto

We develop a new false-name-proof double auction protocol called the Generalized Threshold Price Double auction (GTPD) protocol. False-name-proofness generalizes strategy-proofness by incorporating the possibility of false-name bids, e.g., bids submitted using multiple e-mail addresses. An existing protocol called TPD protocol is false-name-proof but can handle only the cases where marginal utilities of each agent always decrease, while our new GTPD protocol can handle arbitrary evaluation values. When marginal utilities can increase, some bids cannot be divided into a single unit (e.g., an all-or-nothing bid). Due to the existence of such indivisible bids, meeting supply/demand becomes difficult. Furthermore, a seller/buyer can submit a false-name-bid by pretending to be a potential buyer/seller to manipulate allocations and payments. In the GTPD protocol, the auctioneer is required to absorb the supply-demand imbalance up to a given upper-bound. Also, the GTPD incorporate a new false-name-proof one-sided auction protocol that is guaranteed to sell/buy a certain number of units. Simulation results show that when the threshold price is set appropriately, this protocol can obtain a good social surplus, and the number of absorbed units is much smaller than the given upper-bound.

Space Link Extension (SLE) Emulation for High-Throughput Network Communication

NASA Technical Reports Server (NTRS)

Murawski, Robert W.; Tchorowski, Nicole; Golden, Bert

2014-01-01

As the data rate requirements for space communications increases, significant stress is placed not only on the wireless satellite communication links, but also on the ground networks which forward data from end-users to remote ground stations. These wide area network (WAN) connections add delay and jitter to the end-to-end satellite communication link, effects which can have significant impacts on the wireless communication link. It is imperative that any ground communication protocol can react to these effects such that the ground network does not become a bottleneck in the communication path to the satellite. In this paper, we present our SCENIC Emulation Lab testbed which was developed to test the CCSDS SLE protocol implementations proposed for use on future NASA communication networks. Our results show that in the presence of realistic levels of network delay, high-throughput SLE communication links can experience significant data rate throttling. Based on our observations, we present some insight into why this data throttling happens, and trace the probable issue back to non-optimal blocking communication which is sup-ported by the CCSDS SLE API recommended practices. These issues were presented as well to the SLE implementation developers which, based on our reports, developed a new release for SLE which we show fixes the SLE blocking issue and greatly improves the protocol throughput. In this paper, we also discuss future developments for our end-to-end emulation lab and how these improvements can be used to develop and test future space communication technologies.

Space Link Extension (SLE) Emulation for High-Throughput Network Communication

NASA Technical Reports Server (NTRS)

Murawski, Robert; Tchorowski, Nicole; Golden, Bert

2014-01-01

As the data rate requirements for space communications increases, signicant stressis placed not only on the wireless satellite communication links, but also on the groundnetworks which forward data from end-users to remote ground stations. These wide areanetwork (WAN) connections add delay and jitter to the end-to-end satellite communicationlink, eects which can have signicant impacts on the wireless communication link. It isimperative that any ground communication protocol can react to these eects such that theground network does not become a bottleneck in the communication path to the satellite.In this paper, we present our SCENIC Emulation Lab testbed which was developed to testthe CCSDS SLE protocol implementations proposed for use on future NASA communica-tion networks. Our results show that in the presence of realistic levels of network delay,high-throughput SLE communication links can experience signicant data rate throttling.Based on our observations, we present some insight into why this data throttling happens,and trace the probable issue back to non-optimal blocking communication which is sup-ported by the CCSDS SLE API recommended practices. These issues were presented aswell to the SLE implementation developers which, based on our reports, developed a newrelease for SLE which we show xes the SLE blocking issue and greatly improves the pro-tocol throughput. In this paper, we also discuss future developments for our end-to-endemulation lab and how these improvements can be used to develop and test future spacecommunication technologies.

Pre-binding prior to full engagement improves loading conditions for front-row players in contested Rugby Union scrums.

PubMed

Preatoni, E; Cazzola, D; Stokes, K A; England, M; Trewartha, G

2016-12-01

We investigated the effect of a "PreBind" engagement protocol on the biomechanics of contested Rugby Union scrummaging at different playing levels. "PreBind" requires front-row props to take a bind on opposing players prior to the engagement, and to maintain the bind throughout the scrum duration. Twenty-seven teams from five different playing levels performed live scrums under realistic conditions. Video analysis, pressures sensors, and inertial measurement units measured biomechanical outcomes as teams scrummaged following different engagement protocols: the CTPE (referee calls "crouch-touch-pause-engage"), the CTS ("crouch-touch-set"), and the PreBind ("crouch-bind-set") variants. PreBind reduced the set-up distance between the packs (-27%) and the speed at which they came into contact by more than 20%. The peak biomechanical stresses acting on front rows during the engagement phase were decreased in PreBind by 14-25% with respect to CTPE and CTS, without reducing the capability to generate force in the subsequent sustained push. No relevant main effects were recorded for playing level due to within-group variability and there were no interaction effects between playing level and engagement protocol. Pre-binding reduced many mechanical quantities that have been indicated as possible factors for chronic and acute injury, and may lead to safer engagement conditions without affecting subsequent performance. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

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

McNair, Helen A.; Hansen, Vibeke N.; Parker, Christopher

2008-05-01

Purpose: To evaluate the utility of intraprostatic markers in the treatment verification of prostate cancer radiotherapy. Specific aims were: to compare the effectiveness of offline correction protocols, either using gold markers or bony anatomy; to estimate the potential benefit of online correction protocol's using gold markers; to determine the presence and effect of intrafraction motion. Methods and Materials: Thirty patients with three gold markers inserted had pretreatment and posttreatment images acquired and were treated using an offline correction protocol and gold markers. Retrospectively, an offline protocol was applied using bony anatomy and an online protocol using gold markers. Results: Themore » systematic errors were reduced from 1.3, 1.9, and 2.5 mm to 1.1, 1.1, and 1.5 mm in the right-left (RL), superoinferior (SI), and anteroposterior (AP) directions, respectively, using the offline correction protocol and gold markers instead of bony anatomy. The subsequent decrease in margins was 1.7, 3.3, and 4 mm in the RL, SI, and AP directions, respectively. An offline correction protocol combined with an online correction protocol in the first four fractions reduced random errors further to 0.9, 1.1, and 1.0 mm in the RL, SI, and AP directions, respectively. A daily online protocol reduced all errors to <1 mm. Intrafraction motion had greater impact on the effectiveness of the online protocol than the offline protocols. Conclusions: An offline protocol using gold markers is effective in reducing the systematic error. The value of online protocols is reduced by intrafraction motion.« less

Failure of antiarrhythmic drugs to prevent experimental reperfusion ventricular fibrillation.

PubMed

Naito, M; Michelson, E L; Kmetzo, J J; Kaplinsky, E; Dreifus, L S

1981-01-01

Ninety-nine adult mongrel dogs underwent acute ligation of the proximal left anterior descending coronary artery. Thirty minutes later, the occlusion was released to evaluate the effectiveness of five antiarrhythmic protocols in eliminating reperfusion ventricular fibrillation. The five protocols included: protocol 1 --i.v. lidocaine, preligation and prerelease (n = 19); protocol 2 -- i.v. lidocaine, prereperfusion only (n = 22); protocol 3 -- chronic, oral, daily amiodarone for 2 weeks preligation (n = 19); protocol 4 -- i.v. procainamide, preligation and prereperfusion (n = 21); and protocol 5 -- i.v. verapamil, prereperfusion (n = 18). Each regimen was evaluated with respect to the incidence of reperfusion ventricular fibrillation in dogs that survived to reperfusion, and the results were compared to 77 control dogs that underwent identical coronary artery occlusion and release procedures without drug therapy. The incidence of reperfusion ventricular fibrillation was as follows: protocol 1 -- seven of 15 dogs (47%); protocol 2 -- six of 18 (33%); protocol 3 -- 11 of 16 dogs (69%); protocol 4 -- eight of 17 dogs (47%); and protocol 5 -- 10 of 17 dogs (59%), compared with 36 of 60 (60%) in control dogs. Using chi-square analysis, protocol 2 was beneficial (p < 0.05). The dogs were then stratified into high- and low-risk subgroups based on the arrhythmic events of the antecedent coronary artery ligation periods, and predictive risk indexes for the occurrence of reperfusion ventricular fibrillation were developed. the Mantel-Haenszel method of statistical analysis revealed that none of these protocols resulted in a statistically significant reduction in the incidence of reperfusion ventricular fibrillation. Thus, use of these predictive indexes plus appropriate statistical methods has revealed, unexpectedly, limitations in the efficacy of a spectrum of antiarrhythmic agents in preventing reperfusion ventricular fibrillation.

Web usability evaluation with screen reader users: implementation of the partial concurrent thinking aloud technique.

PubMed

Federici, Stefano; Stefano, Federici; Borsci, Simone; Stamerra, Gianluca

2010-08-01

A verbal protocol technique, adopted for a web usability evaluation, requires that the users are able to perform a double task: surfing and talking. Nevertheless, when blind users surf by using a screen reader and talk about the way they interact with the computer, the evaluation is influenced by a structural interference: users are forced to think aloud and listen to the screen reader at the same time. The aim of this study is to build up a verbal protocol technique for samples of visual impaired users in order to overcome the limits of concurrent and retrospective protocols. The technique we improved, called partial concurrent thinking aloud (PCTA), integrates a modified set of concurrent verbalization and retrospective analysis. One group of 6 blind users and another group of 6 sighted users evaluated the usability of a website using PCTA. By estimating the number of necessary users by the means of an asymptotic test, it was found out that the two groups had an equivalent ability of identifying usability problems, both over 80%. The result suggests that PCTA, while respecting the properties of classic verbal protocols, also allows to overcome the structural interference and the limits of concurrent and retrospective protocols when used with screen reader users. In this way, PCTA reduces the efficiency difference of usability evaluation between blind and sighted users.

Clomiphene citrate 'stair-step' protocol vs. traditional protocol in patients with polycystic ovary syndrome: a randomized controlled trial.

PubMed

Deveci, Canan Dura; Demir, Berfu; Sengul, Ozlem; Dilbaz, Berna; Goktolga, Umit

2015-01-01

To evaluate the efficacy of the stair-step protocol using clomiphene citrate (CC) and to assess the uterine and systemic side effects in patients with polycystic ovary syndrome (PCOS). A total of 60 PCOS patients who failed to respond to 50 mg/day for 5 days of CC treatment within the cycle were randomly allocated to the control (traditional protocol) and study (stair-step protocol) groups. In the stair-step protocol,patients were treated with CC 50 mg/day for 5 days and then in nonresponsive patients, the dosage was increased to 100 mg/day for 5 days in the same cycle. Patients who failed the 50 mg/day CC treatment in the previous cycle were stimulated with 100 mg/day CC and were accepted as the control group. Ovulation and pregnancy rates, duration of treatment and uterine and systemic side effects were evaluated. Ovulation and pregnancy rates were similar between the stair-step and the control group (43.3 vs. 33.3 %, respectively) (16.7 vs. 10 %, respectively). The duration of treatment was significantly shorter in stair-step compared to traditional protocol (20.5 ± 2.0 vs. 48.6 ± 2.4 days, respectively). There were no significant differences in the systemic side effects between the groups. Uterine side effects were evaluated with endometrial thickness and uterine artery Doppler ultrasound; no significant differences were observed in stair-step compared to traditional protocol. The stair-step protocol was determined to have a significantly shorter treatment period without any detrimental effect on the ovulation and pregnancy rates.

Brazilian version of the Protocole Montréal d'Evaluation de la Communication (Protocole MEC): normative and reliability data.

PubMed

Fonseca, Rochele Paz; Joanette, Yves; Côté, Hélène; Ska, Bernadette; Giroux, Francine; Fachel, Jandyra Maria Guimarães; Damasceno Ferreira, Gabriela; Parente, Maria Alice de Mattos Pimenta

2008-11-01

The lack of standardized instruments to evaluate communication disorders related to the right hemisphere was verified. A new evaluation tool was developed: Protocole Montréal d'Evaluation de la Communication--Protocole MEC, adapted to Brazilian Portuguese--Bateria Montreal de Avaliação da Comunicação--Bateria MAC (Montreal Evaluation of Communication Battery). The purpose was to present stratified normative data by age and educational level, and to verify the reliability parameters of the MEC Battery. 300 individuals, between the ages of 19 and 75 years, and levels of formal education between 2 and 35 years, participated in this study. They were divided equally into six normative groups, according to three age categories (young adults, intermediary age, and seniors) and two educational levels (low and high). Two procedures were used to check reliability: Cronbach alpha and reliability between evaluators, Results were established at the 10th percentile, and an alert point per task for each normative group. Cronbach's alpha was, in general, between .70 and .90 and the average rate of agreement between evaluators varied from .62 to .94. Standards of age and education were established. The reliability of this instrument was verified. The psychometric legitimization of the MEC Battery will contribute to the diagnostic process for communicative disorders.

Forecasts of health care utilization related to pandemic A(H1N1)2009 influenza in the Nord-Pas-de-Calais region, France.

PubMed

Giovannelli, J; Loury, P; Lainé, M; Spaccaferri, G; Hubert, B; Chaud, P

2015-05-01

To describe and evaluate the forecasts of the load that pandemic A(H1N1)2009 influenza would have on the general practitioners (GP) and hospital care systems, especially during its peak, in the Nord-Pas-de-Calais (NPDC) region, France. Modelling study. The epidemic curve was modelled using an assumption of normal distribution of cases. The values for the forecast parameters were estimated from a literature review of observed data from the Southern hemisphere and French Overseas Territories, where the pandemic had already occurred. Two scenarios were considered, one realistic, the other pessimistic, enabling the authors to evaluate the 'reasonable worst case'. Forecasts were then assessed by comparing them with observed data in the NPDC region--of 4 million people. The realistic scenarios forecasts estimated 300,000 cases, 1500 hospitalizations, 225 intensive care units (ICU) admissions for the pandemic wave; 115 hospital beds and 45 ICU beds would be required per day during the peak. The pessimistic scenario's forecasts were 2-3 times higher than the realistic scenario's forecasts. Observed data were: 235,000 cases, 1585 hospitalizations, 58 ICU admissions; and a maximum of 11.6 ICU beds per day. The realistic scenario correctly estimated the temporal distribution of GP and hospitalized cases but overestimated the number of cases admitted to ICU. Obtaining more robust data for parameters estimation--particularly the rate of ICU admission among the population that the authors recommend to use--may provide better forecasts. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effect of progressive wear on the contact mechanics of hip replacements--does the realistic surface profile matter?

PubMed

Wang, Ling; Yang, Wenjian; Peng, Xifeng; Li, Dichen; Dong, Shuangpeng; Zhang, Shu; Zhu, Jinyu; Jin, Zhongmin

2015-04-13

The contact mechanics of artificial metal-on-polyethylene hip joints are believed to affect the lubrication, wear and friction of the articulating surfaces and may lead to the joint loosening. Finite element analysis has been widely used for contact mechanics studies and good agreements have been achieved with current experimental data; however, most studies were carried out with idealist spherical geometries of the hip prostheses rather than the realistic worn surfaces, either for simplification reason or lacking of worn surface profile. In this study, the worn surfaces of the samples from various stages of hip simulator testing (0 to 5 million cycles) were reconstructed as solid models and were applied in the contact mechanics study. The simulator testing results suggested that the center of the head has various departure value from that of the cup and the value of the departure varies with progressively increased wear. This finding was adopted into the finite element study for better evaluation accuracy. Results indicated that the realistic model provided different evaluation from that of the ideal spherical model. Moreover, with the progressively increased wear, large increase of the contact pressure (from 12 to 31 MPa) was predicted on the articulating surface, and the predicted maximum von Mises stress was increased from 7.47 to 13.26 MPa, indicating the marked effect of the worn surface profiles on the contact mechanics of the joint. This study seeks to emphasize the importance of realistic worn surface profile of the acetabular cup especially following large wear volume. Copyright © 2015 Elsevier Ltd. All rights reserved.

An Evaluation of Protocols for UAV Science Applications

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Stewart, David E.; Sullivan, Donald V.; Finch, Patrick E.

2012-01-01

This paper identifies data transport needs for current and future science payloads deployed on the NASA Global Hawk Unmanned Aeronautical Vehicle (UAV). The NASA Global Hawk communication system and operational constrains are presented. The Genesis and Rapid Intensification Processes (GRIP) mission is used to provide the baseline communication requirements as a variety of payloads were utilized in this mission. User needs and desires are addressed. Protocols are matched to the payload needs and an evaluation of various techniques and tradeoffs are presented. Such techniques include utilization rate-base selective negative acknowledgement protocols and possible use of protocol enhancing proxies. Tradeoffs of communication architectures that address ease-of-use and security considerations are also presented.

Evaluation of dose from kV cone-beam computed tomography during radiotherapy: a comparison of methodologies

NASA Astrophysics Data System (ADS)

Buckley, J.; Wilkinson, D.; Malaroda, A.; Metcalfe, P.

2017-01-01

Three alternative methodologies to the Computed-Tomography Dose Index for the evaluation of Cone-Beam Computed Tomography dose are compared, the Cone-Beam Dose Index, IAEA Human Health Report No. 5 recommended methodology and the AAPM Task Group 111 recommended methodology. The protocols were evaluated for Pelvis and Thorax scan modes on Varian® On-Board Imager and Truebeam kV XI imaging systems. The weighted planar average dose was highest for the AAPM methodology across all scans, with the CBDI being the second highest overall. A 17.96% and 1.14% decrease from the TG-111 protocol to the IAEA and CBDI protocols for the Pelvis mode and 18.15% and 13.10% decrease for the Thorax mode were observed for the XI system. For the OBI system, the variation was 16.46% and 7.14% for Pelvis mode and 15.93% to the CBDI protocol in Thorax mode respectively.

Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial

PubMed Central

Kurebayashi, Leonice Fumiko Sato; da Silva, Maria Júlia Paes

2014-01-01

Objective this randomized single blind clinical study aimed to evaluate the efficacy of auriculotherapy with and without a protocol for reducing stress levels among nursing staff. Method a total of 175 nursing professionals with medium and high scores according to Vasconcelos' Stress Symptoms List were divided into 3 groups: Control (58), Group with protocol (58), Group with no protocol (59). They were assessed at the baseline, after 12 sessions, and at the follow-up (30 days). Results in the analysis of variance, statistically significant differences between the Control and Intervention groups were found in the two evaluations (p<0.05) with greater size of effect indices (Cohen) for the No protocol group. The Yang Liver 1 and 2, Kidney, Brain Stem and Shen Men were the points most used. Conclusion individualized auriculotherapy, with no protocol, could expand the scope of the technique for stress reduction compared with auriculotherapy with a protocol. NCT: 01420835 PMID:25029046

Evaluation of a 15-week CHOP protocol for the treatment of canine multicentric lymphoma.

PubMed

Burton, J H; Garrett-Mayer, E; Thamm, D H

2013-12-01

Dose intense CHOP protocols have been shown to improve outcome for people with non-Hodgkin's lymphoma, but evaluation of dose intense CHOP protocols for canine lymphoma is currently limited. The hypothesis of this retrospective study was that a 15-week dose intense CHOP protocol would have shorter treatment duration with similar efficacy to other doxorubicin-based multidrug protocols. Thirty-one client owned dogs with multicentric lymphoma were treated with a 15-week CHOP chemotherapy protocol with an overall response rate of 100% and a median progression-free interval (PFI) of 140 days [95% confidence interval (CI) 91-335 days]. Dogs that had two or more treatment delays had significantly prolonged PFI and overall survival in multivariate analysis. Dose intensity did not correlate with patient outcome. Dogs experiencing multiple treatment delays secondary to adverse events may receive their individual maximally tolerated dose while dogs with no adverse events may be underdosed. Future studies should focus on individual patient dose optimization. © 2012 Blackwell Publishing Ltd.

An Efficient Mutual Authentication Framework for Healthcare System in Cloud Computing.

PubMed

Kumar, Vinod; Jangirala, Srinivas; Ahmad, Musheer

2018-06-28

The increasing role of Telecare Medicine Information Systems (TMIS) makes its accessibility for patients to explore medical treatment, accumulate and approach medical data through internet connectivity. Security and privacy preservation is necessary for medical data of the patient in TMIS because of the very perceptive purpose. Recently, Mohit et al.'s proposed a mutual authentication protocol for TMIS in the cloud computing environment. In this work, we reviewed their protocol and found that it is not secure against stolen verifier attack, many logged in patient attack, patient anonymity, impersonation attack, and fails to protect session key. For enhancement of security level, we proposed a new mutual authentication protocol for the similar environment. The presented framework is also more capable in terms of computation cost. In addition, the security evaluation of the protocol protects resilience of all possible security attributes, and we also explored formal security evaluation based on random oracle model. The performance of the proposed protocol is much better in comparison to the existing protocol.

Thermo-chemical pretreatment of rice straw for further processing for levulinic acid production.

PubMed

Elumalai, Sasikumar; Agarwal, Bhumica; Sangwan, Rajender S

2016-10-01

A variety of pretreatment protocols for rice straw fiber reconstruction were evaluated under mild conditions (upto 0.2%wt. and 121°C) with the object of improving polymer susceptibility to chemical attack while preserving carbohydrate sugars for levulinic acid (LA) production. Each of the protocols tested significantly enhanced pretreatment recoveries of carbohydrate sugars and lignin, and a NaOH protocol showed the most promise, with enhanced carbohydrate preservation (upto 20% relative to the other protocols) and more effective lignin dissolution (upto 60%). Consequently, post-pretreatment fibers were evaluated for LA preparation using an existing co-solvent system consisting of HCl and THF, in addition supplementation of DMSO was attempted, in order to improve final product recovery. In contrast to pretreatment response, H2SO4 protocol fibers yielded highest LA conc. (21%wt. with 36% carbohydrate conversion efficiency) under the modest reaction conditions. Apparent spectroscopic analysis witnessed for fiber destruction and delocalization of inherent constituents during pretreatment protocols. Copyright © 2016 Elsevier Ltd. All rights reserved.

A methodology for generating normal and pathological brain perfusion SPECT images for evaluation of MRI/SPECT fusion methods: application in epilepsy

NASA Astrophysics Data System (ADS)

Grova, C.; Jannin, P.; Biraben, A.; Buvat, I.; Benali, H.; Bernard, A. M.; Scarabin, J. M.; Gibaud, B.

2003-12-01

Quantitative evaluation of brain MRI/SPECT fusion methods for normal and in particular pathological datasets is difficult, due to the frequent lack of relevant ground truth. We propose a methodology to generate MRI and SPECT datasets dedicated to the evaluation of MRI/SPECT fusion methods and illustrate the method when dealing with ictal SPECT. The method consists in generating normal or pathological SPECT data perfectly aligned with a high-resolution 3D T1-weighted MRI using realistic Monte Carlo simulations that closely reproduce the response of a SPECT imaging system. Anatomical input data for the SPECT simulations are obtained from this 3D T1-weighted MRI, while functional input data result from an inter-individual analysis of anatomically standardized SPECT data. The method makes it possible to control the 'brain perfusion' function by proposing a theoretical model of brain perfusion from measurements performed on real SPECT images. Our method provides an absolute gold standard for assessing MRI/SPECT registration method accuracy since, by construction, the SPECT data are perfectly registered with the MRI data. The proposed methodology has been applied to create a theoretical model of normal brain perfusion and ictal brain perfusion characteristic of mesial temporal lobe epilepsy. To approach realistic and unbiased perfusion models, real SPECT data were corrected for uniform attenuation, scatter and partial volume effect. An anatomic standardization was used to account for anatomic variability between subjects. Realistic simulations of normal and ictal SPECT deduced from these perfusion models are presented. The comparison of real and simulated SPECT images showed relative differences in regional activity concentration of less than 20% in most anatomical structures, for both normal and ictal data, suggesting realistic models of perfusion distributions for evaluation purposes. Inter-hemispheric asymmetry coefficients measured on simulated data were found within the range of asymmetry coefficients measured on corresponding real data. The features of the proposed approach are compared with those of other methods previously described to obtain datasets appropriate for the assessment of fusion methods.

Evaluation of Hydroxyatrazine in the Endocrine Disruptor Screening and Testing Program’s Male and Female Pubertal Protocols.

EPA Science Inventory

Evaluation of Hydroxyatrazine in the Endocrine Disruptor Screening and Testing Program’s Male and Female Pubertal Protocols. ABSTRACT Two critical components of the validation of any in vivo screening assay are to demonstrate sensitivity (ability to detect weak endocrine ...

DEVELOPMENT AND APPLICATION OF PROTOCOLS FOR EVALUATION OF OIL SPILL BIOREMEDIATION (RESEARCH BRIEF)

EPA Science Inventory

Protocols were developed and evaluated to assess the efficacy and environmental safety of commercial oil spill bioremediation agents (CBAs). Test systems that simulate oil slicks on open water or oiled sandy beaches were used to test the effectiveness of CBAs. Gravimetric and gas...

Measurement profiles of nano-scale ion beam for optimized radiation energy losses

NASA Astrophysics Data System (ADS)

Woo, T. H.; Cho, H. S.

2011-10-01

The behavior of charged particles is investigated for nano-scale ion beam therapy using a medical accelerator. Computational work is performed for the Bragg-peak simulation, which is focused on human organ material of pancreas and thyroid. The Results show that the trends of the dose have several different kinds of distributions. Before constructing a heavy ion collider, this study can give us the reliability of the therapeutic effect. Realistic treatment using human organs is calculated in a simple and cost effective manner using the computational code, the Stopping and Range of Ions in Matter 2008 (SRIM 2008). Considering the safety of the therapy, it is suggested to give a patient orient planning of the cancer therapy. The energy losses in ionization and phonon are analyzed, which are the behaviors in the molecular level nano-scopic investigation. The different fluctuations are shown at 150 MeV, where the lowest temperature is found in proton and pancreas case. Finally, the protocol for the radiation therapy is constructed by the simulation in which the procedure for a better therapy is selected. An experimental measurement incorporated with the simulations could be programmed by this protocol.

Finite-key security analysis of quantum key distribution with imperfect light sources

DOE PAGES

Mizutani, Akihiro; Curty, Marcos; Lim, Charles Ci Wen; ...

2015-09-09

In recent years, the gap between theory and practice in quantum key distribution (QKD) has been significantly narrowed, particularly for QKD systems with arbitrarily flawed optical receivers. The status for QKD systems with imperfect light sources is however less satisfactory, in the sense that the resulting secure key rates are often overly dependent on the quality of state preparation. This is especially the case when the channel loss is high. Very recently, to overcome this limitation, Tamaki et al proposed a QKD protocol based on the so-called 'rejected data analysis', and showed that its security in the limit of infinitelymore » long keys is almost independent of any encoding flaw in the qubit space, being this protocol compatible with the decoy state method. Here, as a step towards practical QKD, we show that a similar conclusion is reached in the finite-key regime, even when the intensity of the light source is unstable. More concretely, we derive security bounds for a wide class of realistic light sources and show that the bounds are also efficient in the presence of high channel loss. Our results strongly suggest the feasibility of long distance provably secure communication with imperfect light sources.« less

Tracheal decannulation protocol in patients affected by traumatic brain injury.

PubMed

Zanata, Isabel de Lima; Santos, Rosane Sampaio; Hirata, Gisela Carmona

2014-04-01

Introduction The frequency of tracheostomy in patients with traumatic brain injury (TBI) contrasts with the lack of objective criteria for its management. The study arose from the need for a protocol in the decision to remove the tracheal tube. Objective To evaluate the applicability of a protocol for tracheal decannulation. Methods A prospective study with 20 patients, ranging between 21 and 85 years of age (average 33.55), 4 of whom were women (20%) and 16 were men (80%). All patients had been diagnosed by a neurologist as having TBI, and the anatomical region of the lesion was known. Patients were evaluated following criteria for tracheal decannulation through a clinical evaluation protocol developed by the authors. Results Decannulation was performed in 12 (60%) patients. Fourteen (70%) had a score greater than 8 on the Glasgow Coma Scale and only 2 (14%) of these were not able to undergo decannulation. Twelve (60%) patients maintained the breathing pattern with occlusion of the tube and were successfully decannulated. Of the 20 patients evaluated, 11 (55%) showed no signs suggestive of tracheal aspiration, and of these, 9 (82%) began training on occlusion of the cannula. The protocol was relevant to establish the beginning of the decannulation process. The clinical assessment should focus on the patient's condition to achieve early tracheal decannulation. Conclusion This study allowed, with the protocol, to establish six criteria for tracheal decannulation: level of consciousness, respiration, tracheal secretion, phonation, swallowing, and coughing.

Tracheal Decannulation Protocol in Patients Affected by Traumatic Brain Injury

PubMed Central

Zanata, Isabel de Lima; Santos, Rosane Sampaio; Hirata, Gisela Carmona

2014-01-01

Introduction The frequency of tracheostomy in patients with traumatic brain injury (TBI) contrasts with the lack of objective criteria for its management. The study arose from the need for a protocol in the decision to remove the tracheal tube. Objective To evaluate the applicability of a protocol for tracheal decannulation. Methods A prospective study with 20 patients, ranging between 21 and 85 years of age (average 33.55), 4 of whom were women (20%) and 16 were men (80%). All patients had been diagnosed by a neurologist as having TBI, and the anatomical region of the lesion was known. Patients were evaluated following criteria for tracheal decannulation through a clinical evaluation protocol developed by the authors. Results Decannulation was performed in 12 (60%) patients. Fourteen (70%) had a score greater than 8 on the Glasgow Coma Scale and only 2 (14%) of these were not able to undergo decannulation. Twelve (60%) patients maintained the breathing pattern with occlusion of the tube and were successfully decannulated. Of the 20 patients evaluated, 11 (55%) showed no signs suggestive of tracheal aspiration, and of these, 9 (82%) began training on occlusion of the cannula. The protocol was relevant to establish the beginning of the decannulation process. The clinical assessment should focus on the patient's condition to achieve early tracheal decannulation. Conclusion This study allowed, with the protocol, to establish six criteria for tracheal decannulation: level of consciousness, respiration, tracheal secretion, phonation, swallowing, and coughing. PMID:25992074

Evaluation of the effects of footwear hygiene protocols on nonspecific bacterial contamination of floor surfaces in an equine hospital.

PubMed

Stockton, Kelly A; Morley, Paul S; Hyatt, Doreene R; Burgess, Brandy A; Patterson, Gage; Dunowska, Magda; Lee, David E

2006-04-01

To evaluate the effects of footwear hygiene protocols on bacterial contamination of floor surfaces in an equine hospital. Field trial. Footwear hygiene protocols evaluated included use of rubber overboots with footbaths and footmats containing a quaternary ammonium disinfectant, rubber overboots with footbaths and footmats containing a peroxygen disinfectant, and no restrictions on footwear type but mandatory use of footbaths and footmats containing a peroxygen disinfectant. Nonspecific aerobic bacterial counts were determined via 2 procedures for sample collection and bacterial enumeration (contact plates vs swabbing combined with use of spread plates), and the effects of each footwear hygiene protocol were compared. There were no consistent findings suggesting that any of the protocols were associated with differences in numbers of bacteria recovered from floor surfaces. Although there were detectable differences in numbers of bacteria recovered in association with different footwear hygiene protocols, differences in least square mean bacterial counts did not appear to be clinically relevant (ie, were < 1 log10). Although cleaning and disinfection of footwear are important aids in reducing the risk of nosocomial transmission of infectious agents in veterinary hospitals, the numbers of aerobic bacteria recovered from floor surfaces were not affected by use of rubber overboots or the types of disinfectant used in this study. Further study is warranted to evaluate the usefulness of footwear hygiene practices relative to their efficacy for reducing transmission of specific pathogens or decreasing nosocomial disease risk.

Evaluation of simulation training in cardiothoracic surgery: the Senior Tour perspective.

PubMed

Fann, James I; Feins, Richard H; Hicks, George L; Nesbitt, Jonathan C; Hammon, John W; Crawford, Fred A

2012-02-01

The study objective was to introduce senior surgeons, referred to as members of the "Senior Tour," to simulation-based learning and evaluate ongoing simulation efforts in cardiothoracic surgery. Thirteen senior cardiothoracic surgeons participated in a 2½-day Senior Tour Meeting. Of 12 simulators, each participant focused on 6 cardiac (small vessel anastomosis, aortic cannulation, cardiopulmonary bypass, aortic valve replacement, mitral valve repair, and aortic root replacement) or 6 thoracic surgical simulators (hilar dissection, esophageal anastomosis, rigid bronchoscopy, video-assisted thoracoscopic surgery lobectomy, tracheal resection, and sleeve resection). The participants provided critical feedback regarding the realism and utility of the simulators, which served as the basis for a composite assessment of the simulators. All participants acknowledged that simulation may not provide a wholly immersive experience. For small vessel anastomosis, the portable chest model is less realistic compared with the porcine model, but is valuable in teaching anastomosis mechanics. The aortic cannulation model allows multiple cannulations and can serve as a thoracic aortic surgery model. The cardiopulmonary bypass simulator provides crisis management experience. The porcine aortic valve replacement, mitral valve annuloplasty, and aortic root models are realistic and permit standardized training. The hilar dissection model is subject to variability of porcine anatomy and fragility of the vascular structures. The realistic esophageal anastomosis simulator presents various approaches to esophageal anastomosis. The exercise associated with the rigid bronchoscopy model is brief, and adding additional procedures should be considered. The tracheal resection, sleeve resection, and video-assisted thoracoscopic surgery lobectomy models are highly realistic and simulate advanced maneuvers. By providing the necessary tools, such as task trainers and assessment instruments, the Senior Tour may be one means to enhance simulation-based learning in cardiothoracic surgery. The Senior Tour members can provide regular programmatic evaluation and critical analyses to ensure that proposed simulators are of educational value. Published by Mosby, Inc.

Standardization of a Videofluoroscopic Swallow Study Protocol to Investigate Dysphagia in Dogs.

PubMed

Harris, R A; Grobman, M E; Allen, M J; Schachtel, J; Rawson, N E; Bennett, B; Ledyayev, J; Hopewell, B; Coates, J R; Reinero, C R; Lever, T E

2017-03-01

Videofluoroscopic swallow study (VFSS) is the gold standard for diagnosis of dysphagia in veterinary medicine but lacks standardized protocols that emulate physiologic feeding practices. Age impacts swallow function in humans but has not been evaluated by VFSS in dogs. To develop a protocol with custom kennels designed to allow free-feeding of 3 optimized formulations of contrast media and diets that address limitations of current VFSS protocols. We hypothesized that dogs evaluated by a free-feeding VFSS protocol would show differences in objective swallow metrics based on age. Healthy juvenile, adult, and geriatric dogs (n = 24). Prospective, experimental study. Custom kennels were developed to maintain natural feeding behaviors during VFSS. Three food consistencies (thin liquid, pureed food, and dry kibble) were formulated with either iohexol or barium to maximize palatability and voluntary prehension. Dogs were evaluated by 16 swallow metrics and compared across age groups. Development of a standardized VFSS protocol resulted in successful collection of swallow data in healthy dogs. No significant differences in swallow metrics were observed among age groups. Substantial variability was observed in healthy dogs when evaluated under these physiologic conditions. Features typically attributed to pathologic states, such as gastric reflux, were seen in healthy dogs. Development of a VFSS protocol that reflects natural feeding practices may allow emulation of physiology resulting in clinical signs of dysphagia. Age did not result in significant changes in swallow metrics, but additional studies are needed, particularly in light of substantial normal variation. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.