Learning from Action Evaluation of the Use of Multimedia Case Studies in Management Information Systems Courses

ERIC Educational Resources Information Center

Kawulich, Barbara B.

2011-01-01

This manuscript shares lessons learned from conducting an action evaluation of the use of multimedia case studies in Management Information Systems (MIS) courses. Three undergraduate MIS classes took part in the study. The purpose for using case studies in these classes was to teach students about the role of MIS in business. An action evaluation…

Case Studies in Library Computer Systems.

ERIC Educational Resources Information Center

Palmer, Richard Phillips

Twenty descriptive case studies of computer applications in a variety of libraries are presented in this book. Computerized circulation, serial and acquisition systems in public, high school, college, university and business libraries are included. Each of the studies discusses: 1) the environment in which the system operates, 2) the objectives of…

Compressed Air System Redesign Results in Increased Production at a Fuel System Plant (Caterpillar Fuel Systems Pontiac Plant)

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

None

2001-06-01

This case study is one in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. This case study documents the activities, savings, and lessons learned on the Caterpillar's Pontiac Plant project.

A case study of the Maintenance Decision Support System (MDSS) in Maine.

DOT National Transportation Integrated Search

2007-09-10

This report presents the results of a case study evaluation of a Maintenance Decision Support System (MDSS) project under a program funded by the U.S. Department of Transportations (USDOT) Intelligent Transportation Systems (ITS) Joint Program Off...

Case Studies in a Physiology Course on the Autonomic Nervous System: Design, Implementation, and Evaluation

ERIC Educational Resources Information Center

Zimmermann, Martina

2010-01-01

The introduction of case studies on the autonomic nervous system in a fourth-semester physiology course unit for Pharmacy students is described in this article. This article considers how these case studies were developed and presents their content. Moreover, it reflects on their implementation and, finally, the reception of such a transformation…

Driving towards malaria elimination in Botswana by 2018: progress on case-based surveillance, 2013–2014

PubMed Central

Edwards, J.; Namboze, J.; Butt, W.; Moakofhi, K.; Obopile, M.; Manzi, M.; Takarinda, K. C.; Zachariah, R.; Owiti, P.; Oumer, N.; Mosweunyane, T.

2018-01-01

Background: Reliable information reporting systems ensure that all malaria cases are tested, treated and tracked to avoid further transmission. Botswana aimed to eliminate malaria by 2018, and surveillance is key. This study focused on assessing the uptake of the new malaria case-based surveillance (CBS) system introduced in 2012, which captures information on malaria cases reported in the Integrated Disease Surveillance and Response (IDSR) system. Methods: This was a retrospective descriptive study based on routine data focusing on Ngami, Chobe and Okavango, three high-risk districts in Botswana. Aggregated data variables were extracted from the IDSR and compared with data from the CBS. Results: The IDSR reported 456 malaria cases in 2013 and 1346 in 2014, of which respectively only 305 and 884 were reported by the CBS. The CBS reported 34% fewer cases than the IDSR system, indicating substantial differences between the two systems. The key malaria indicators with the greatest variability among the districts included in the study were case identification number and date of diagnosis. Conclusion: The IDSR and CBS systems are essential for malaria elimination, as shown by the significant gaps in reporting between the two systems. These findings highlight the need for further investigation into these discrepancies. Strengthening the CBS system will help to reach the objective of malaria elimination in Botswana. PMID:29713590

Driving towards malaria elimination in Botswana by 2018: progress on case-based surveillance, 2013-2014.

PubMed

Motlaleng, M; Edwards, J; Namboze, J; Butt, W; Moakofhi, K; Obopile, M; Manzi, M; Takarinda, K C; Zachariah, R; Owiti, P; Oumer, N; Mosweunyane, T

2018-04-25

Background: Reliable information reporting systems ensure that all malaria cases are tested, treated and tracked to avoid further transmission. Botswana aimed to eliminate malaria by 2018, and surveillance is key. This study focused on assessing the uptake of the new malaria case-based surveillance (CBS) system introduced in 2012, which captures information on malaria cases reported in the Integrated Disease Surveillance and Response (IDSR) system. Methods: This was a retrospective descriptive study based on routine data focusing on Ngami, Chobe and Okavango, three high-risk districts in Botswana. Aggregated data variables were extracted from the IDSR and compared with data from the CBS. Results: The IDSR reported 456 malaria cases in 2013 and 1346 in 2014, of which respectively only 305 and 884 were reported by the CBS. The CBS reported 34% fewer cases than the IDSR system, indicating substantial differences between the two systems. The key malaria indicators with the greatest variability among the districts included in the study were case identification number and date of diagnosis. Conclusion: The IDSR and CBS systems are essential for malaria elimination, as shown by the significant gaps in reporting between the two systems. These findings highlight the need for further investigation into these discrepancies. Strengthening the CBS system will help to reach the objective of malaria elimination in Botswana.

System Safety in Early Manned Space Program: A Case Study of NASA and Project Mercury

NASA Technical Reports Server (NTRS)

Hansen, Frederick D.; Pitts, Donald

2005-01-01

This case study provides a review of National Aeronautics and Space Administration s (NASA's) involvement in system safety during research and evolution from air breathing to exo-atmospheric capable flight systems culminating in the successful Project Mercury. Although NASA has been philosophically committed to the principals of system safety, this case study points out that budget and manpower constraints-as well as a variety of internal and external pressures can jeopardize even a well-designed system safety program. This study begins with a review of the evolution and early years of NASA's rise as a project lead agency and ends with the lessons learned from Project Mercury.

iHelp: an intelligent online helpdesk system.

PubMed

Wang, Dingding; Li, Tao; Zhu, Shenghuo; Gong, Yihong

2011-02-01

Due to the importance of high-quality customer service, many companies use intelligent helpdesk systems (e.g., case-based systems) to improve customer service quality. However, these systems face two challenges: 1) Case retrieval measures: most case-based systems use traditional keyword-matching-based ranking schemes for case retrieval and have difficulty to capture the semantic meanings of cases and 2) result representation: most case-based systems return a list of past cases ranked by their relevance to a new request, and customers have to go through the list and examine the cases one by one to identify their desired cases. To address these challenges, we develop iHelp, an intelligent online helpdesk system, to automatically find problem-solution patterns from the past customer-representative interactions. When a new customer request arrives, iHelp searches and ranks the past cases based on their semantic relevance to the request, groups the relevant cases into different clusters using a mixture language model and symmetric matrix factorization, and summarizes each case cluster to generate recommended solutions. Case and user studies have been conducted to show the full functionality and the effectiveness of iHelp.

Associated congenital anomalies among cases with Down syndrome.

PubMed

Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

2015-12-01

Down syndrome (DS) is the most common congenital anomaly widely studied for at least 150 years. However, the type and the frequency of congenital anomalies associated with DS are still controversial. Despite prenatal diagnosis and elective termination of pregnancy for fetal anomalies, in Europe, from 2008 to 2012 the live birth prevalence of DS per 10,000 was 10. 2. The objectives of this study were to examine the major congenital anomalies occurring in infants and fetuses with Down syndrome. The material for this study came from 402,532 consecutive pregnancies of known outcome registered by our registry of congenital anomalies between 1979 and 2008. Four hundred sixty seven (64%) out of the 728 cases with DS registered had at least one major associated congenital anomaly. The most common associated anomalies were cardiac anomalies, 323 cases (44%), followed by digestive system anomalies, 42 cases (6%), musculoskeletal system anomalies, 35 cases (5%), urinary system anomalies, 28 cases (4%), respiratory system anomalies, 13 cases (2%), and other system anomalies, 26 cases (3.6%). Among the cases with DS with congenital heart defects, the most common cardiac anomaly was atrioventricular septal defect (30%) followed by atrial septum defect (25%), ventricular septal defect (22%), patent ductus arteriosus (5%), coarctation of aorta (5%), and tetralogy of Fallot (3%). Among the cases with DS with a digestive system anomaly recorded, duodenal atresia (67%), Hirschsprung disease (14%), and tracheo-esophageal atresia (10%) were the most common. Fourteen (2%) of the cases with DS had an obstructive anomaly of the renal pelvis, including hydronephrosis. The other most common anomalies associated with cases with DS were syndactyly, club foot, polydactyly, limb reduction, cataract, hydrocephaly, cleft palate, hypospadias and diaphragmatic hernia. Many studies to assess the anomalies associated with DS have reported various results. There is no agreement in the literature as to which associated anomalies are most common in cases with DS with associated anomalies. In this study we observed a higher percentage of associated anomalies than in the other reported series as well as an increase in the incidence of duodenal atresia, urinary system anomalies, musculoskeletal system anomalies, and respiratory system anomalies, and a decrease in the incidence of anal atresia, annular pancreas, and limb reduction defects. In conclusion, we observed a high prevalence of total congenital anomalies and specific patterns of malformations associated with Down syndrome which emphasizes the need to evaluate carefully all cases with Down syndrome for possible associated major congenital anomalies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

On the Difficulties of Concurrent-System Design, Illustrated with a 2×2 Switch Case Study

NASA Astrophysics Data System (ADS)

Daylight, Edgar G.; Shukla, Sandeep K.

While various specification languages for concurrent-system design exist today, it is often not clear which specification language is more suitable than another for a particular case study. To address this problem, we study four different specification languages for the same 2×2 Switch case study: TLA + , Bluespec, Statecharts, and the Algebra of Communicating Processes (ACP). By slightly altering the design intent of the Switch, we obtain more complicated behaviors of the Switch. For each design intent, we investigate how each specification, in each of the specification languages, captures the corresponding behavior. By using three different criteria, we judge each specification and specification language. For our case study, however, all four specification languages perform poorly in at least two criteria! Hence, this paper illustrates, on a seemingly simple case study, some of the prevailing difficulties of concurrent-system design.

Higher Education Provision Using Systems Thinking Approach--Case Studies

ERIC Educational Resources Information Center

Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

2018-01-01

The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM)…

Significance of User Participation in a Hospital Information System Success: Insights From a Case Study.

PubMed

Saleem, Naveed; Steel, Douglas; Gercek, Gokhan; Chandra, Ashish

User participation in the development of a system is universally prescribed as an effective strategy to ensure the success of the resultant system. However, the existing literature on the merits of user participation only provides equivocal evidence. Various analyses of this literature point out that this equivocal evidence may be due to inconsistent operational measures of the user participation and system success constructs. Planned organizational change and participative decision making, the underlying paradigms of user participation construct, suggest that the development of some information systems may require blending of users' system-related functional expertise and developers' technical expertise to ensure system success. These paradigms also maintain that in case of well-defined, structured information systems user participation should enhance the likelihood of system success through better user understanding of the need for the system and system content and objectives, user trust, and a sense of system ownership. This research also described a case study involving the development and implementation of a medical records system for a neonatal intensive care unit in a large hospital in Texas. The case study provides evidence that in systems that require incorporation of user functional expertise user participation will enhance the likelihood of system success.

Making intelligent systems team players: Additional case studies

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

1993-01-01

Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

Higher education provision using systems thinking approach - case studies

NASA Astrophysics Data System (ADS)

Dhukaram, Anandhi Vivekanandan; Sgouropoulou, Cleo; Feldman, Gerald; Amini, Ardavan

2018-01-01

The purpose of this paper is to highlight the complexities involved in higher education provision and how systems thinking and socio-technical systems (STS) thinking approach can be used to understand the education ecosystem. Systems thinking perspective is provided using two case studies: the development of European Learner Mobility (EuroLM) service and the delivery of Enterprise System Management (ESM) course at the Birmingham City University, UK. The case studies present how systems thinking using STS approaches like applied organisational change and Cognitive Work Analysis can be used to capture a conceptual model of the education system for understanding the interactions and relationships between the people, technology, processes and the organisations. Using systems thinking perspective, EuroLM has developed a set of technical standards addressed to the European systems developers and ESM delivery ensures that students communicate and collaborate.

Issues in Designing a Hypermedia Document System: The Intermedia Case Study.

ERIC Educational Resources Information Center

Yankelovich, Nicole; And Others

1986-01-01

Intermedia, a hypermedia system developed at Brown University's Institute for Research (Rhode Island) in Information and Scholarship, is first described, and then used as a case study to explore a number of key issues that software designers must consider in the development of hypermedia document systems. A hypermedia document system is defined as…

Influence of Cultural, Organizational, and Automation Capability on Human Automation Trust: A Case Study of Auto-GCAS Experimental Test Pilots

NASA Technical Reports Server (NTRS)

Koltai, Kolina; Ho, Nhut; Masequesmay, Gina; Niedober, David; Skoog, Mark; Cacanindin, Artemio; Johnson, Walter; Lyons, Joseph

2014-01-01

This paper discusses a case study that examined the influence of cultural, organizational and automation capability upon human trust in, and reliance on, automation. In particular, this paper focuses on the design and application of an extended case study methodology, and on the foundational lessons revealed by it. Experimental test pilots involved in the research and development of the US Air Force's newly developed Automatic Ground Collision Avoidance System served as the context for this examination. An eclectic, multi-pronged approach was designed to conduct this case study, and proved effective in addressing the challenges associated with the case's politically sensitive and military environment. Key results indicate that the system design was in alignment with pilot culture and organizational mission, indicating the potential for appropriate trust development in operational pilots. These include the low-vulnerability/ high risk nature of the pilot profession, automation transparency and suspicion, system reputation, and the setup of and communications among organizations involved in the system development.

An Extended Case Study Methoology for Investigating Influence of Cultural, Organizational, and Automation Factors on Human-Automation Trust

NASA Technical Reports Server (NTRS)

Koltai, Kolina Sun; Ho, Nhut; Masequesmay, Gina; Niedober, David; Skoog, Mark; Johnson, Walter; Cacanindin, Artemio

2014-01-01

This paper discusses a case study that examined the influence of cultural, organizational and automation capability upon human trust in, and reliance on, automation. In particular, this paper focuses on the design and application of an extended case study methodology, and on the foundational lessons revealed by it. Experimental test pilots involved in the research and development of the US Air Forces newly developed Automatic Ground Collision Avoidance System served as the context for this examination. An eclectic, multi-pronged approach was designed to conduct this case study, and proved effective in addressing the challenges associated with the cases politically sensitive and military environment. Key results indicate that the system design was in alignment with pilot culture and organizational mission, indicating the potential for appropriate trust development in operational pilots. These include the low-vulnerabilityhigh risk nature of the pilot profession, automation transparency and suspicion, system reputation, and the setup of and communications among organizations involved in the system development.

Enabling Business Processes through Information Management and IT Systems: The FastFit and Winter Gear Distributors Case Studies

ERIC Educational Resources Information Center

Kesner, Richard M.; Russell, Bruce

2009-01-01

The "FastFit Case Study" and its companion, the "Winter Gear Distributors Case Study" provide undergraduate business students with a suitable and even familiar business context within which to initially consider the role of information management (IM) and to a lesser extent the role of information technology (IT) systems in enabling a business.…

Simulation study of the ROMPS robot control system

NASA Technical Reports Server (NTRS)

Nguyen, Charles C.; Liu, HUI-I.

1994-01-01

This is a report presenting the progress of a research grant funded by NASA for work performed from June 1, 1993 to August 1, 1993. The report deals with the Robot Operated Material Processing System (ROMPS). It presents results of a computer simulation study conducted to investigate the performance of the control systems controlling the azimuth, elevation, and radial axes of the ROMPS and its gripper. Four study cases are conducted. The first case investigates the control of free motion of the three areas. In the second case, the compliant motion in the elevation axis with the wrist compliant device is studied in terms of position accuracy and impact forces. The third case focuses on the behavior of the control system in controlling the robot motion along the radial axis when pulling the pallet out of the rack. In the fourth case, the compliant motion of the gripper grasping a solid object under the effect of the gripper passive compliance is studied in terms of position accuracy and contact forces. For each of the above cases, a set of PIR gains will be selected to optimize the controller performance and computer simulation results will be presented and discussed.

A PILOT STUDY COMPARING THE BLOCK SYSTEM AND THE INTERMITTENT SYSTEM OF SCHEDULING SPEECH CORRECTION CASES IN THE PUBLIC SCHOOLS.

ERIC Educational Resources Information Center

WEAVER, JOHN B.; WOLLERSHEIM, JANET P.

TO DETERMINE THE MOST EFFICIENT USES OF THE PUBLIC SCHOOL SPEECH CORRECTIONIST'S SKILLS AND TIME, A STUDY WAS UNDERTAKEN TO INVESTIGATE THE EFFECTIVENESS OF THE INTERMITTENT SYSTEM AND THE BLOCK SYSTEM OF SCHEDULING SPEECH CASES. WITH THE INTERMITTENT SYSTEM THE CORRECTIONIST IS ASSIGNED TO A NUMBER OF SCHOOLS AND GENERALLY SEES CHILDREN TWICE A…

Improving School Leadership. Volume 2: Case Studies on System Leadership

ERIC Educational Resources Information Center

Hopkins, David, Ed.; Nusche, Deborah, Ed.; Pont, Beatriz, Ed.

2008-01-01

This book explores what specialists are saying about system leadership for school improvement. Case studies examine innovative approaches to sharing leadership across schools in Belgium (Flanders), Finland and the United Kingdom (England) and leadership development programmes for system improvement in Australia and Austria. As these are emerging…

Case Study: eCoaching in a Corporate Environment

ERIC Educational Resources Information Center

Warner, Teri L. C.

2012-01-01

This qualitative particularistic case study was an exploration and evaluation of an online, asynchronous, non-human coaching system called an "eCoaching system." Developed by the researcher, the eCoaching system combined performance coaching with the latest technologies in eLearning. The coaching was based on the appreciative inquiry approach, and…

Reliability of intracerebral hemorrhage classification systems: A systematic review.

PubMed

Rannikmäe, Kristiina; Woodfield, Rebecca; Anderson, Craig S; Charidimou, Andreas; Chiewvit, Pipat; Greenberg, Steven M; Jeng, Jiann-Shing; Meretoja, Atte; Palm, Frederic; Putaala, Jukka; Rinkel, Gabriel Je; Rosand, Jonathan; Rost, Natalia S; Strbian, Daniel; Tatlisumak, Turgut; Tsai, Chung-Fen; Wermer, Marieke Jh; Werring, David; Yeh, Shin-Joe; Al-Shahi Salman, Rustam; Sudlow, Cathie Lm

2016-08-01

Accurately distinguishing non-traumatic intracerebral hemorrhage (ICH) subtypes is important since they may have different risk factors, causal pathways, management, and prognosis. We systematically assessed the inter- and intra-rater reliability of ICH classification systems. We sought all available reliability assessments of anatomical and mechanistic ICH classification systems from electronic databases and personal contacts until October 2014. We assessed included studies' characteristics, reporting quality and potential for bias; summarized reliability with kappa value forest plots; and performed meta-analyses of the proportion of cases classified into each subtype. We included 8 of 2152 studies identified. Inter- and intra-rater reliabilities were substantial to perfect for anatomical and mechanistic systems (inter-rater kappa values: anatomical 0.78-0.97 [six studies, 518 cases], mechanistic 0.89-0.93 [three studies, 510 cases]; intra-rater kappas: anatomical 0.80-1 [three studies, 137 cases], mechanistic 0.92-0.93 [two studies, 368 cases]). Reporting quality varied but no study fulfilled all criteria and none was free from potential bias. All reliability studies were performed with experienced raters in specialist centers. Proportions of ICH subtypes were largely consistent with previous reports suggesting that included studies are appropriately representative. Reliability of existing classification systems appears excellent but is unknown outside specialist centers with experienced raters. Future reliability comparisons should be facilitated by studies following recently published reporting guidelines. © 2016 World Stroke Organization.

Nonlinear dynamics in ecosystem response to climatic change: Case studies and policy implications

USGS Publications Warehouse

Burkett, Virginia R.; Wilcox, Douglas A.; Stottlemyer, Robert; Barrow, Wylie; Fagre, Dan; Baron, Jill S.; Price, Jeff; Nielsen, Jennifer L.; Allen, Craig D.; Peterson, David L.; Ruggerone, Greg; Doyle, Thomas

2005-01-01

Many biological, hydrological, and geological processes are interactively linked in ecosystems. These ecological phenomena normally vary within bounded ranges, but rapid, nonlinear changes to markedly different conditions can be triggered by even small differences if threshold values are exceeded. Intrinsic and extrinsic ecological thresholds can lead to effects that cascade among systems, precluding accurate modeling and prediction of system response to climate change. Ten case studies from North America illustrate how changes in climate can lead to rapid, threshold-type responses within ecological communities; the case studies also highlight the role of human activities that alter the rate or direction of system response to climate change. Understanding and anticipating nonlinear dynamics are important aspects of adaptation planning since responses of biological resources to changes in the physical climate system are not necessarily proportional and sometimes, as in the case of complex ecological systems, inherently nonlinear.

Exploring the business case for ambulatory electronic health record system adoption.

PubMed

Song, Paula H; McAlearney, Ann Scheck; Robbins, Julie; McCullough, Jeffrey S

2011-01-01

Widespread implementation and use of electronic health record (EHR) systems has been recognized by healthcare leaders as a cornerstone strategy for systematically reducing medical errors and improving clinical quality. However, EHR adoption requires a significant capital investment for healthcare providers, and cost is often cited as a barrier. Despite the capital requirements, a true business case for EHR system adoption and implementation has not been made. This is of concern, as the lack of a business case can influence decision making about EHR investments. The purpose of this study was to examine the role of business case analysis in healthcare organizations' decisions to invest in ambulatory EHR systems, and to identify what factors organizations considered when justifying an ambulatory EHR. Using a qualitative case study approach, we explored how five organizations that are considered to have best practices in ambulatory EHR system implementation had evaluated the business case for EHR adoption. We found that although the rigor of formal business case analysis was highly variable, informants across these organizations consistently reported perceiving that a positive business case for EHR system adoption existed, especially when they considered both financial and non-financial benefits. While many consider EHR system adoption inevitable in healthcare, this viewpoint should not deter managers from conducting a business case analysis. Results of such an analysis can inform healthcare organizations' understanding about resource allocation needs, help clarify expectations about financial and clinical performance metrics to be monitored through EHR systems, and form the basis for ongoing organizational support to ensure successful system implementation.

Making a Case for a Blended Approach: The Need for The Design-Based Case Study

ERIC Educational Resources Information Center

Deaton, Cynthia C. M.; Malloy, Jacquelynn A.

2017-01-01

Design-based case studies address research questions that involve instructional innovations within a bounded system. This blend of case study and design-based research provides a systematic approach to examining instructional innovations that are bounded by perspective, context, and time. Design-based case studies provide a framework for engaging…

Food system sustainability for health and well-being of Indigenous Peoples.

PubMed

Kuhnlein, Harriet V

2015-09-01

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions. Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries. The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas. Leaders of the Indigenous Peoples' case studies, their communities and their academic partners. Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples. Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

Coupling socioeconomic and lake systems for sustainability: a conceptual analysis using Lake St. Clair region as a case study.

PubMed

Mavrommati, Georgia; Baustian, Melissa M; Dreelin, Erin A

2014-04-01

Applying sustainability at an operational level requires understanding the linkages between socioeconomic and natural systems. We identified linkages in a case study of the Lake St. Clair (LSC) region, part of the Laurentian Great Lakes system. Our research phases included: (1) investigating and revising existing coupled human and natural systems frameworks to develop a framework for this case study; (2) testing and refining the framework by hosting a 1-day stakeholder workshop and (3) creating a causal loop diagram (CLD) to illustrate the relationships among the systems' key components. With stakeholder assistance, we identified four interrelated pathways that include water use and discharge, land use, tourism and shipping that impact the ecological condition of LSC. The interrelationships between the pathways of water use and tourism are further illustrated by a CLD with several feedback loops. We suggest that this holistic approach can be applied to other case studies and inspire the development of dynamic models capable of informing decision making for sustainability.

Bifurcation study of phase oscillator systems with attractive and repulsive interaction.

PubMed

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

Bifurcation study of phase oscillator systems with attractive and repulsive interaction

NASA Astrophysics Data System (ADS)

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2014-08-01

We study a model of globally coupled phase oscillators that contains two groups of oscillators with positive (synchronizing) and negative (desynchronizing) incoming connections for the first and second groups, respectively. This model was previously studied by Hong and Strogatz (the Hong-Strogatz model) in the case of a large number of oscillators. We consider a generalized Hong-Strogatz model with a constant phase shift in coupling. Our approach is based on the study of invariant manifolds and bifurcation analysis of the system. In the case of zero phase shift, various invariant manifolds are analytically described and a new dynamical mode is found. In the case of a nonzero phase shift we obtained a set of bifurcation diagrams for various systems with three or four oscillators. It is shown that in these cases system dynamics can be complex enough and include multistability and chaotic oscillations.

OPTIMIZED REAL-TIME CONTROL OF COMBINED SEWERAGE SYSTEMS: TWO CASE STUDIES

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC ...

Diversity in case management modalities: the Summit model.

PubMed

Peterson, G A; Drone, I D; Munetz, M R

1997-06-01

Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner.

Case study and lessons learned for the Great Lakes ITS Program, Airport ITS Integration and the Road Infrastructure Management System projects, final report, Wayne County, Michigan

DOT National Transportation Integrated Search

2007-03-02

This report presents the case study and lessons learned for the national evaluation of the Great Lakes Intelligent Transportation Systems (GLITS) Airport ITS Integration and Road Infrastructure Management System (RIMS) projects. The Airport ITS Integ...

C++ and operating systems performance - A case study

NASA Technical Reports Server (NTRS)

Russo, Vincent F.; Madany, Peter W.; Campbell, Roy H.

1990-01-01

Object-oriented design and programming has many software engineering advantages. Its application to large systems, however, has previously been constrained by performance concerns. The Choices operating system, which has over 75,000 lines of code, is object-oriented and programmed in C++. This paper is a case study of the performance of Choices.

Underreporting of fatal poisonings in Brazil - A descriptive study using data from four information systems.

PubMed

Magalhães, Andrea Franco Amoras; Caldas, Eloisa Dutra

2018-06-01

Poisoning is a worldwide problem that involves individuals of all ages and a range of chemicals. In this study, fatal poisoning cases that occurred in the Federal District of Brazil (DF) from 2009 to 2013 were described using information from four systems, and the reasons for underreporting of each system were discussed. Data were obtained from the mortality information system (SIM), the notifiable disease information system (SINAN), the poison information center (CIT), and the forensic medicine institute (IML) of the DF. In total, 288 cases were reported to SIM, 18 to SINAN, 29 to CIT and 101 cases identified in the IML. SIM data indicated a prevalence of 2.24 cases/year/100,000 individuals in the DF, higher than the national estimation (1.36). After eliminating the 98 duplicate cases among the systems, 338 fatal unique cases were identified, from which 74.0% were reported in only one system (mainly the SIM), 23.4% in two systems, 8 cases in three systems and only 1 case was reported in the four systems. Over two thirds of the 338 fatalities involved men (67.4%), and 46.9% involved individuals aged 20-39 years. Medications were the main agent involved (49.4%), followed by pesticides (29.9%). The fatalities occurred mainly after unintentional exposure (50.8%) and suicide (47.7%, of which 53.5% involved pesticides). These results confirmed the previous hypothesis that none of the information systems could capture the whole picture of fatal poisonings in the DF. Underreporting was found in all systems, indicating the need to improve the information quality and the coordination of data reporting, so that health authorities can better understand and reduce these fatalities. Copyright © 2018 Elsevier B.V. All rights reserved.

Railroad classification yard technology : computer system methodology : case study : Potomac Yard

DOT National Transportation Integrated Search

1981-08-01

This report documents the application of the railroad classification yard computer system methodology to Potomac Yard of the Richmond, Fredericksburg, and Potomac Railroad Company (RF&P). This case study entailed evaluation of the yard traffic capaci...

Application of Text Information Extraction System for Real-Time Cancer Case Identification in an Integrated Healthcare Organization.

PubMed

Xie, Fagen; Lee, Janet; Munoz-Plaza, Corrine E; Hahn, Erin E; Chen, Wansu

2017-01-01

Surgical pathology reports (SPR) contain rich clinical diagnosis information. The text information extraction system (TIES) is an end-to-end application leveraging natural language processing technologies and focused on the processing of pathology and/or radiology reports. We deployed the TIES system and integrated SPRs into the TIES system on a daily basis at Kaiser Permanente Southern California. The breast cancer cases diagnosed in December 2013 from the Cancer Registry (CANREG) were used to validate the performance of the TIES system. The National Cancer Institute Metathesaurus (NCIM) concept terms and codes to describe breast cancer were identified through the Unified Medical Language System Terminology Service (UTS) application. The identified NCIM codes were used to search for the coded SPRs in the back-end datastore directly. The identified cases were then compared with the breast cancer patients pulled from CANREG. A total of 437 breast cancer concept terms and 14 combinations of "breast"and "cancer" terms were identified from the UTS application. A total of 249 breast cancer cases diagnosed in December 2013 was pulled from CANREG. Out of these 249 cases, 241 were successfully identified by the TIES system from a total of 457 reports. The TIES system also identified an additional 277 cases that were not part of the validation sample. Out of the 277 cases, 11% were determined as highly likely to be cases after manual examinations, and 86% were in CANREG but were diagnosed in months other than December of 2013. The study demonstrated that the TIES system can effectively identify potential breast cancer cases in our care setting. Identified potential cases can be easily confirmed by reviewing the corresponding annotated reports through the front-end visualization interface. The TIES system is a great tool for identifying potential various cancer cases in a timely manner and on a regular basis in support of clinical research studies.

A Database Design and Development Case: NanoTEK Networks

ERIC Educational Resources Information Center

Ballenger, Robert M.

2010-01-01

This case provides a real-world project-oriented case study for students enrolled in a management information systems, database management, or systems analysis and design course in which database design and development are taught. The case consists of a business scenario to provide background information and details of the unique operating…

IVHS institutional issues and case studies : ADVANCE case study

DOT National Transportation Integrated Search

1994-04-01

This operational test case study is one of six performed in response to a Volpe National Transportation Systems Center technical task directive (TTD) to Science Applications International Corporation (SAIC) entitled, IVHS Institutional Issues and ...

Systems Engineering Case Studies, Synopsis of the Learning Principles

DTIC Science & Technology

2009-08-24

TBMCS refers to the Theater Battle Management Core System Systems Engineering Case Study Peacekeeper refers to the Peacekeeper Intercontinental...primary mirror defect going to orbit undetected in spite of substantial evidence that could have been used to prevent this occurrence. TBMCS /1...The requirements baseline was volatile up to system acceptance, which took place after TBMCS passed operational test and evaluation. Approved for

A New Approach to Integrate Internet-of-Things and Software-as-a-Service Model for Logistic Systems: A Case Study

PubMed Central

Chen, Shang-Liang; Chen, Yun-Yao; Hsu, Chiang

2014-01-01

Cloud computing is changing the ways software is developed and managed in enterprises, which is changing the way of doing business in that dynamically scalable and virtualized resources are regarded as services over the Internet. Traditional manufacturing systems such as supply chain management (SCM), customer relationship management (CRM), and enterprise resource planning (ERP) are often developed case by case. However, effective collaboration between different systems, platforms, programming languages, and interfaces has been suggested by researchers. In cloud-computing-based systems, distributed resources are encapsulated into cloud services and centrally managed, which allows high automation, flexibility, fast provision, and ease of integration at low cost. The integration between physical resources and cloud services can be improved by combining Internet of things (IoT) technology and Software-as-a-Service (SaaS) technology. This study proposes a new approach for developing cloud-based manufacturing systems based on a four-layer SaaS model. There are three main contributions of this paper: (1) enterprises can develop their own cloud-based logistic management information systems based on the approach proposed in this paper; (2) a case study based on literature reviews with experimental results is proposed to verify that the system performance is remarkable; (3) challenges encountered and feedback collected from T Company in the case study are discussed in this paper for the purpose of enterprise deployment. PMID:24686728

A new approach to integrate Internet-of-things and software-as-a-service model for logistic systems: a case study.

PubMed

Chen, Shang-Liang; Chen, Yun-Yao; Hsu, Chiang

2014-03-28

Cloud computing is changing the ways software is developed and managed in enterprises, which is changing the way of doing business in that dynamically scalable and virtualized resources are regarded as services over the Internet. Traditional manufacturing systems such as supply chain management (SCM), customer relationship management (CRM), and enterprise resource planning (ERP) are often developed case by case. However, effective collaboration between different systems, platforms, programming languages, and interfaces has been suggested by researchers. In cloud-computing-based systems, distributed resources are encapsulated into cloud services and centrally managed, which allows high automation, flexibility, fast provision, and ease of integration at low cost. The integration between physical resources and cloud services can be improved by combining Internet of things (IoT) technology and Software-as-a-Service (SaaS) technology. This study proposes a new approach for developing cloud-based manufacturing systems based on a four-layer SaaS model. There are three main contributions of this paper: (1) enterprises can develop their own cloud-based logistic management information systems based on the approach proposed in this paper; (2) a case study based on literature reviews with experimental results is proposed to verify that the system performance is remarkable; (3) challenges encountered and feedback collected from T Company in the case study are discussed in this paper for the purpose of enterprise deployment.

Interpretive Research Aiming at Theory Building: Adopting and Adapting the Case Study Design

ERIC Educational Resources Information Center

Diaz Andrade, Antonio

2009-01-01

Although the advantages of case study design are widely recognised, its original positivist underlying assumptions may mislead interpretive researchers aiming at theory building. The paper discusses the limitations of the case study design for theory building and explains how grounded theory systemic process adds to the case study design. The…

Optimized Real-Time Control of Combined Sewerage Systems: Two Case Studies (Proceedings Paper)

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC al...

Pursuing an Ethic of Care: A Case Study of One Female Superintendent

ERIC Educational Resources Information Center

Rico, Rachelle G.

2009-01-01

This instrumental case study explores how the Ethic of Care is experienced within one Midwestern school system as an alternative approach to traditional school system hierarchical infrastructures. Through the qualitative tradition of portraiture (Lawrence-Lightfoot & Davis, 1997), this study documents the caring leadership actions, behaviors…

Using systems thinking in patient safety: a case study on medicines management.

PubMed

Brimble, Mandy; Jones, Aled

2017-06-29

Systems thinking is used as a way of understanding behaviours and actions in complex healthcare organisations. An important premise of the concept is that every action in a system causes a reaction elsewhere in that system. These reactions can lead to unintended consequences, sometimes long after the original action, and so are not always attributed to them. This article applies systems thinking to a medicines management case study, to highlight how quality-improvement practitioners can use the approach to underpin planning and implementation of patient-safety initiatives. The case study is specific to transcribing in children's hospices, but the strategies can be applied to other areas. The article explains that, while root cause analysis tools are useful for identifying the cause of, and possible solutions to, problems, they need to be considered carefully in terms of unintended consequences, and how the system into which the solution is implemented can be affected by the change. Analysis of problems using a systems-thinking approach can help practitioners to develop robust and well informed business cases to present to decision makers.

Rural automated highway systems case study : greater Yellowstone rural ITS corridor : final report

DOT National Transportation Integrated Search

1998-01-01

In cooperation with the National Automated Highway System Consortium (NAHSC), case studies are being conducted on existing transportation corridors to determine the feasibility of AHS. Initial activities by the NAHSC have focused on urbanized areas. ...

Evaluation of the Cape Cod Advanced Public Transit System : phase 1 and 2

DOT National Transportation Integrated Search

2000-03-01

This case study is one of a series of case studies that examine procurement approaches used to deliver Intelligent Transportation System (ITS) projects. ITS projects are often complex and leverage the latest technology in telecommunications, computer...

A Novel Classification System for Injuries After Electronic Cigarette Explosions.

PubMed

Patterson, Scott B; Beckett, Allison R; Lintner, Alicia; Leahey, Carly; Greer, Ashley; Brevard, Sidney B; Simmons, Jon D; Kahn, Steven A

Electronic cigarettes (e-cigarettes) contain lithium batteries that have been known to explode and/or cause fires that have resulted in burn injury. The purpose of this article is to present a case study, review injuries caused by e-cigarettes, and present a novel classification system from the newly emerging patterns of burns. A case study was presented and online media reports for e-cigarette burns were queried with search terms "e-cigarette burns" and "electronic cigarette burns." The reports and injury patterns were tabulated. Analysis was then performed to create a novel classification system based on the distinct injury patterns seen in the study. Two patients were seen at our regional burn center after e-cigarette burns. One had an injury to his thigh and penis that required operative intervention after ignition of this device in his pocket. The second had a facial burn and corneal abrasions when the device exploded while he was inhaling vapor. The Internet search and case studies resulted in 26 cases for evaluation. The burn patterns were divided in direct injury from the device igniting and indirect injury when the device caused a house or car fire. A numerical classification was created: direct injury: type 1 (hand injury) 7 cases, type 2 (face injury) 8 cases, type 3 (waist/groin injury) 11 cases, and type 5a (inhalation injury from using device) 2 cases; indirect injury: type 4 (house fire injury) 7 cases and type 5b (inhalation injury from fire started by the device) 4 cases. Multiple e-cigarette injuries are occurring in the United States and distinct patterns of burns are emerging. The classification system developed in this article will aid in further study and future regulation of these dangerous devices.

[Central nervous system dysgerminoma: a clinicopathological study of 3 cases].

PubMed

Bellil, Selma; Braham, Emna; Limaiem, Faten; Bellil, Khadija; Chelly, Ines; Mekni, Amina; Haouet, Slim; Zitouna, Moncef; Jemel, Hafedh; Khaldi, Moncef; Kchir, Nidhameddine

2009-03-01

Intracranial germ cell tumors are rarely seen and typically localize in the pineal or suprasellar region. The largest category of germ cell tumors is dysgerminoma. to describe clinicopathological features and immunohistochemical profile of dysgerminomas. We report three cases of central nervous system dysgerminomas. There were two young women and a man who were 6, 11 and 23-year-old. They presented with symptoms of insipidus diabetes (n=3) with association to visual field defects in the third case. Radiological findings showed a supra seller lesion in two cases. Double localization in the pineal and suprasellar regions was seen in the third case. Histologic examination and immunohistochemical study of surgical specimen were consistent with primary central nervous system dysgerminoma.

Using ADDIE and Systems Thinking as the Framework for Developing a MOOC: A Case Study

ERIC Educational Resources Information Center

Croxton, Rebecca A.; Chow, Anthony S.

2015-01-01

This article presents a case study of how systems thinking and the instructional systems design ADDIE (analysis, design, development, implementation, and assessment) model were used to design and develop one of the first MOOCs at a mid-sized university in the southeastern United States. Contemporary issues surrounding MOOCs at both the macro…

Control systems on Lie groups.

NASA Technical Reports Server (NTRS)

Jurdjevic, V.; Sussmann, H. J.

1972-01-01

The controllability properties of systems which are described by an evolution equation in a Lie group are studied. The revelant Lie algebras induced by a right invariant system are singled out, and the basic properties of attainable sets are derived. The homogeneous case and the general case are studied, and results are interpreted in terms of controllability. Five examples are given.

Data Mining in Course Management Systems: Moodle Case Study and Tutorial

ERIC Educational Resources Information Center

Romero, Cristobal; Ventura, Sebastian; Garcia, Enrique

2008-01-01

Educational data mining is an emerging discipline, concerned with developing methods for exploring the unique types of data that come from the educational context. This work is a survey of the specific application of data mining in learning management systems and a case study tutorial with the Moodle system. Our objective is to introduce it both…

Comparing Management Approaches for Automatic Test Systems: A Strategic Missile Case Study

DTIC Science & Technology

2005-03-01

ground up, and is commonly conducted following five methods : ethnography , grounded theory , case study , phenomenological study , and biography...traditions frequently used (Creswell, 1998:5). The five traditions are biography, phenomenological study , grounded theory study , ethnography , and... Ethnography Biography Case Study Grounded Theory

a Study on Satellite Diagnostic Expert Systems Using Case-Based Approach

NASA Astrophysics Data System (ADS)

Park, Young-Tack; Kim, Jae-Hoon; Park, Hyun-Soo

1997-06-01

Many research works are on going to monitor and diagnose diverse malfunctions of satellite systems as the complexity and number of satellites increase. Currently, many works on monitoring and diagnosis are carried out by human experts but there are needs to automate much of the routine works of them. Hence, it is necessary to study on using expert systems which can assist human experts routine work by doing automatically, thereby allow human experts devote their expertise more critical and important areas of monitoring and diagnosis. In this paper, we are employing artificial intelligence techniques to model human experts' knowledge and inference the constructed knowledge. Especially, case-based approaches are used to construct a knowledge base to model human expert capabilities which use previous typical exemplars. We have designed and implemented a prototype case-based system for diagnosing satellite malfunctions using cases. Our system remembers typical failure cases and diagnoses a current malfunction by indexing the case base. Diverse methods are used to build a more user friendly interface which allows human experts can build a knowledge base in as easy way.

[Clinical analysis of 138 multiple primary cancers diagnosed of digestive system malignant tumor initially].

PubMed

Lyu, J M; Xiong, H C; Wu, B; Zhou, X Q; Hu, J

2018-02-23

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P <0.05). Conclusions: The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient' prognosis was radical treatment to every primary cancer.

Transformational change in healthcare: an examination of four case studies.

PubMed

Charlesworth, Kate; Jamieson, Maggie; Davey, Rachel; Butler, Colin D

2016-04-01

Objectives Healthcare leaders around the world are calling for radical, transformational change of our health and care systems. This will be a difficult and complex task. In this article, we examine case studies in which transformational change has been achieved, and seek to learn from these experiences. Methods We used the case study method to investigate examples of transformational change in healthcare. The case studies were identified from preliminary doctoral research into the transition towards future sustainable health and social care systems. Evidence was collected from multiple sources, key features of each case study were displayed in a matrix and thematic analysis was conducted. The results are presented in narrative form. Results Four case studies were selected: two from the US, one from Australia and one from the UK. The notable features are discussed for each case study. There were many common factors: a well communicated vision, innovative redesign, extensive consultation and engagement with staff and patients, performance management, automated information management and high-quality leadership. Conclusions Although there were some notable differences between the case studies, overall the characteristics of success were similar and collectively provide a blueprint for transformational change in healthcare. What is known about the topic? Healthcare leaders around the world are calling for radical redesign of our systems in order to meet the challenges of modern society. What does this paper add? There are some remarkable examples of transformational change in healthcare. The key factors in success are similar across the case studies. What are the implications for practitioners? Collectively, these key factors can guide future attempts at transformational change in healthcare.

URBAN DRINKING WATER DISTRIBUTION SYSTEMS: A U.S. PERSPECTIVE

EPA Science Inventory

This paper will examine several case studies that illustrate the critical role drinking water treatment and distribution systems play in protecting public health. It will also present a case study that documents the dramatic impact that the regulations promulgated under the Safe...

Metropolitan transportation management center : a case study : Michigan intelligent transportation system : improving safety and air quality while reducing stress for motorists

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of Michigan's Intelligent Transportation Systems transportation management center (MITSC). It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts ...

Systems Engineering Technical Leadership Development Program

DTIC Science & Technology

2012-02-01

leading others in creative problem solving, complexity, and why projects fail . These topics were additionally supported by case studies designed to...Your Core Values Dominick Wed 12:30-1:30 Lunch Wed 1:30-2:45 Case Study: Why Projects Fail Pennotti Wed 2:45-3:00 Break Wed 3:00-4:30 Project...Case Study: When Good Wasn’t Good Enough 11. Technical Value-5: Group Project: AR2D2 RFP 12. Customer Expectation-1: Lecture: Why Systems Fail

Automated and Autonomous Systems for Combat Service Support: Scoping Study and Technology Prioritisation

DTIC Science & Technology

2016-10-01

workshop, and use case development for automated and autonomous systems for CSS. The scoping study covers key concepts and trends, a technology scan, and...requirements and delimiters for the selected technologies. The report goes on to present detailed use cases for two technologies of interest: semi...selected use cases . As a result of the workshop, the large list of technologies and applications from the scoping study was narrowed down to the top

A Community of Congruence among Secondary Social Studies Teachers: A Case Study

ERIC Educational Resources Information Center

Province, Rachael

2012-01-01

The purpose of this case study was to explore the community of one purposely selected department of secondary social studies teachers. I aimed to provide insight into the nature of one community of congruence amid the many constraints and systemic pressures in school systems today. Many have suggested that education is a microcosm of larger…

Northeast Artificial Intelligence Consortium (NAIC). Volume 15. Strategies for Coupling Symbolic and Numerical Computation in Knowledge Base Systems

DTIC Science & Technology

1990-12-01

Implementation of Coupled System 18 15.4. CASE STUDIES & IMPLEMENTATION EXAMPLES 24 15.4.1. The Case Studies of Coupled System 24 15.4.2. Example: Coupled System...occurs during specific phases of the problem-solving process. By decomposing the coupling process into its component layers we effectively study the nature...by the qualitative model, appropriate mathematical model is invoked. 5) The results are verified. If successful, stop. Else go to (2) and use an

Composite Socio-Technical Systems: A Method for Social Energy Systems

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

Zhang, Yingchen; He, Fulin; Hao, Jun

In order to model and study the interactions between social on technical systems, a systemic method, namely the composite socio-technical systems (CSTS), is proposed to incorporate social systems, technical systems and the interaction mechanism between them. A case study on University of Denver (DU) campus grid is presented in paper to demonstrate the application of the proposed method. In the case study, the social system, technical system, and the interaction mechanism are defined and modelled within the framework of CSTS. Distributed and centralized control and management schemes are investigated, respectively, and numerical results verifies the feasibility and performance of themore » proposed composite system method.« less

Gender Differences in Student Performance in Large Lecture Classrooms Using Personal Response Systems ("Clickers") with Narrative Case Studies

ERIC Educational Resources Information Center

Kang, Hosun; Lundeberg, Mary; Wolter, Bjorn; delMas, Robert; Herreid, Clyde F.

2012-01-01

This study investigated gender differences in science learning between two pedagogical approaches: traditional lecture and narrative case studies using personal response systems ("clickers"). Thirteen instructors of introductory biology classes at 12 different institutions across the USA and Canada used two types of pedagogy (Clicker…

Waiting for a Crisis: Case Studies of Crisis Leaders in Higher Education

ERIC Educational Resources Information Center

Muffet-Willett, Stacy L.

2010-01-01

This study examines the system of crisis leadership in higher education. Using case study methods, five crisis leadership participants were interviewed to develop a deep understanding of how they perceive their university crisis leadership system. Two participants were from a private institution, and three were from a public institution. Higher…

Bar-code medication administration system for anesthetics: effects on documentation and billing.

PubMed

Nolen, Agatha L; Rodes, W Dyer

2008-04-01

The effects of using a new bar-code medication administration (BCMA) system for anesthetics to automate documentation of drug administration by anesthesiologists were studied. From October 1, 2004, to September 15, 2005, all medications administered to patients undergoing cardiac surgery were documented with a BCMA system at a large acute care facility. Drug claims data for 12 targeted anesthetics in diagnosis-related groups (DRGs) 104-111 were analyzed to determine the quantity of drugs charged and the revenue generated. Those data were compared with claims data for a historical case-control group (October 1, 2003, to September 15, 2004, for the same DRGs) for which medication use was documented manually. From October 1, 2005, to October 1, 2006, anesthesiologists for cardiac surgeries either voluntarily used the automated system or completed anesthesia records manually. A total of 870 cardiac surgery cases for which the BCMA system was used were evaluated. There were 961 cardiac surgery cases in the historical control group. The BCMA system increased the quantity of drugs documented per case by 21.7% and drug revenue captured per case by 18.8%. The time needed by operating-room pharmacy staff to process an anesthesia record for billing decreased by eight minutes per case. After two years, anesthesiologists voluntarily used the new technology on 100% of cardiac surgery patients. Implementation of a BCMA system for anesthetic use in cardiac surgery increased the quantity of drugs charged by 21.7% per case and drug revenue per case by 18.8%. Anesthesiologists continued to use the automated system on a voluntary basis after conclusion of the initial study.

Impact of Operating Room Environment on Postoperative Central Nervous System Infection in a Resource-Limited Neurosurgical Center in South Asia.

PubMed

Chidambaram, Swathi; Vasudevan, Madabushi Chakravarthy; Nair, Mani Nathan; Joyce, Cara; Germanwala, Anand V

2018-02-01

Postoperative central nervous system infections (PCNSIs) are serious complications following neurosurgical intervention. We previously investigated the incidence and causative pathogens of PCNSIs at a resource-limited, neurosurgical center in south Asia. This follow-up study was conducted to analyze differences in PCNSIs at the same institution following only one apparent change: the operating room air filtration system. This was a retrospective study of all neurosurgical cases performed between December 1, 2013, and March 31, 2016 at our center. Providers, patient demographic data, case types, perioperative care, rate of PCNSI, and rates of other complications were reviewed. These results were then compared with the findings of our previous study of neurosurgical cases between June 1, 2012, and June 30, 2013. All 623 neurosurgical operative cases over the study period were reviewed. Four patients (0.6%) had a PCNSI, and no patients had a positive cerebrospinal fluid (CSF) culture. In the previous study, among 363 cases, 71 patients (19.6%) had a PCNSI and 7 (1.9%) had a positive CSF culture (all Gram-negative organisms). The differences in both parameters are statistically significant (P < 0.001). Between the 2 studies, there was no change in treatment providers, case types, case durations, antibiotic administration practices, and patient demographics. The rates of PCNSI and positive CSF culture were significantly lower in our present cohort compared with the cohort in our previous study. The sole apparent change involves the air filtration system inside the neurosurgical operating rooms; this environmental change occurred during the 5 months between the 2 studies. This study demonstrates the impact of environmental factors in reducing infections. Copyright © 2017 Elsevier Inc. All rights reserved.

Child-Sized Gaps in the System: Case Studies of Child Suicidality and Support within the Australian Healthcare System

ERIC Educational Resources Information Center

McKay, Kathy; Shand, Fiona

2016-01-01

While children both understand the concept of, and have died by, suicide, little research has been conducted on children's experiences of healthcare systems during and after a suicidal crisis. This article focuses on three case studies of mothers with suicidal daughters and aims to describe the health service experiences of parents whose children…

Teacher Attitudes as Related to the Implementation of the New Jersey Teacher Evaluation System

ERIC Educational Resources Information Center

Gallo, Donna

2016-01-01

The focus of this qualitative case study is on an attitudinal change of teachers towards teacher evaluation with the implementation of a new evaluation system. The goal of this qualitative case study was to gain an understanding of how the implementation of the new New Jersey teacher evaluation system relates to teachers' attitudes toward…

Land Application of Wastes: An Educational Program. Case Studies Reviewed - Module 14.

ERIC Educational Resources Information Center

Clarkson, W. W.; And Others

This module provides information about 14 existing land application systems. Each case study gives the location and description of the system, volume treated, climate and soil type, cost, land area, and other data. A brief comment about the system is given as well as a more detailed discussion. References are cited which may be used to examine 100…

Case Study: A Peek behind the Curtain of Tenure and Promotion

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Prud'homme-Genereux, Annie; Schiller, Nancy A.; Herreid, Ky F.; Wright, Carolyn

2015-01-01

This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes a survey that looks at the system for tenure and promotion.

DIAGNOSTIC TOOL DEVELOPMENT AND APPLICATION THROUGH REGIONAL CASE STUDIES

EPA Science Inventory

Case studies are a useful vehicle for developing and testing conceptual models, classification systems, diagnostic tools and models, and stressor-response relationships. Furthermore, case studies focused on specific places or issues of interest to the Agency provide an excellent ...

Automated surface quality inspection with ARGOS: a case study

NASA Astrophysics Data System (ADS)

Kiefhaber, Daniel; Etzold, Fabian; Warken, Arno F.; Asfour, Jean-Michel

2017-06-01

The commercial availability of automated inspection systems for optical surfaces specified according to ISO 10110-7 promises unsupervised and automated quality control with reproducible results. In this study, the classification results of the ARGOS inspection system are compared to the decisions by well-trained inspectors based on manual-visual inspection. Both are found to agree in 93.6% of the studied cases. Exemplary cases with differing results are studied, and shown to be partly caused by shortcomings of the ISO 10110-7 standard, which was written for the industry standard manual-visual inspection. Applying it to high resolution images of the whole surface of objective machine vision systems brings with it a few challenges which are discussed.

Management Design Theories

NASA Astrophysics Data System (ADS)

Pries-Heje, Jan; Baskerville, Richard L.

This paper elaborates a design science approach for management planning anchored to the concept of a management design theory. Unlike the notions of design theories arising from information systems, management design theories can appear as a system of technological rules, much as a system of hypotheses or propositions can embody scientific theories. The paper illus trates this form of management design theories with three grounded cases. These grounded cases include a software process improvement study, a user involvement study, and an organizational change study. Collectively these studies demonstrate how design theories founded on technological rules can not only improve the design of information systems, but that these concepts have great practical value for improving the framing of strategic organi zational design decisions about such systems. Each case is either grounded in an empirical sense, that is to say, actual practice, or it is grounded to practices described extensively in the practical literature. Such design theories will help managers more easily approach complex, strategic decisions.

Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care.

PubMed

Halling, Anders; Fridh, Gerd; Ovhed, Ingvar

2006-06-28

Individualbased measures for comorbidity are of increasing importance for planning and funding health care services. No measurement for individualbased healthcare costs exist in Sweden. The aim of this study was to validate the Johns Hopkins ACG Case-Mix System's predictive value of polypharmacy (regular use of 4 or more prescription medicines) used as a proxy for health care costs in an elderly population and to study if the prediction could be improved by adding variables from a population based study i.e. level of education, functional status indicators and health perception. The Johns Hopkins ACG Case-Mix System was applied to primary health care diagnoses of 1402 participants (60-96 years) in a cross-sectional community based study in Karlskrona, Sweden (the Swedish National study on Ageing and Care) during a period of two years before they took part in the study. The predictive value of the Johns Hopkins ACG Case-Mix System was modeled against the regular use of 4 or more prescription medicines, also using age, sex, level of education, instrumental activity of daily living- and measures of health perception as covariates. In an exploratory biplot analysis the Johns Hopkins ACG Case-Mix System, was shown to explain a large part of the variance for regular use of 4 or more prescription medicines. The sensitivity of the prediction was 31.9%, whereas the specificity was 88.5%, when the Johns Hopkins ACG Case-Mix System was adjusted for age. By adding covariates to the model the sensitivity was increased to 46.3%, with a specificity of 90.1%. This increased the number of correctly classified by 5.6% and the area under the curve by 11.1%. The Johns Hopkins ACG Case-Mix System is an important factor in measuring comorbidity, however it does not reflect an individual's capability to function despite a disease burden, which has importance for prediction of comorbidity. In this study we have shown that information on such factors, which can be obtained from short questionnaires increases the probability to correctly predict an individual's use of resources, such as medications.

Practices implemented by a Texas charter school system to overcome science teacher shortage

NASA Astrophysics Data System (ADS)

Yasar, Bilgehan M.

The purpose of this study was to examine practices used by a charter school system to hire and retain science teachers. The research design for this study was a qualitative case study. This single instrumental case study explored the issue within a bounded system. Purposeful sampling strategy was used to identify the participants who were interviewed individually. Findings of the case study supported that using online resources, advertising in the newspaper, attending job fairs, using alternative certification programs, attracting alumni, contacting the college of educations and hiring internationally helped the charter school system with hiring science teachers. Improving teacher salary scale, implementing teacher mentorship programs, reimbursing teachers for certification and master's programs, providing professional development and supporting teachers helped to retain science teachers. Therefore, this study contributes to determining strategies and techniques, selecting methods and programs, training administrators, and monitoring for successful hiring and retaining science teacher implementation.

The effect of misclassification errors on case mix measurement.

PubMed

Sutherland, Jason M; Botz, Chas K

2006-12-01

Case mix systems have been implemented for hospital reimbursement and performance measurement across Europe and North America. Case mix categorizes patients into discrete groups based on clinical information obtained from patient charts in an attempt to identify clinical or cost difference amongst these groups. The diagnosis related group (DRG) case mix system is the most common methodology, with variants adopted in many countries. External validation studies of coding quality have confirmed that widespread variability exists between originally recorded diagnoses and re-abstracted clinical information. DRG assignment errors in hospitals that share patient level cost data for the purpose of establishing cost weights affects cost weight accuracy. The purpose of this study is to estimate bias in cost weights due to measurement error of reported clinical information. DRG assignment error rates are simulated based on recent clinical re-abstraction study results. Our simulation study estimates that 47% of cost weights representing the least severe cases are over weight by 10%, while 32% of cost weights representing the most severe cases are under weight by 10%. Applying the simulated weights to a cross-section of hospitals, we find that teaching hospitals tend to be under weight. Since inaccurate cost weights challenges the ability of case mix systems to accurately reflect patient mix and may lead to potential distortions in hospital funding, bias in hospital case mix measurement highlights the role clinical data quality plays in hospital funding in countries that use DRG-type case mix systems. Quality of clinical information should be carefully considered from hospitals that contribute financial data for establishing cost weights.

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

PubMed

Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

2012-05-01

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

[The Hospital Information System of the Brazilian National Unified Health System: a preliminary evaluation of performance in monitoring RhD hemolytic disease of the newborn].

PubMed

Lobato, Gustavo; Reichenheim, Michael Eduardo; Coeli, Claudia Medina

2008-03-01

This study aimed to evaluate the adequacy of the Hospital Information System of the National Unified Health System (SIH-SUS) in identifying cases of RhD hemolytic disease of the newborn (HDN) at the Fernandes Figueira Institute (IFF/FIOCRUZ) from 1998 to 2003. Neonatal records, data from the Medical Archives, and AIH (Hospital Admissions Authorization Form) data consolidated in the SIH-SUS were analyzed. Cases were identified according to the following fields: principal diagnosis, secondary diagnosis, and procedure performed. During the period studied, 194 cases of HDN were diagnosed. The Medical Archives registered 148 newborns with HDN, however only 147 AIHs were issued and 145 consolidated in the SIH-SUS. Among these 145 cases, 84 cited HDN as the principal diagnosis, while secondary diagnosis identified 38 additional cases and the procedures performed failed to identify any further cases. Thus, the SIH-SUS identified only 122 (62.9%) of the 194 cases of HDN treated at the IFF/FIOCRUZ. Although it is necessary to evaluate other units, the SIH-SUS does not appear to be reliable for monitoring HDN. Additional studies are essential for employing secondary administrative data in the context of epidemiological surveillance.

Prevalence and distribution of congenital abnormalities in Turkey: differences between the prenatal and postnatal periods.

PubMed

Oztarhan, Kazim; Gedikbasi, Ali; Yildirim, Dogukan; Arslan, Oguz; Adal, Erdal; Kavuncuoglu, Sultan; Ozbek, Sibel; Ceylan, Yavuz

2010-12-01

The aim of this study was to determine the distribution of cases associated with congenital abnormalities during the following three periods: pregnancy, birth, and the neonatal period. This was a retrospective study of cases between 2002 and 2006. All abnormal pregnancies, elective terminations of pregnancies, stillbirths, and births with congenital abnormalities managed in the Neonatology Unit were classified based on the above distribution scheme. During the 5-year study period, 1906 cases with congenital abnormalities were recruited, as follows: 640 prenatally detected and terminated cases, with most abnormalities related to the central nervous system, chromosomes, and urogenital system (56.7%, 12.7%, and 8.9%, respectively); 712 neonates with congenital abnormalities (congenital heart disease [49.2%], central nervous system abnormalities [14.7%], and urogenital system abnormalities [12.9%]); and hospital stillbirths, of which 34.2% had malformations (220 prenatal cases [34.4%] had multiple abnormalities, whereas 188 liveborn cases [26.4%] had multiple abnormalities). The congenital abnormalities rate between 2002 and 2006 was 2.07%. Systematic screening for fetal anomalies is the primary means for identification of affected pregnancies. © 2010 The Authors. Congenital Anomalies © 2010 Japanese Teratology Society.

Reform of China's Technical and Vocational Education in the Transition from a Planned Economy System to a Socialist Market Economy System--A Case Study. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Yu, Zuguang; Zeng, Zida

Since the early 1990s, China's government has followed a socialist market economy system. Accordingly, the technical and vocational education (TVE) should be restructured to meet its needs. Reform of the TVE system has four aspects. First, reform of the planning system includes a move from a central plan of enrollment to planning according to…

Metropolitan transportation management center : a case study : Boston Central Artery/Tunnel Integrated Project control system : responding to incidents rapidly and effectively

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of the Boston Central Artery/Tunnel Integration Project Control System (IPCS) operations control center. It follows the outline provided in the companion document, Metropolitan Transportation Management Ce...

The Enterprise Training System and Training Content Analysis of Selected Manufacturing Companies in Taiwan, R.O.C.: A Case Study.

ERIC Educational Resources Information Center

Kuo, Mike Chu-Hsun

A study investigated the current enterprise training system in Taiwan and proposed suitable training suggestions for manufacturing industry through a carefully designed case study. Literature review and field study were used to gather research data. Interviews were conducted at four large manufacturing companies during the period October 1990 to…

School Technology Leadership: Artifacts in Systems of Practice

ERIC Educational Resources Information Center

Dexter, Sara

2011-01-01

A cross-case analysis of five case studies of team-based technology leadership in middle schools with laptop programs identifies systems of practice that organize teams' distributed leadership. These cases suggest that successfully implementing a complex improvement effort warrants a team-based leadership approach, especially for an improvement…

Reporting of HIV-infected pregnant women: estimates from a Brazilian study.

PubMed

Domingues, Rosa Maria Soares Madeira; Saraceni, Valéria; Leal, Maria do Carmo

2018-01-01

To estimate the coverage of the reporting of cases of HIV-infected pregnant women, to estimate the increase in the coverage of the reporting with the routine search of data in other Brazilian health information systems, and to identify missed opportunities for identification of HIV-infected pregnant women in Brazilian maternity hospitals. This is a descriptive study on the linkage of Brazilian databases with primary data from the "Nascer no Brasil" study and secondary database collection from national health information systems. The "Nascer no Brasil" is a national-based study carried out in 2011-2012 with 23,894 pregnant women, which identified HIV-infected pregnant women using prenatal and medical records. We searched for cases of HIV-infected pregnant women identified in the "Nascer no Brasil" study in the Information System of Notifiable Diseases, the Control System for Laboratory Tests of the National CD4+/CD8+ Lymphocyte Count and HIV Viral Load Network, and the Logistics Control System for Medications. We used the OpenRecLink software for the linkage of databases. We estimated the notification coverage, with the respective confidence interval, of the evaluated Brazilian health information systems. We estimated the coverage of the reporting of HIV-infected pregnant women in the Information System of Notifiable Diseases as 57.1% (95%CI 42.9-70.2), and we located 89.3% of the HIV-infected pregnant women (95%CI 81.2-94.2) in some of the Brazilian health information systems researched. The search in other national health information systems would result in an increase of 57.1% of the reported cases. We identified no missed opportunities for the diagnosis of HIV+ in pregnant women in the maternity hospitals evaluated by the "Nascer no Brasil" study. The routine search for information in other Brazilian health information systems, a procedure carried out by the Ministry of Health for cases of AIDS in adults and children, should be adopted for cases of HIV in pregnancy.

Disk MHD generator study

NASA Technical Reports Server (NTRS)

Retallick, F. D.

1980-01-01

Directly-fired, separately-fired, and oxygen-augmented MHD power plants incorporating a disk geometry for the MHD generator were studied. The base parameters defined for four near-optimum-performance MHD steam power systems of various types are presented. The finally selected systems consisted of (1) two directly fired cases, one at 1920 K (2996F) preheat and the other at 1650 K (2500 F) preheat, (2) a separately-fired case where the air is preheated to the same level as the higher temperature directly-fired cases, and (3) an oxygen augmented case with the same generator inlet temperature of 2839 (4650F) as the high temperature directly-fired and separately-fired cases. Supersonic Mach numbers at the generator inlet, gas inlet swirl, and constant Hall field operation were specified based on disk generator optimization. System pressures were based on optimization of MHD net power. Supercritical reheat stream plants were used in all cases. Open and closed cycle component costs are summarized and compared.

Applied Nuclear Accountability Systems: A Case Study in the System Architecture and Development of NuMAC

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

Campbell, Andrea Beth

2004-07-01

This is a case study of the NuMAC nuclear accountability system developed at a private fuel fabrication facility. This paper investigates nuclear material accountability and safeguards by researching expert knowledge applied in the system design and development. Presented is a system developed to detect and deter the theft of weapons grade nuclear material. Examined is the system architecture that includes: issues for the design and development of the system; stakeholder issues; how the system was built and evolved; software design, database design, and development tool considerations; security and computing ethics. (author)

Hospitals as complex adaptive systems: A case study of factors influencing priority setting practices at the hospital level in Kenya.

PubMed

Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

2017-02-01

There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months. In this paper, we apply complex adaptive system (CAS) theory to examine the factors that influence PSRA practices. We found that PSRA practices in the case hospitals were influenced by, 1) inadequate financing level and poorly designed financing arrangements, 2) limited hospital autonomy and decision space, and 3) inadequate management and leadership capacity in the hospital. The case study hospitals exhibited properties of complex adaptive systems (CASs) that exist in a dynamic state with multiple interacting agents. Weaknesses in system 'hardware' (resource scarcity) and 'software' (including PSRA guidelines that reduced hospitals decision space, and poor leadership skills) led to the emergence of undesired properties. The capacity of hospitals to set priorities should be improved across these interacting aspects of the hospital organizational system. Interventions should however recognize that hospitals are CAS. Rather than rectifying isolated aspects of the system, they should endeavor to create conditions for productive emergence. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Trends in prevalence of patient case-mix adjusters used in the Medicare dialysis payment system.

PubMed

Hollenbeak, Christopher S; Rubin, Robert J; Tzivelekis, Spiros; Stephens, J Mark

2015-06-01

The Medicare End-Stage Renal Disease Prospective Payment System (PPS) used data from 2006-08 to set weights for each case-mix adjuster that is part of the bundled payment formula. The details of the population case-mix were not made public, and little is known about consistency of case-mix over time. This study estimated the prevalence of case-mix adjusters during 2006-2008 and analyzed changes in case-mix prevalence from 2000-2008. Cross-sectional cohort study using United States Renal Data System data for Medicare dialysis patients. Three 3-year cohorts (2000-02, 2003-05, 2006-08) were analyzed for changes over time in case-mix prevalence. Double-digit trends were observed in many case-mix categories between 2000-02 and 2006-08. Large declines were observed in prevalence of patients with low BMI, pericarditis, new to dialysis, and ages 18-44. Large increases were observed in chronic co-morbidities, pneumonia and age cohort 80+. Substantial changes in case-mix adjuster prevalence suggest the PPS payment formula should be regularly updated.

Comparative assessment of the prevalence of periodontal disease in subjects with and without systemic autoimmune diseases: A case-control study.

PubMed

Ramesh Kumar, S G; Aswath Narayanan, M B; Jayanthi, D

2016-01-01

Immune mechanism shares a common pathway both for systemic autoimmune diseases and periodontal diseases. Scientific exploration of literature revealed limited studies on the association between systemic autoimmune diseases and periodontal diseases in India. The aim of the study is to find whether the presence of systemic autoimmune diseases in an individual is a risk factor for the development of periodontal disease. This was a hospital-based case-control study. A sample of 253 patients with systemic autoimmune diseases, attending the Rheumatology Department of Government General Hospital, Chennai-3, and 262 patients without systemic autoimmune diseases, attending the outpatient department of the Tamil Nadu Government Dental College and Hospital, Chennai-3, constituted the case and control groups, respectively. Age, gender, and oral hygiene status matching was done. Oral hygiene status was assessed using oral hygiene index (OHI) and periodontal status was assessed using community periodontal index (CPI) and loss of attachment (LOA) index. Statistical analysis was done using SPSS version 15 (SPSS Inc, 2006, Chicago). Results showed 99.2% and 73.9% prevalence of gingivitis and periodontitis, respectively, in the case group as compared to 85.5% and 14.9%, respectively, in the control group. There is no linear relationship between OHI scores and prevalence of periodontitis (CPI and LOA scores) in the case group. Patients suffering from systemic autoimmune diseases showed more prevalence of periodontal diseases irrespective of oral hygiene scores. It is postulated that the presence of systemic autoimmune diseases may pose a risk for the development of periodontal diseases.

Dynamics of Complexity and Accuracy: A Longitudinal Case Study of Advanced Untutored Development

ERIC Educational Resources Information Center

Polat, Brittany; Kim, Youjin

2014-01-01

This longitudinal case study follows a dynamic systems approach to investigate an under-studied research area in second language acquisition, the development of complexity and accuracy for an advanced untutored learner of English. Using the analytical tools of dynamic systems theory (Verspoor et al. 2011) within the framework of complexity,…

The MORPG-Based Learning System for Multiple Courses: A Case Study on Computer Science Curriculum

ERIC Educational Resources Information Center

Liu, Kuo-Yu

2015-01-01

This study aimed at developing a Multiplayer Online Role Playing Game-based (MORPG) Learning system which enabled instructors to construct a game scenario and manage sharable and reusable learning content for multiple courses. It used the curriculum of "Introduction to Computer Science" as a study case to assess students' learning…

The Use of Electronic Voting Systems in Lectures within Business and Marketing: A Case Study of Their Impact on Student Learning

ERIC Educational Resources Information Center

Masikunas, George; Panayiotidis, Andreas; Burke, Linda

2007-01-01

This article presents a case study of the impact on student learning of introducing an electronic voting system (EVS) into large-group lectures for first-year undergraduate students undertaking degrees in marketing and business systems. We discuss the potential for using EVS-style interactive lectures in marketing and business programmes. We then…

Full Chain Benchmarking for Open Architecture Airborne ISR Systems: A Case Study for GMTI Radar Applications

DTIC Science & Technology

2015-09-15

middleware implementations via a common object-oriented software hierarchy, with library -specific implementations of the five GMTI benchmark ...Full-Chain Benchmarking for Open Architecture Airborne ISR Systems A Case Study for GMTI Radar Applications Matthias Beebe, Matthew Alexander...time performance, effective benchmarks are necessary to ensure that an ARP system can meet the mission constraints and performance requirements of

Exploring a Systems Approach to Mainstreaming Sustainability in Universities: A Case Study of Rhodes University in South Africa

ERIC Educational Resources Information Center

Togo, Muchaiteyi; Lotz-Sisitka, Heila

2013-01-01

This paper explores the use of systems theory to inform the mainstreaming of sustainability in a university's functions as it responds to sustainable development challenges in its local context. Offering a case study of Rhodes University, the paper shows how the use of systems models and concepts, underpinned by a critical realist ontology and an…

The Therapeutic Collaboration in Life Design Counselling: The Case of Ryan

ERIC Educational Resources Information Center

do Céu Taveira, Maria; Ribeiro, Eugénia; Cardoso, Paulo; Silva, Filipa

2017-01-01

This study examined the therapeutic collaboration in a case of Life Design Counseling (LDC) with narrative change and positive career outcomes. The therapeutic collaboration-change model and correspondent coding system were used to intensively study the helping relationship throughout three sessions of LDC. The collaboration coding system enables…

Upgrade of Compressed Air Control System Reduces Energy Costs at Michelin Tire Plant. Office of Industrial Technologies (OIT) BestPractices Project Case Study

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

Not Available

2002-01-01

This case study highlights the upgraded compressed air system at a Michelin tire manufacturing plant in Spartanburg, South Carolina. The controls upgrade project enabled multiple compressor operation without blow-off, and significantly reduced energy costs.

A Case Study: To Internet or Not To Internet.

ERIC Educational Resources Information Center

Carman, Jared; Boynton, Doug

1997-01-01

Interactive multimedia training can be delivered via CD-ROM, hard drive, local area networks (LAN), wide area networks (WAN), Intranet, Internet and hybrid systems. This article presents a case study of how two companies (Los Angeles Times and Allen Communication) evaluated alternative delivery systems, chose one, and implemented multimedia…

The Psychometric Properties of Classroom Response System Data: A Case Study

ERIC Educational Resources Information Center

Kortemeyer, Gerd

2016-01-01

Classroom response systems (often referred to as "clickers") have slowly gained adoption over the recent decade; however, critics frequently doubt their pedagogical value starting with the validity of the gathered responses: There is concern that students simply "click" random answers. This case study looks at different…

An Educational Transition: Post-Secondary Correctional Education--A Qualitative Case Study

ERIC Educational Resources Information Center

Bartholomew, Greg

2013-01-01

Administration of post-secondary correctional education (PSCE) programs within state was vastly changed through legislation enacted in 2009. This study examined the transition of a PSCE system formerly facilitated by higher education to the current system administered by the State Department of Corrections (SDC). This qualitative case study…

[Clinical analysis and follow-up study of cardiavascular system involvement in 10 children with methylmalonic aciduria combined with hyperhomocysteinemia].

PubMed

Qi, Yan-Hua; Qi, Jian-Guang; Liu, Yu-Peng; Yan, Hui; Liu, Xue-Qin; Zhang, Xin; Xiao, Hui-Jie; Yang, Yan-Ling; DU, Jun-Bao

2015-09-01

To study the clinical features and treatment outcomes of cardiovascular system involvement in children with methylmalonic aciduria combined with hyperhomocysteinemia (MMACHC). The clinical data of 10 children with methylmalonic aciduria combined with hyperhomocysteinemia and who had cardiovascular system involvement were retrospectively analyzed and the treatment outcomes were followed up. In the 10 patients, there were 4 cases with initial presentations of cardiovascular system symptoms such as shortness of breath and dyspnea, 3 cases with urinary tract symptoms such as edema, hematuria and proteinuria, and 3 cases with nervous system symptoms such as developmental retardation and convulsions. The 10 patients had different types and severity of cardiovascular injuries. After 3 months to 8 years of follow-up, the congenital heart defects resolved naturally in 2 cases, and the patient with arrhythmia had no obvious changes. In 5 cases of hypertension, blood pressures recovered to normal in 3 cases, and 1 case was lost to follow-up. In 5 patients with pulmonary hypertension, 2 died, 2 recovered, and 1 case had mildly elevated pulmonary artery pressure. Seven patients underwent MMACHC gene testing, and 5 showed c.80A>G mutations. Metabolic disease should be taken into account for the children with unexplained pulmonary hypertension and hypertension with the onset of the shortness of breath and dyspnea. The severity of cardiovascular system involvement might be one of the most important factors affecting the prognosis of children with MMACHC. Cardiavascular system involvement of the patients may be related to MMACHC c.80A>G mutations.

Lupus Anticoagulant-hypoprothrombinemia Syndrome (LAC-HPS) in Children With Systemic Lupus Erythematosus: Report of 3 Cases.

PubMed

Komvilaisak, Patcharee; Wisanuyotin, Suwannee; Jettrisuparb, Arunee; Wiangnon, Surapon

2017-11-01

Lupus anticoagulant, also known as lupus antibody, is generally associated with thrombosis rather than bleeding events. Lupus anticoagulant-hypoprothrombinemia syndrome in children is rather rare but can lead to mild to life-threatening bleeding. Here, we report 3 cases of lupus anticoagulant-hypoprothrombinemia syndrome associated with systemic lupus erythematosus. They initially presented with mucocutaneous bleedings, and subsequently developed other symptoms fulfilling the laboratory criteria for systemic lupus erythematosus. Case 2 and 3 had significant epistaxis and intracerebral hemorrhage responded to systemic corticosteroid along with fresh frozen plasma. Three cases demonstrated acquired hypoprothrombinemia with no correction of mixing studies. Case 1 had low factor X level, which has never been reported previously. In all 3 cases, their coagulogram returned to normal level after corticosteroid treatment.

The Educational System in Japan: Case Study Findings.

ERIC Educational Resources Information Center

Stevenson, Harold; Lee, Shin-Ying; Nerison-Low, Roberta

This document summarizes the findings of a year-long study that used case studies of specific schools in Japan to collect qualitative data on the Japanese educational experience. From 1994-95 the Case Study Project (a component of the Third International Mathematics and Science Study) collected information from interviews with students, parents,…

Emotion, Engagement, and Case Studies

ERIC Educational Resources Information Center

Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

2014-01-01

Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

Integrating evidence-based practices for increasing cancer screenings in safety net health systems: a multiple case study using the Consolidated Framework for Implementation Research.

PubMed

Liang, Shuting; Kegler, Michelle C; Cotter, Megan; Emily, Phillips; Beasley, Derrick; Hermstad, April; Morton, Rentonia; Martinez, Jeremy; Riehman, Kara

2016-08-02

Implementing evidence-based practices (EBPs) to increase cancer screenings in safety net primary care systems has great potential for reducing cancer disparities. Yet there is a gap in understanding the factors and mechanisms that influence EBP implementation within these high-priority systems. Guided by the Consolidated Framework for Implementation Research (CFIR), our study aims to fill this gap with a multiple case study of health care safety net systems that were funded by an American Cancer Society (ACS) grants program to increase breast and colorectal cancer screening rates. The initiative funded 68 safety net systems to increase cancer screening through implementation of evidence-based provider and client-oriented strategies. Data are from a mixed-methods evaluation with nine purposively selected safety net systems. Fifty-two interviews were conducted with project leaders, implementers, and ACS staff. Funded safety net systems were categorized into high-, medium-, and low-performing cases based on the level of EBP implementation. Within- and cross-case analyses were performed to identify CFIR constructs that influenced level of EBP implementation. Of 39 CFIR constructs examined, six distinguished levels of implementation. Two constructs were from the intervention characteristics domain: adaptability and trialability. Three were from the inner setting domain: leadership engagement, tension for change, and access to information and knowledge. Engaging formally appointed internal implementation leaders, from the process domain, also distinguished level of implementation. No constructs from the outer setting or individual characteristics domain differentiated systems by level of implementation. Our study identified a number of influential CFIR constructs and illustrated how they impacted EBP implementation across a variety of safety net systems. Findings may inform future dissemination efforts of EBPs for increasing cancer screening in similar settings. Moreover, our analytic approach is similar to previous case studies using CFIR and hence could facilitate comparisons across studies.

Using a social entrepreneurial approach to enhance the financial and social value of health care organizations.

PubMed

Liu, Sandra S; Lu, Jui-Fen Rachel; Guo, Kristina L

2014-01-01

In this study, a conceptual framework was developed to show that social entrepreneurial practices can be effectively translated to meet the social needs in health care. We used a theory-in-use case study approach that encompasses postulation of a working taxonomy from literature scanning and a deliberation of the taxonomy through triangulation of multilevel data of a case study conducted in a Taiwan-based hospital system. Specifically, we demonstrated that a nonprofit organization can adopt business principles that emphasize both financial and social value. We tested our model and found comprehensive accountability across departments throughout the case hospital system, and this led to sustainable and continual growth of the organization. Through social entrepreneurial practices, we established that both financial value creation and fulfilling the social mission for the case hospital system can be achieved.

Computer-Aided System Engineering and Analysis (CASE/A) Programmer's Manual, Version 5.0

NASA Technical Reports Server (NTRS)

Knox, J. C.

1996-01-01

The Computer Aided System Engineering and Analysis (CASE/A) Version 5.0 Programmer's Manual provides the programmer and user with information regarding the internal structure of the CASE/A 5.0 software system. CASE/A 5.0 is a trade study tool that provides modeling/simulation capabilities for analyzing environmental control and life support systems and active thermal control systems. CASE/A has been successfully used in studies such as the evaluation of carbon dioxide removal in the space station. CASE/A modeling provides a graphical and command-driven interface for the user. This interface allows the user to construct a model by placing equipment components in a graphical layout of the system hardware, then connect the components via flow streams and define their operating parameters. Once the equipment is placed, the simulation time and other control parameters can be set to run the simulation based on the model constructed. After completion of the simulation, graphical plots or text files can be obtained for evaluation of the simulation results over time. Additionally, users have the capability to control the simulation and extract information at various times in the simulation (e.g., control equipment operating parameters over the simulation time or extract plot data) by using "User Operations (OPS) Code." This OPS code is written in FORTRAN with a canned set of utility subroutines for performing common tasks. CASE/A version 5.0 software runs under the VAX VMS(Trademark) environment. It utilizes the Tektronics 4014(Trademark) graphics display system and the VTIOO(Trademark) text manipulation/display system.

IVHS Institutional Issues and Case Studies, Analysis and Lessons Learned, Final Report

DOT National Transportation Integrated Search

1994-04-01

This 'Analysis and Lessons Learned' report contains observations, conclusions, and recommendations based on the performance of six case studies of Intelligent Vehicle-Highway Systems (IVHS) projects. Information to support the development of the case...

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case

DTIC Science & Technology

1992-10-01

Prototyping with Application Generators: Lessons Learned from the Naval Aviation Logistics Command Management Information System Case. This study... management information system to automate manual Naval aviation maintenance tasks-NALCOMIS. With the use of a fourth-generation programming language

Reliability of robotic system during general surgical procedures in a university hospital.

PubMed

Buchs, Nicolas C; Pugin, François; Volonté, Francesco; Morel, Philippe

2014-01-01

Data concerning the reliability of robotic systems are scarce, especially for general surgery. The aim of this study was to assess the incidence and consequences of robotic malfunction in a teaching institution. From January 2006 to September 2012, 526 consecutive robotic general surgical procedures were performed. All failures were prospectively recorded in a computerized database and reviewed retrospectively. Robotic malfunctions occurred in 18 cases (3.4%). These dysfunctions concerned the robotic instruments in 9 cases, the robotic arms in 4 cases, the surgical console in 3 cases, and the optical system in 2 cases. Two malfunctions were considered critical, and 1 led to a laparoscopic conversion (conversion rate due to malfunction, .2%). Overall, there were more dysfunctions at the beginning of the study period (2006 to 2010) than more recently (2011 to 2012) (4.2% vs 2.6%, P = .35). The robotic system malfunction rate was low. Most malfunctions could be resolved during surgery, allowing the procedures to be completed safely. With increased experience, the system malfunction rate seems to be reduced. Copyright © 2014 Elsevier Inc. All rights reserved.

DEVELOPING AN INTEGRATED MANAGEMENT SYSTEM FOR URBAN AND ENERGY PLANNING TOWARDS A LOW-CARBON CITY

NASA Astrophysics Data System (ADS)

Maeda, Hideto; Nakakubo, Toyohiko; Tokai, Akihiro

In this study, we developed an integrated management model that supports local government to make a promising energy saving measure on a block-scale combined with urban planning. We applied the model to Osaka city and estimated CO2 emissions from the residential and commercial buildings to 2050. The urban renewal cases selected in this study included advanced multipole accumulation case, normal multipole accumulation case, and actual trend continuation case. The energy saving options introduced in each case included all-electric HP system, micro grid system, and we also set the option where the greater CO2 reduction one is selected in each block. The results showed that CO2 emission in 2050 would be reduced by 54.8-57.6% relative to the actual condition by introducing the new energy system in all cases. In addition, the amount of CO2 reduction in actual trend continuation case was highest. The major factor was that the effect of CO2 emission reductions by installing the solar power generation panel was higher than the effect by utilizing heated water mutually on the high-density blocks in terms of total urban buildings' energy consumption.

Crisis Management Systems: A Case Study for Aspect-Oriented Modeling

NASA Astrophysics Data System (ADS)

Kienzle, Jörg; Guelfi, Nicolas; Mustafiz, Sadaf

The intent of this document is to define a common case study for the aspect-oriented modeling research community. The domain of the case study is crisis management systems, i.e., systems that help in identifying, assessing, and handling a crisis situation by orchestrating the communication between all parties involved in handling the crisis, by allocating and managing resources, and by providing access to relevant crisis-related information to authorized users. This document contains informal requirements of crisis management systems (CMSs) in general, a feature model for a CMS product line, use case models for a car crash CMS (CCCMS), a domain model for the CCCMS, an informal physical architecture description of the CCCMS, as well as some design models of a possible object-oriented implementation of parts of the CCCMS backend. AOM researchers who want to demonstrate the power of their AOM approach or technique can hence apply the approach at the most appropriate level of abstraction.

Lesjes van de Nederlanders: Little Lessons from the Dutch to Promote Educational Quality. AIR 1995 Annual Forum Paper.

ERIC Educational Resources Information Center

Palmer, Barbara H.

This study explored quality assessment and accountability in Dutch university education using a case study approach. The Dutch national system of quality assurance is described, and developments since the mid-1980s are traced. The university case studies illustrate models which are being employed to implement the quality assurance system including…

Unethical Leadership in Higher Education and the Precarious Journey to Recovery: A Case Study of the Alabama Community College System

ERIC Educational Resources Information Center

Kelly, Donald L.

2009-01-01

Recent events of the Alabama Community College System are examined as an historical organizational case study. Critical events are noted along with associated professional literature related to those events and actions. While the study attempts to explain the organizational culture that allowed the rise of unethical leadership, the primary focus…

Child Protection and Justice Systems Processing of Serious Child Abuse and Neglect Cases

ERIC Educational Resources Information Center

Sedlak, Andrea J.; Schultz, Dana; Wells, Susan J.; Lyons, Peter; Doueck, Howard J.; Gragg, Frances

2006-01-01

Objective: The aim of this study was to examine the trajectory of cases through four systems: child protection, law enforcement, the dependency courts, and the criminal courts. Method: This study focused on a county selected from a 41-county telephone survey conducted for the National Incidence Study of Child Abuse and Neglect (NIS-3). For this…

Implementation of Network Leader Sponsored Supply Chain Management Systems: A Case Study of Supplier IT Business Value

ERIC Educational Resources Information Center

Miller, Mark S.

2010-01-01

This qualitative multiple-case study was conducted to explore and understand how the implementation of required relationship-specific supply chain management system (SCMS) dictated by the network leader within a supplier network affects a supplier organization. The study, on a very broad sense, attempted to research the current validity of how the…

Student-Generated Questioning Activity in Second Language Courses Using a Customized Personal Response System: A Case Study

ERIC Educational Resources Information Center

Song, Donggil; Oh, Eun Young; Glazewski, Krista

2017-01-01

This case study reports on the implementation of student-generated questioning using a customized personal response system (PRS) by two groups of students in second language (L2) courses at a university in the United States. This study aimed to understand more about instructor and student experience with student-generated questioning for promoting…

Non-invasive, home-based electroencephalography hypoglycaemia warning system for personal monitoring using skin surface electrodes: a single-case feasibility study.

PubMed

Clewett, Christopher J; Langley, Phillip; Bateson, Anthony D; Asghar, Aziz; Wilkinson, Antony J

2016-03-01

Hypoglycaemia unawareness is a common condition associated with increased risk of severe hypoglycaemia. The purpose of the authors' study was to develop a simple to use, home-based and non-invasive hypoglycaemia warning system based on electroencephalography (EEG), and to demonstrate its use in a single-case feasibility study. A participant with type 1 diabetes forms a single-person case study where blood sugar levels and EEG were recorded. EEG was recorded using skin surface electrodes placed behind the ear located within the T3 region by the participant in the home. EEG was analysed retrospectively to develop an algorithm which would trigger a warning if EEG changes associated with hypoglycaemia onset were detected. All hypoglycaemia events were detected by the EEG hypoglycaemia warning algorithm. Warnings were triggered with blood glucose concentration levels at or below 4.2 mmol/l in this participant and no warnings were issued when in euglycaemia. The feasibility of a non-invasive EEG-based hypoglycaemia warning system for personal monitoring in the home has been demonstrated in a single case study. The results suggest that further studies are warranted to evaluate the system prospectively in a larger group of participants.

Human exploration mission studies

NASA Technical Reports Server (NTRS)

Cataldo, Robert L.

1989-01-01

The Office of Exploration has established a process whereby all NASA field centers and other NASA Headquarters offices participate in the formulation and analysis of a wide range of mission strategies. These strategies were manifested into specific scenarios or candidate case studies. The case studies provided a systematic approach into analyzing each mission element. First, each case study must address several major themes and rationale including: national pride and international prestige, advancement of scientific knowledge, a catalyst for technology, economic benefits, space enterprise, international cooperation, and education and excellence. Second, the set of candidate case studies are formulated to encompass the technology requirement limits in the life sciences, launch capabilities, space transfer, automation, and robotics in space operations, power, and propulsion. The first set of reference case studies identify three major strategies: human expeditions, science outposts, and evolutionary expansion. During the past year, four case studies were examined to explore these strategies. The expeditionary missions include the Human Expedition to Phobos and Human Expedition to Mars case studies. The Lunar Observatory and Lunar Outpost to Early Mars Evolution case studies examined the later two strategies. This set of case studies established the framework to perform detailed mission analysis and system engineering to define a host of concepts and requirements for various space systems and advanced technologies. The details of each mission are described and, specifically, the results affecting the advanced technologies required to accomplish each mission scenario are presented.

University Teachers' Job Dissatisfaction: Application of Two-Factor Theory--A Case of Pakistani Education System

ERIC Educational Resources Information Center

Mir, Imran Anwar

2012-01-01

This qualitative case study presents the reasons of teachers' job dissatisfaction in the government educational institutes in Pakistan. This case study is based on the two factor theory of Herzberg. The results of this case study reveal four core factors that cause job dissatisfaction among teachers in the public sector universities in developing…

The Advocacy of an Appraisal System for Teachers: A Case Study

ERIC Educational Resources Information Center

Bisschoff, Tom; Mathye, Annah

2009-01-01

Education systems all over the world, like all other organisations, have certain organisational goals that they set and wish to achieve. It is argued that for increased pupil performance, in the case of education systems, teachers must work harder and smarter. A performance system is regarded as part of the process to achieve this organisational…

Criticality Calculations with MCNP6 - Practical Lectures

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

Brown, Forrest B.; Rising, Michael Evan; Alwin, Jennifer Louise

2016-11-29

These slides are used to teach MCNP (Monte Carlo N-Particle) usage to nuclear criticality safety analysts. The following are the lecture topics: course information, introduction, MCNP basics, criticality calculations, advanced geometry, tallies, adjoint-weighted tallies and sensitivities, physics and nuclear data, parameter studies, NCS validation I, NCS validation II, NCS validation III, case study 1 - solution tanks, case study 2 - fuel vault, case study 3 - B&W core, case study 4 - simple TRIGA, case study 5 - fissile mat. vault, criticality accident alarm systems. After completion of this course, you should be able to: Develop an input modelmore » for MCNP; Describe how cross section data impact Monte Carlo and deterministic codes; Describe the importance of validation of computer codes and how it is accomplished; Describe the methodology supporting Monte Carlo codes and deterministic codes; Describe pitfalls of Monte Carlo calculations; Discuss the strengths and weaknesses of Monte Carlo and Discrete Ordinants codes; The diffusion theory model is not strictly valid for treating fissile systems in which neutron absorption, voids, and/or material boundaries are present. In the context of these limitations, identify a fissile system for which a diffusion theory solution would be adequate.« less

[Neuroendocrine neoplasm of digestive system with different grades: a clinicopathologic and prognostic study].

PubMed

Zhang, Ming-hui; Liu, Yan-hui; Luo, Xin-lan; Lin, Xing-tao; Zhuang, Heng-guo

2012-07-01

To study the clinicopathologic and prognostic features of neuroendocrine neoplasm of digestive system with different grades. The clinicopathologic features of 139 cases of neuroendocrine neoplasm occurring in digestive system were retrospectively reviewed and graded according to the 2010 World Health Organization classification of tumours of the digestive system. Immunohistochemical study for synaptophysin, chromogranin A and Ki-67 was carried out. The follow-up and survival data were analysed using Kaplan-Meier method. Prognostic factors were tested by Log-rank testing and independent risk factors were analysed using Cox regression model. Amongst the 139 cases studied, there were 88 cases (63.3%) of grade 1 tumors, 9 cases (6.5%) of grade 2 tumors and 42 cases (30.2%) of grade 3 tumors. There was diffusely positive staining for synaptophysin and chromogranin A in most of the grade 1 and grade 2 tumors. The staining in grade 3 tumors however was focal (P < 0.05). The differences in tumor size, depth of invasion, presence of tumor emboli, perineural permeation, nodal involvement, distant metastasis and survival rate amongst the three groups was statistically significant (P < 0.05). There is significant difference in the clinicopathologic and prognostic features of neuroendocrine neoplasm of digestive system with different grades. It is considered as an independent prognostic factor and represents a useful tool for prognostic evaluation of such tumors, both in clinical practice and research.

Examining MTSS Implementation across Systems for SLD Identification: A Case Study

ERIC Educational Resources Information Center

Barrett, Courtenay A.; Newman, Daniel S.

2018-01-01

Although research supports the effectiveness of the multitiered system of supports (MTSS) on academic and behavioral outcomes, districts aim to engage in data-based decision making and examine the effectiveness of their own MTSS implementation. This case study describes how one regional education service agency (RESA) in the Midwest implemented…

Pathways to Systemic Reform: Case Studies of Ohio Schools.

ERIC Educational Resources Information Center

Kahle, Jane Butler, Ed.; Kelly, Mary Kay, Ed.

This document presents five case studies of Ohio schools in order to discuss ongoing systemic reform in Ohio. Papers include: (1) "Steele Middle School: 'The Best Education for the Best Is the Best Education for All'" (Jane Butler Kahle, Kathryn Scantlebury, Arta Damnjanovic, and Mary Kay Kelly); (2) "Urban Middle School: 'How Much…

Who Gains by Communications Development? Studies of Information Technolgies in Developing Countries. Working Paper 76-1.

ERIC Educational Resources Information Center

Clippinger, John H.

To identify the distribution of benefits that accrue from introducing communications technology in developing societies, two case studies were undertaken. The first case looks at telecommunications development in Algeria where telecommunications systems are being rapidly introduced to speed up industrialization and where a satellite system is in…

Increasing College Retention with a Personalized System of Instruction: A Case Study

ERIC Educational Resources Information Center

Foss, Karen A.; Foss, Sonja K.; Paynton, Scott; Hahn, Laura

2014-01-01

This case study addresses the exigence of low retention and graduation rates of college students. The authors sought to incorporate the perspectives of all three stakeholders implicated in retention efforts--administrators, faculty, and students--by implementing a personalized system of instruction (PSI) in eight of their college courses. This…

Partnering for Transportation Success at Acadia National Park : A Case Study of the Island Explorer Shuttle Bus System at Mount Desert Island and Acadia National Park.

DOT National Transportation Integrated Search

2003-05-01

This report presents the first in a series of case studies on lessons learned from planning and : implementing alternative transportation systems (ATS) and from developing partnerships with : local and regional communities. The report is supported by...

Pushing the Employment Agenda: Case Study Research of High Performing States in Integrated Employment

ERIC Educational Resources Information Center

Hall, Allison Cohen; Butterworth, John; Winsor, Jean; Gilmore, Dana; Metzel, Deborah

2007-01-01

Organizational variables, including policies, practices, collaborations, and funding mechanisms resulting in high performance in integrated employment, were described through case study research in 3 states. Findings address how contextual factors, system-level strategies, and goals of the system are related as well as how they sustain systems…

It System Integration: Global Medical Acquisition of Health Tech Case Study

ERIC Educational Resources Information Center

Russo, Mark; White, Bruce

2013-01-01

Mergers and Acquisitions are just part of life in business. For example, in the health care technology field in 2012, Veritas Capital Partners acquired Thomson Reuters' Healthcare. Other major active acquisition companies included: Medical Transcription Billing, T-System Technologies and Sharecare. In this case study, a larger health technology…

Reforming the Japanese Preschool System: An Ethnographic Case Study of Policy Implementation

ERIC Educational Resources Information Center

Hayashi, Akiko; Tobin, Joseph

2017-01-01

This is an ethnographic study of how two Japanese kindergartens are implementing the "yohoichigenka" policy aimed at reforming the Japanese early childhood education system. The cases of these two kindergartens demonstrate what happens when a top-down mandate reaches the level of individual programs. The programs creatively find ways of…

Ethiopian New Public Universities: Achievements, Challenges and Illustrative Case Studies

ERIC Educational Resources Information Center

van Deuren, Rita; Kahsu, Tsegazeab; Mohammed, Seid; Woldie, Wondimu

2016-01-01

Purpose: This paper aims to analyze and illustrate achievements and challenges of Ethiopian higher education, both at the system level and at the level of new public universities. Design/methodology/approach: Achievements and challenges at the system level are based on literature review and secondary data. Illustrative case studies are based on…

Generalized implementation of software safety policies

NASA Technical Reports Server (NTRS)

Knight, John C.; Wika, Kevin G.

1994-01-01

As part of a research program in the engineering of software for safety-critical systems, we are performing two case studies. The first case study, which is well underway, is a safety-critical medical application. The second, which is just starting, is a digital control system for a nuclear research reactor. Our goal is to use these case studies to permit us to obtain a better understanding of the issues facing developers of safety-critical systems, and to provide a vehicle for the assessment of research ideas. The case studies are not based on the analysis of existing software development by others. Instead, we are attempting to create software for new and novel systems in a process that ultimately will involve all phases of the software lifecycle. In this abstract, we summarize our results to date in a small part of this project, namely the determination and classification of policies related to software safety that must be enforced to ensure safe operation. We hypothesize that this classification will permit a general approach to the implementation of a policy enforcement mechanism.

An analytical study of the dual mass mechanical system stability

NASA Astrophysics Data System (ADS)

Nikolov, Svetoslav; Sinapov, Petko; Kralov, Ivan; Ignatov, Ignat

2011-12-01

In this paper an autonomous, nonlinear model of five ordinary differential equations modeling the motion of a dual mass mechanical system with universal joint is studied. The model is investigated qualitatively. On the base of the stability analysis performed, we obtain that the system is: i) in an equilibrium state, or ii) in a structurally unstable behavior when equilibrium states disappear. In case (i) the system is in a normal technical condition and in case (ii) hard break-downs take place.

Hong Kong's Cross-System University Partnerships

ERIC Educational Resources Information Center

Postiglione, Gerard A.; Yunyun, Qin; Te, Alice Y. C.

2016-01-01

The authors examine the special case of Hong Kong higher education's institutional partnerships in the Chinese mainland. After noting the rise of cross-system university partnership in Asia, it provides a neoinstitutional perspective on the differences between the two China higher education systems. Finally, a case study of the experience of the…

Corporate Energy Conservation Program for Alcoa North American Extrusions: Office of Industrial Technologies (OIT) Aluminum BestPractices Management Case Study

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

U.S. Department of Energy

2001-08-06

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

75 FR 65355 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Project Case Studies of Communities and States Funded under Community Activities under the Communities..., system, and environmental changes. Intensive case studies will be conducted with 24 sites: Six ARRA... Act. The case study sites will be selected to include a mix of State or community characteristics...

EVALUATION OF THE EFFECTS OF PROCESSING DELAYS AND PROTECTIVE PLASTIC CASES ON IMAGE QUALITY OF A PHOTOSTIMULABLE PHOSPHOR PLATE SYSTEM

PubMed Central

Bramante, Clóvis Monteiro; Bramante, Alexandre Silva; de Souza, Rogério Emílio; Moraes, Ivaldo Gomes; Bernardineli, Norberti; Garcia, Roberto Brandão

2008-01-01

This ex vivo study evaluated the quality of digital radiographic images obtained with the photostimulable phosphor plate system (Digora) according to the processing delay and maintenance of optical plates in either opaque (supplied with the system) or transparent protective plastic cases during this period. Five radiographs were obtained from the mandibular molar region of a dry human mandible using optical plates. These plates were placed in the protective plastic cases before obtaining the radiographs and were processed immediately or after processing delays of 5, 60 and 120 min, when the case was removed. The results revealed a reduction in image quality when processing was delay 120 min compared to the other times. The opaque case provided better protection to the sensor than the transparent case. In conclusion, a 120-min processing delay for the Digora system caused a reduction in image quality, yet without interfering with the quality of diagnosis. The opaque case supplied by the system's manufacturer provided better protection to the optical plate than the transparent case. PMID:19089233

A prototype case-based reasoning human assistant for space crew assessment and mission management

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

Cognitive neuropsychology and its vicissitudes: The fate of Caramazza's axioms.

PubMed

Shallice, Tim

2015-01-01

Cognitive neuropsychology is characterized as the discipline in which one draws conclusions about the organization of the normal cognitive systems from the behaviour of brain-damaged individuals. In a series of papers, Caramazza, later in collaboration with McCloskey, put forward four assumptions as the bridge principles for making such inferences. Four potential pitfalls, one for each axiom, are discussed with respect to the use of single-case methods. Two of the pitfalls also apply to case series and group study procedures, and the other two are held to be indirectly testable or avoidable. Moreover, four other pitfalls are held to apply to case series or group study methods. It is held that inferences from single-case procedures may profitably be supported or rejected using case series/group study methods, but also that analogous support needs to be given in the other direction for functionally based case series or group studies. It is argued that at least six types of neuropsychological method are valuable for extrapolation to theories of the normal cognitive system but that the single- or multiple-case study remains a critical part of cognitive neuropsychology's methods.

Case Study for the ARRA-funded GSHP Demonstration at University at Albany

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

Liu, Xiaobing; Malhotra, Mini; Xiong, Zeyu

High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This report highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects—a distributed GSHP system at a new 500-bed apartment-style student residence hall at the University at Albany. This case studymore » is based on the analysis of detailed design documents, measured performance data, published catalog data of heat pump equipment, and actual construction costs. Simulations with a calibrated computer model are performed for both the demonstrated GSHP system and a baseline heating, ventilation, and airconditioning (HVAC) system to determine the energy savings and other related benefits achieved by the GSHP system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GSHP system, as well as the pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the demonstrated GSHP system compared with the baseline HVAC system. This case study also identifies opportunities for improving the operational efficiency of the demonstrated GSHP system.« less

Retrospective evaluation of prehospital triage, presentation, interventions and outcome in paediatric drowning managed by a physician staffed helicopter emergency medical service.

PubMed

Garner, Alan A; Barker, Claire L; Weatherall, Andrew D

2015-11-06

Drowning patients may benefit from the advanced airway management capabilities that can be provided by physician staffed helicopter emergency medical services. The aim of this study is to describe paediatric drowning patients treated by such a service examining tasking systems, initial physiology at the incident scene, survival and neurological outcome. Retrospective analysis of paediatric drowning victims over a 5- year period. Case identification system, patient age, site of drowning, presence or absence of cardiac output, first Glasgow Coma Scale (GCS) score and interventions were collected from prehospital notes, and survival and neurological outcomes from hospital and rehabilitation notes. The P-HEMS direct case identification system operating in parallel with a central control system identified all severe drowning cases but 3 of 7 cases (43%) were missed when the central control system operated in isolation. All severe drowning cases (22) identified for P-HEMS response were intubated and transported directly to a paediatric specialist centre. Intubation required adjuvant anaesthesia in 10 (45%) cases. All children with GCS greater than eight on arrival of the P-HEMS survived neurologically intact. Seven of eight children with a GCS between four and seven survived without neurological impairment and all children with a GCS greater than three survived. Four of twelve asystolic children survived including one child who at 18 months post drowning is neurologically normal. All children who survived had return of spontaneous circulation prior to arrival in the emergency department. P-HEMS played a significant role in the management of severe paediatric drowning in this case series. Requirement for P-HEMS only interventions were high and all identified cases were transferred directly to a paediatric specialist centre. Discontinuation of the P-HEMS direct case identication system that operated during the majority of the study period resulted in deterioration in system performance with some paediatric drowning cases subsequently not identified for P-HEMS response being transported to adult hospitals.

American Association of University Women: Branch Operations Data Modeling Case

ERIC Educational Resources Information Center

Harris, Ranida B.; Wedel, Thomas L.

2015-01-01

A nationally prominent woman's advocacy organization is featured in this case study. The scenario may be used as a teaching case, an assignment, or a project in systems analysis and design as well as database design classes. Students are required to document the system operations and requirements, apply logical data modeling concepts, and design…

A Simple Case Study of a Grid Performance System

NASA Technical Reports Server (NTRS)

Aydt, Ruth; Gunter, Dan; Quesnel, Darcy; Smith, Warren; Taylor, Valerie; Biegel, Bryan (Technical Monitor)

2001-01-01

This document presents a simple case study of a Grid performance system based on the Grid Monitoring Architecture (GMA) being developed by the Grid Forum Performance Working Group. It describes how the various system components would interact for a very basic monitoring scenario, and is intended to introduce people to the terminology and concepts presented in greater detail in other Working Group documents. We believe that by focusing on the simple case first, working group members can familiarize themselves with terminology and concepts, and productively join in the ongoing discussions of the group. In addition, prototype implementations of this basic scenario can be built to explore the feasibility of the proposed architecture and to expose possible shortcomings. Once the simple case is understood and agreed upon, complexities can be added incrementally as warranted by cases not addressed in the most basic implementation described here. Following the basic performance monitoring scenario discussion, unresolved issues are introduced for future discussion.

Life cycle design metrics for energy generation technologies: Method, data, and case study

NASA Astrophysics Data System (ADS)

Cooper, Joyce; Lee, Seung-Jin; Elter, John; Boussu, Jeff; Boman, Sarah

A method to assist in the rapid preparation of Life Cycle Assessments of emerging energy generation technologies is presented and applied to distributed proton exchange membrane fuel cell systems. The method develops life cycle environmental design metrics and allows variations in hardware materials, transportation scenarios, assembly energy use, operating performance and consumables, and fuels and fuel production scenarios to be modeled and comparisons to competing systems to be made. Data and results are based on publicly available U.S. Life Cycle Assessment data sources and are formulated to allow the environmental impact weighting scheme to be specified. A case study evaluates improvements in efficiency and in materials recycling and compares distributed proton exchange membrane fuel cell systems to other distributed generation options. The results reveal the importance of sensitivity analysis and system efficiency in interpreting case studies.

Monitoring and validation of decentralised water and wastewater systems for increased uptake.

PubMed

Sharma, A K; Cook, S; Chong, M N

2013-01-01

Decentralised water and wastewater systems are being implemented to meet growing demand for municipal services either in combination with centralised systems or as standalone systems. In Australia, there has been increased investment in decentralised water and wastewater systems in response to the capacity constraints of existing centralised systems, an extended period of below average rainfall, uncertainly in traditional water sources due to potential climate change impacts, and the need to reduce the environmental impact of urban development. The implementation of decentralised water systems as a mainstream practice at different development scales is impeded by the knowledge gaps on their actual performance in a range of development types and settings. As the wide-spread uptake of these approaches in modern cities is relatively new compared to centralised approaches, there is limited information available on their planning, design, implementation, reliability and robustness. This paper presents a number of case studies where monitoring studies are under way to validate the performance of decentralised water and wastewater systems. The results from these case studies show the yield and reliability of these decentralised systems, as well as the associated energy demand and ecological footprint. The outputs from these case studies, and other monitoring studies, are important in improving decentralised system design guidelines and developing industry wide management norms for the operation and maintenance of decentralised systems.

The Application of an Engineering Design and Information Systems Case Study in a Senior Level Product Data Management Course

ERIC Educational Resources Information Center

Connolly, Patrick

2011-01-01

This study examines the use of an engineering design and information systems case study over a three week period in a senior level class covering the topics of product data management (PDM) and product lifecycle management (PLM). Students that have taken the course in the past have struggled with the sometimes nebulous and difficult to…

An Articulated Pan-Canadian Core Curriculum: Are We Dreaming in Colour? The Tourism Learning System. An Association of Canadian Community Colleges Sponsored Sectoral Case Study.

ERIC Educational Resources Information Center

Bird, Geoffrey; Hood, Terry; White, Brian

This paper offers findings from a case study of western Canada's Tourism Learning System (TLS) initiative. TLS aims to facilitate possible adoption of a national tourism learning system, as well as adaptation of development principles to other industries. The tourism industry now accounts for more than 25% of the world's trade and nearly 10% of…

[Diagnostic values of bronchoscopy and multi-slice spiral CT for congenital dysplasia of the respiratory system in infants: a comparative study].

PubMed

Wang, Xing-Lu; Huang, Ying; Li, Qu-Bei; Dai, Ji-Hong

2013-09-01

To investigate and compare the diagnostic values of bronchoscopy and multi-slice spiral computed tomography (CT) for congenital dysplasia of the respiratory system in infants. Analysis was performed on the clinical data, bronchoscopic findings and multi-slice spiral CT findings of 319 infants (≤1 years old) who underwent bronchoscopy and/or multi-slice spiral CT and were diagnosed with congenital dysplasia of the respiratory system. A total of 476 cases of congenital dysplasia of the respiratory system were found in the 319 infants, including primary dysplasia of the respiratory system (392 cases) and compressive dysplasia of the respiratory system (84 cases). Of the 392 cases of primary dysplasia of the respiratory system, 225 (57.4%) were diagnosed by bronchoscopy versus 167 (42.6%) by multi-slice spiral CT. There were significant differences in etiological diagnosis between bronchoscopy and multi-slice spiral CT in infants with congenital dysplasia of the respiratory system (P<0.05). All 76 cases of primary dysplasia of the respiratory system caused by tracheobronchomalacia were diagnosed by bronchoscopy and all 17 cases of primary dysplasia of the respiratory system caused by lung tissue dysplasia were diagnosed by multi-slice spiral CT. Of the 84 cases of compressive dysplasia of the respiratory system, 74 cases were diagnosed by multi-slice spiral CT and only 10 cases were diagnosed by bronchoscopy. Compared with multi-slice spiral CT, bronchoscopy can detect primary dysplasia of the respiratory system more directly. Bronchoscopy is valuable in the confirmed diagnosis of tracheobronchomalacia. Multi-slice spiral CT has a higher diagnostic value for lung tissue dysplasia than bronchoscopy.

Evaluating performance of local case-mix system by international comparison: a case study in Beijing, China.

PubMed

Jian, Wei-Yan; Lu, Ming; Cui, Tao; Hu, Mu

2011-01-01

Case-mix is an important tool for health planning and management in many countries. As a major developing country, China is considering the introduction of the case-mix system in the health reform. Beijing, the capital of China, developed a local case-mix version whose performance needs to be evaluated before utilization. The objective of this study was to evaluate the performance of the case-mix system developed in Beijing by comparing it with those used in Australia and the U.S.A. A total of 1.3 million inpatient records from 154 hospitals in Beijing in 2008 were grouped respectively using three case-mix systems: (i) Beijing Diagnosis Related Groups (BJ-DRGs); (ii) US-based All Patient DRGs; and (iii) Australian Refined DRGs. Coefficient of variation (CV) and reduction in variance (RIV) were used to measure the performance of DRGs system. The BJ-DRGs produced the best CV and RIV results for expenditure. However, at the level of Major Diagnostic Category (MDC), three MDCs of BJ-DRGs gave the poorest RIVs for both expenditure and length of stay. Although the performance of BJ-DRGs was acceptable, further revision and improvement is needed. Comparisons with other mature DRGs versions can assist in identifying the improvement priorities of the local version. Copyright © 2011 John Wiley & Sons, Ltd.

Association between rs2431697 T allele on 5q33.3 and systemic lupus erythematosus: case-control study and meta-analysis.

PubMed

Tang, Zhao-Ming; Wang, Ping; Chang, Pan-Pan; Hasahya, Tony; Xing, Hui; Wang, Jin-Ping; Hu, Li-Hua

2015-11-01

rs2431697 is located on 5q33.3, between pituitary tumor-transforming gene 1 and miR-146a. Several studies have estimated the association between rs2431697 and systemic lupus erythematosus risk. However, the results were inconsistent. A case-control study was carried out to explore the association between rs2431697 and systemic lupus erythematosus risk in a central Chinese population. Meta-analyses combining present with previous studies were conducted to further explore the association. Our case-control study included 322 cases and 353 controls. rs2431697 T allele was associated with increased risk of systemic lupus erythematosus (odds ratios (ORs) = 1.461, 95% confidence intervals (CI) 1.091-1.957, P = 0.011). The association was stronger between T allele and the risk of anti-double-stranded DNA (dsDNA)-positive systemic lupus erythematosus (OR = 2.510, 95% CI 1.545-4.077, P < 0.001). The meta-analyses included 8648 systemic lupus erythematosus patients and 10947 controls. rs2431697 T allele had an overall OR of 1.262 (95% CI 1.205-1.323, P < 0.001) under fixed-effects model. After stratified by ethnicity, I (2) reduced from 24.3 to 0 %. T allele had an OR of 1.213 (95% CI 1.145-1.284, P < 0.001) in European descendant and 1.365 (95% CI 1.259-1.480, P < 0.001) in Asian under fixed-effects model. Data on women were also extracted, and T allele had an OR of 1.337 (95% CI 1.162-1.539, P < 0.001) under random-effects model. The pooled ORs were not influenced by each study in sensitivity analyses. There were no publication biases observed in these analyses. The results from our case-control study and the meta-analyses indicate that rs2431697 T allele significantly associates with the increased risk of systemic lupus erythematosus.

Using Case Studies in Business Education to Promote Networked Thinking: Findings of an Intervention Study

ERIC Educational Resources Information Center

Pilz, Matthias; Zenner, Lea

2018-01-01

Case studies are central to the way management is currently taught at universities. Among other benefits attributed to the case study method is that it promotes networked thinking by learners. Networked thinking takes account of interactions and repercussions, making it crucial to decision-making within the complex system of rules that shapes…

Microscope-Integrated OCT Feasibility and Utility With the EnFocus System in the DISCOVER Study.

PubMed

Runkle, Anne; Srivastava, Sunil K; Ehlers, Justis P

2017-03-01

To evaluate the feasibility and utility of a novel microscope-integrated intraoperative optical coherence tomography (OCT) system. The DISCOVER study is an investigational device study evaluating microscope-integrated intraoperative OCT systems for ophthalmic surgery. This report focuses on subjects imaged with the EnFocus prototype system (Leica Microsystems/Bioptigen, Morrisville, NC). OCT was performed at surgeon-directed milestones. Surgeons completed a questionnaire after each case to evaluate the impact of OCT on intraoperative management. Fifty eyes underwent imaging with the EnFocus system. Successful imaging was obtained in 46 of 50 eyes (92%). In eight cases (16%), surgical management was changed based on intraoperative OCT findings. In membrane peeling procedures, intraoperative OCT findings were discordant from the surgeon's initial impression in seven of 20 cases (35%). This study demonstrates the feasibility of microscope-integrated intraoperative OCT using the Bioptigen EnFocus system. Intraoperative OCT may provide surgeons with additional information that may influence surgical decision-making. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:216-222.]. Copyright 2017, SLACK Incorporated.

Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the Use of Low-Rank Coal

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

Rader, Jeff; Aguilar, Kelly; Aldred, Derek

2012-03-30

The purpose of this project was to evaluate the ability of advanced low rank coal gasification technology to cause a significant reduction in the COE for IGCC power plants with 90% carbon capture and sequestration compared with the COE for similarly configured IGCC plants using conventional low rank coal gasification technology. GE’s advanced low rank coal gasification technology uses the Posimetric Feed System, a new dry coal feed system based on GE’s proprietary Posimetric Feeder. In order to demonstrate the performance and economic benefits of the Posimetric Feeder in lowering the cost of low rank coal-fired IGCC power with carbonmore » capture, two case studies were completed. In the Base Case, the gasifier was fed a dilute slurry of Montana Rosebud PRB coal using GE’s conventional slurry feed system. In the Advanced Technology Case, the slurry feed system was replaced with the Posimetric Feed system. The process configurations of both cases were kept the same, to the extent possible, in order to highlight the benefit of substituting the Posimetric Feed System for the slurry feed system.« less

Case Study for the ARRA-funded Ground Source Heat Pump (GSHP) Demonstration at Wilders Grove Solid Waste Service Center in Raleigh, NC

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

Liu, Xiaobing; Malhotra, Mini; Xiong, Zeyu

High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This paper highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects, a distributed GSHP system for providing all the space conditioning, outdoor air ventilation, and 100% domestic hot water tomore » the Wilders Grove Solid Waste Service Center of City of Raleigh, North Carolina. This case study is based on the analysis of measured performance data, construction costs, and simulations of the energy consumption of conventional central heating, ventilation, and air-conditioning (HVAC) systems providing the same level of space conditioning and outdoor air ventilation as the demonstrated GSHP system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GSHP system, pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the GSHP system compared with conventional HVAC systems. This case study also identified opportunities for reducing uncertainties in the performance evaluation and improving the operational efficiency of the demonstrated GSHP system.« less

Technical assistance for law-enforcement communications: Case study report two

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Two case histories are presented. In one study the feasibility of consolidating dispatch center operations for small agencies is considered. System load measurements were taken and queueing analysis applied to determine numbers of personnel required for each separate agency and for a consolidated dispatch center. Functional requirements were developed and a cost model was designed to compare relative costs of various alternatives including continuation of the present system, consolidation of a manual system, and consolidated computer-aided dispatching. The second case history deals with the consideration of a multi-regional, intrastate radio frequency for improved interregional communications. Sample standards and specifications for radio equipment are provided.

Refrigerated display case lighting with LEDs

NASA Astrophysics Data System (ADS)

Raghavan, Ramesh; Narendran, Nadarajah

2002-11-01

The rapid development of high brightness light emitting diodes (LEDs) has triggered many applications, especially in the area of display lighting. This paper focuses on the application of white LEDs in refrigerated display cases. The fluorescent lighting presently used in commercial refrigerators is inefficient in the application and also it provides poor lighting for merchandising. A laboratory human factors experiment was conducted to assess the preference for the different lighting systems, namely, fluorescent and LED. Two refrigerated display cases, one with the traditional fluorescent lighting system and the other with a prototype LED lighting system, were placed side-by-side in a laboratory setting. Illuminance measurements made within the two display cases showed that the lighting was more uniform with the LED system compared to the traditional fluorescent system. Sixteen human subjects participated in this study and rated their preference for the two lighting systems. The results show that human subjects strongly preferred the display case with the LED lighting. The authors of this manuscript believe a field study would be greatly beneficial to further confirm these results and to understand the relationship between preference and sales. Considering the luminous efficacy of white LEDs presently available in the marketplace, it is possible to develop a LED based lighting system for commercial refrigerators that is competitive with fluorescent lighting system in terms of energy use. The LED based lighting would provide better lighting than traditional fluorescent lighting.

Mathematical Creativity, Cohen Forcing, and Evolving Systems: Elements for a Case Study on Paul Cohen

ERIC Educational Resources Information Center

Dickman, Benjamin

2013-01-01

The Evolving Systems approach to case studies due initially to Piaget-contemporary Howard Gruber, and complemented by subsequent work on sociocultural factors developed by Mihaly Csikszentmihalyi and others, provides an inroad for examining creative achievements in a variety of domains. This paper provides a proof of concept for how one might…

Towards Geographic Information Systems (GIS) Implementation: A Case Study

ERIC Educational Resources Information Center

Meaney, Miriam

2006-01-01

"Despite its central role in real-world geography, the Geographic Information System (GIS) has had little uptake to date in School Geography." (Wiegand, 2001) This statement can be accurately applied to the author's current school setting and was the focus of her and her colleagues' case study, commenced in 2004 and continued into 2005.…

Life in the Cloud: A WorldShare Management Services Case Study

ERIC Educational Resources Information Center

Hartman, Robin R.

2012-01-01

A small, private academic library took the risk of moving from a traditional integrated library system to adopting a system "in the cloud." This case study presents the setting, history, and local needs of the library, including staffing challenges, and explains the decision-making rationale and process. A description of the library's transition…

Implementing a Portfolio Assessment System for Chapter 1 Program Improvement: A Case Study.

ERIC Educational Resources Information Center

Leitner, David; Trevisan, Mike

This paper presents findings of a case study that documented the implementation of a portfolio assessment system in response to mandated program improvement and assessed its impact on teacher and student behaviors. The sample included elementary and middle school teachers and students from three Chapter 1 schools in a rural California school…

Teachers' Implicit Meaning Systems and Their Implications for Pedagogical Thinking and Practice: A Case Study from Finland

ERIC Educational Resources Information Center

Rissanen, Inkeri; Kuusisto, Elina; Hanhimäki, Eija; Tirri, Kirsi

2018-01-01

This qualitative case study examines teachers' implicit meaning systems built around their core beliefs on the malleability of human qualities. Previous research has demonstrated the influence of students' implicit theories on motivation and achievement and has presented successful interventions for students. However, research on teachers'…

A Case Study in Market Transformation for Residential Energy Efficiency Programs

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

Building Technologies Office

This case study describes how the Midwest Energy Efficiency Alliance (MEEA) partnered with gas and electric utilities in Iowa to establish the Iowa residential heating, ventilation, and air conditioning System Adjustment and Verified Efficiency (HVAC SAVE) program, taking it to scale improving the performance and energy efficiency of HVAC systems, growing businesses, and gaining consumer trust.

A Case Study in an Integrated Development and Problem Solving Environment

ERIC Educational Resources Information Center

Deek, Fadi P.; McHugh, James A.

2003-01-01

This article describes an integrated problem solving and program development environment, illustrating the application of the system with a detailed case study of a small-scale programming problem. The system, which is based on an explicit cognitive model, is intended to guide the novice programmer through the stages of problem solving and program…

Designing for Problem-Based Learning in a Collaborative STEM Lab: A Case Study

ERIC Educational Resources Information Center

Estes, Michele D.; Liu, Juhong; Zha, Shenghua; Reedy, Kim

2014-01-01

Higher education institutions are using virtual telepresence systems to engage in collaborative course redesign and research projects. These systems hold promise and challenge for inter-institutional work in STEM areas. This paper describes a case study involving two universities in the 4-VA consortium, and the redesign of a shared STEM lab. The…

Socioeconomic School Segregation in a Market-Oriented Educational System. The Case of Chile

ERIC Educational Resources Information Center

Valenzuela, Juan Pablo; Bellei, Cristian; de los Ríos, Danae

2014-01-01

This paper presents an empirical analysis of the socioeconomic status (SES) school segregation in Chile, whose educational system is regarded as an extreme case of a market-oriented education. The study estimated the magnitude and evolution of the SES segregation of schools at both national and local levels, and it studied the relationship between…

CIS Program Redesign Driven by IS2010 Model: A Case Study

ERIC Educational Resources Information Center

Surendran, Ken; Amer, Suhair; Schwieger, Dana

2012-01-01

The release of the IS2010 Model Curriculum has triggered review of existing Information Systems (IS) programs. It also provides an opportunity to replace low enrollment IS programs with flexible ones that focus on specific application domains. In this paper, the authors present a case study of their redesigned Computer Information Systems (CIS)…

Utilizing a 'systems' approach to improve the management of waste from healthcare facilities: best practice case studies from England and Wales.

PubMed

Tudor, Terry L; Woolridge, Anne C; Bates, Margaret P; Phillips, Paul S; Butler, Sharon; Jones, Keith

2008-06-01

Changes in environmental legislation and standards governing healthcare waste, such as the Hazardous Waste Regulations are expected to have a significant impact on healthcare waste quantities and costs in England and Wales. This paper presents findings from two award winning case study organizations, the Cardiff and Vale NHS Trust and the Cornwall NHS Trust on 'systems' they have employed for minimizing waste. The results suggest the need for the development and implementation of a holistic range of systems in order to develop best practice, including waste minimization strategies, key performance indicators, and staff training and awareness. The implications for the sharing of best practice from the two case studies are also discussed.

Operationalizing System Importance Measures for Assessing System of System Resilience

NASA Astrophysics Data System (ADS)

Chandrahasa, Rakshit

In recent times, there has been a shift in focus from component level to system level analysis and an increasing effort to understand and design resilience into the system. Several efforts have been carried out in creating metrics to analyse resilience. Understanding and implementing system resilience in complex System of Systems will help us in building safer and resilient systems. System Importance Measures (SIMs) was formulated to analyse System of System resilience and help in designing a resilient SoS. Here, we operationalize these System Importance Measures for designing a resilient SoS. We first look at the existing methodology to improve the visual representation of system resilience and its usability. We demonstrate this using our first case study with a Naval warfare SoS. We incorporate probability into the SIM formulation. We expand the existing SIMs to quantify the effects of disruptions and mitigation likelihoods. We built a second case study based on Air transportation networks and demonstrated our expanded metrics in both the case studies. SIM based analysis of SoS resilience provides us with two different analysis of resilience, with and without probability. Having an outlook on how the resilience changes with a probability of disruptions can aid the designer making informed choices on design changes and help in creating a resilient SoS.

Alcoa North American Extrusions Implements Energy Use Assessments at Multiple Facilities: Office of Industrial Technologies (OIT) BestPractices Aluminum Assessment Case Study

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

U.S. Department of Energy

2001-08-05

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

Innovation and Global elearning: A Case Study at Brigham Young University--Idaho

ERIC Educational Resources Information Center

Young, Alan L.

2016-01-01

This chapter provides a case study of innovation using eLearning in higher education. The case study shows how one university made system-wide organizational and procedural changes to create low-cost, open-access distance learning opportunities on a global level in response to student needs and opportunities.

An Instrumental Case Study of Administrative Smart Practices for Fully Online Programs and Degrees

ERIC Educational Resources Information Center

Gregory, Charles V.

2017-01-01

The purpose of this instrumental case study was to explore administrators' responses to significant administrative challenges of fully online programs and degrees. The case was a single public community college located in the Integrated Postsecondary Education Data System Plains Region. In this study Bardach's (1994) method to identify and…

Real Time Locations Systems or Outsourcing: A Case Study

ERIC Educational Resources Information Center

Lawrence, Cameron; Firth, David; Khumalo, Floyd

2013-01-01

Information Technology has transformed almost all aspects of modern healthcare and is playing a vital role in the administration of hospitals around the world. This case study examines one hospital's struggle to solve crucial operational problems related to the efficient management of medical equipment inventory. This case study is the result of…

University ERP Implementation in Germany: Qualitative Exploratory Case Study of Administrative Staff Experiences

ERIC Educational Resources Information Center

Thelen, Anja

2015-01-01

Enterprise Resource Planning (ERP) implementations are expensive, time-consuming, and often do not lead to the expected outcome of integrated IT systems. Many German universities are implementing ERP systems as Campus Management Systems (CMS) and a solution to any problem, need, or requirement the organization has. This exploratory case study…

The Spectrum of School--University Partnerships: A Typology of Organizational Learning Systems

ERIC Educational Resources Information Center

Callahan, Jamie L.; Martin, Dorian

2007-01-01

School-university partnerships are not uni-dimensional projects. Success in these partnerships can be found in loosely-coupled systems such as client-server partnerships and in more tightly-coupled systems such as collaborative development centers. Using a comparative case study approach, we explore two school-university partnership case studies…

Challenges of rehabilitation case mix measurement in Ontario hospitals.

PubMed

Sutherland, Jason Murray; Walker, Jan

2008-03-01

Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.

Open-Ended Cases in Agroecology: Farming and Food Systems in the Nordic Region and the US Midwest

ERIC Educational Resources Information Center

Francis, Charles; King, James; Lieblein, Geir; Breland, Tor Arvid; Salomonsson, Lennart; Sriskandarajah, Nadarajah; Porter, Paul; Wiedenhoeft, Mary

2009-01-01

Our aim is to describe open-ended case studies for learning real-life problem solving skills, and relate this approach to conventional, closed-ended decision case studies. Teaching methods are open-ended cases in agroecology, an alternative to traditional strategies that lead students through prepared materials and structured discussions to…

Synoptic study of the seasonal variability of dust cases observed by the TOMS satellite over northern Saudi Arabia

NASA Astrophysics Data System (ADS)

Awad, Adel M.; Mashat, Abdul-Wahab S.; Alamoudi, Ahmad O.; Assiri, Mazen E.

2016-05-01

The aerosol index (AI) from the Total Ozone Mapping Spectrometer (TOMS) satellite and meteorological parameters from National Center for Environmental Prediction and the National Center for Atmospheric Research (NCEP/NCAR) reanalysis datasets were used to examine seasonal dust cases in northern Saudi Arabia. Considering all seasons, winter has the fewest dust cases, whereas summer has the most dust cases. Synoptically, surface high-pressure systems in the eastern and western regions are important for the occurrence of dust cases over the northern Arabian Peninsula. When the eastern high pressure prevails, the effects of the Indian low-pressure system on the Arabian Peninsula are weakened or become nonexistent. The extension of the western high-pressure system toward the southeast provides an opportunity for a low-pressure system over Southeast Africa to connect with the Indian low-pressure system, which increases the width of the low-pressure trough and affects the Arabian Peninsula by increasing the amount of dust over the region. At 850 hPa, the weather systems typically rotate clockwise between winter and autumn. In winter, cyclonic systems prevail in the northern region, while anticyclonic systems prevail in the south. The systems are oriented toward the northeast in spring, the west in summer, and the southeast in autumn. Moreover, northern cyclones at 500 hPa shrink as they move northward and the maximum wind speed at 250 hPa decreases from winter to summer. Furthermore, the case study confirms that a change in the relative strength of the pressure systems and a change in the orientation of the isobars (contours) affect the amount of dust over the area. When the orientation of the isobar (contour) lines become strictly north to south or east to west, the amount of dust decreases and vice versa.

The Value of SysML Modeling During System Operations: A Case Study

NASA Technical Reports Server (NTRS)

Dutenhoffer, Chelsea; Tirona, Joseph

2013-01-01

System models are often touted as engineering tools that promote better understanding of systems, but these models are typically created during system design. The Ground Data System (GDS) team for the Dawn spacecraft took on a case study to see if benefits could be achieved by starting a model of a system already in operations. This paper focuses on the four steps the team undertook in modeling the Dawn GDS: defining a model structure, populating model elements, verifying that the model represented reality, and using the model to answer system-level questions and simplify day-to-day tasks. Throughout this paper the team outlines our thought processes and the system insights the model provided.

The value of SysML modeling during system operations: A case study

NASA Astrophysics Data System (ADS)

Dutenhoffer, C.; Tirona, J.

System models are often touted as engineering tools that promote better understanding of systems, but these models are typically created during system design. The Ground Data System (GDS) team for the Dawn spacecraft took on a case study to see if benefits could be achieved by starting a model of a system already in operations. This paper focuses on the four steps the team undertook in modeling the Dawn GDS: defining a model structure, populating model elements, verifying that the model represented reality, and using the model to answer system-level questions and simplify day-to-day tasks. Throughout this paper the team outlines our thought processes and the system insights the model provided.

Comparative Study of State Case Review Systems Phase II: Dispositional Hearings. National Survey. Volume I.

ERIC Educational Resources Information Center

Cahalan, Margaret; And Others

Under the Adoption Assistance and Child Welfare Act of 1980 (P.L. 96-272), Congress outlined a case review system to assure that child welfare agencies monitor children under their care, that parental and child rights are protected, that agencies periodically report progress in implementing case plans, and that agencies work toward a permanent…

A systematic review of ultrasound-accelerated catheter-directed thrombolysis in the treatment of deep vein thrombosis.

PubMed

Shi, Yadong; Shi, Wanyin; Chen, Liang; Gu, Jianping

2018-04-01

To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened. Our literature search identified a total of 16 unique clinical studies. Twelve of the sixteen studies were retrospective case series studies. To date, only one randomised controlled trial (RCT) is available. Overall, UACDT using the EKOS system was performed 548 times in 512 patients. Among all cases, 77-100% achieved substantial lysis (> 50%) based on the different definitions of the individual studies. This treatment modality appears to be safe, as there were no reported procedure-related pulmonary embolisms (PE) and only one procedure-related death was reported. Bleeding events were reported in 14 of the 16 studies, and 3.9% (20/512) of the cases of bleeding were considered major. During the follow-up, post-thrombotic syndrome was observed in 17.1% (20/117) of cases. UACDT using the EKOS system is an effective, safe and promising treatment modality for DVT, but the existing clinical evidence is inadequate to make UACDT using the EKOS system the first-line choice for DVT. Additional prospective large-sample RCTs with long-term follow-ups are warranted to define the role of UACDT using the EKOS system in the treatment of DVT.

A Pedagogical Approach toward Teaching an Information Systems Student How to Conduct a Web Usability Study for an Honors Project: A Case Study

ERIC Educational Resources Information Center

Jesse, Gayle

2013-01-01

The purpose of this paper is to provide educators with a course model and pedagogy to teach a computer information systems usability course. This paper offers a case study based on an honors student project titled "Web Usability: Phases of Developing an Interactive Event Database." Each individual phase--creating a prototype along with…

A Case Study on the Application of a Structured Experimental Method for Optimal Parameter Design of a Complex Control System

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2015-01-01

This report documents a case study on the application of Reliability Engineering techniques to achieve an optimal balance between performance and robustness by tuning the functional parameters of a complex non-linear control system. For complex systems with intricate and non-linear patterns of interaction between system components, analytical derivation of a mathematical model of system performance and robustness in terms of functional parameters may not be feasible or cost-effective. The demonstrated approach is simple, structured, effective, repeatable, and cost and time efficient. This general approach is suitable for a wide range of systems.

TBIdoc: 3D content-based CT image retrieval system for traumatic brain injury

NASA Astrophysics Data System (ADS)

Li, Shimiao; Gong, Tianxia; Wang, Jie; Liu, Ruizhe; Tan, Chew Lim; Leong, Tze Yun; Pang, Boon Chuan; Lim, C. C. Tchoyoson; Lee, Cheng Kiang; Tian, Qi; Zhang, Zhuo

2010-03-01

Traumatic brain injury (TBI) is a major cause of death and disability. Computed Tomography (CT) scan is widely used in the diagnosis of TBI. Nowadays, large amount of TBI CT data is stacked in the hospital radiology department. Such data and the associated patient information contain valuable information for clinical diagnosis and outcome prediction. However, current hospital database system does not provide an efficient and intuitive tool for doctors to search out cases relevant to the current study case. In this paper, we present the TBIdoc system: a content-based image retrieval (CBIR) system which works on the TBI CT images. In this web-based system, user can query by uploading CT image slices from one study, retrieval result is a list of TBI cases ranked according to their 3D visual similarity to the query case. Specifically, cases of TBI CT images often present diffuse or focal lesions. In TBIdoc system, these pathological image features are represented as bin-based binary feature vectors. We use the Jaccard-Needham measure as the similarity measurement. Based on these, we propose a 3D similarity measure for computing the similarity score between two series of CT slices. nDCG is used to evaluate the system performance, which shows the system produces satisfactory retrieval results. The system is expected to improve the current hospital data management in TBI and to give better support for the clinical decision-making process. It may also contribute to the computer-aided education in TBI.

A robust estimation of the effects of motorcycle autonomous emergency braking (MAEB) based on in-depth crashes in Australia.

PubMed

Savino, Giovanni; Mackenzie, Jamie; Allen, Trevor; Baldock, Matthew; Brown, Julie; Fitzharris, Michael

2016-09-01

Autonomous emergency braking (AEB) is a safety system that detects imminent forward collisions and reacts by slowing down the host vehicle without any action from the driver. AEB effectiveness in avoiding and mitigating real-world crashes has recently been demonstrated. Research suggests that a translation of AEB to powered 2-wheelers could also be beneficial. Previous studies have estimated the effects of a motorcycle AEB system (MAEB) via computer simulations. Though effects of MAEB were computed for motorcycle crashes derived from in-depth crash investigation, there may be some inaccuracies due to limitations of postcrash investigation (e.g., inaccuracies in preimpact velocity of the motorcycle). Furthermore, ideal MAEB technology was assumed, which may lead to overestimation of the benefits. This study sought to evaluate the sensitivity of the simulations to variations in reconstructed crash cases and the capacity of the MAEB system in order to provide a more robust estimation of MAEB effects. First, a comprehensive classification of accidents was used to identify scenarios in which MAEB was likely to apply, and representative crash cases from those available for this study were populated for each crash scenario. Second, 100 variant cases were generated by randomly varying a set of simulation parameters with given normal distributions around the baseline values. Variants reflected uncertainties in the original data. Third, the effects of MAEB were estimated in terms of the difference in the impact speed of the host motorcycle with and without the system via computer simulations of each variant case. Simulations were repeated assuming both an idealized and a realistic MAEB system. For each crash case, the results in the baseline case and in the variants were compared. A total of 36 crash cases representing 11 common crash scenarios were selected from 3 Australian in-depth data sets: 12 cases from New South Wales, 13 cases from Victoria, and 11 cases from South Australia. The reduction in impact speed elicited by MAEB in the baseline cases ranged from 2.8 to 10.0 km/h. The baseline cases over- or underestimated the mean impact speed reduction of the variant cases by up to 20%. Constraints imposed by simulating more realistic capabilities for an MAEB system produced a decrease in the estimated impact speed reduction of up to 14% (mean 5%) compared to an idealized system. The small difference between the baseline and variant case results demonstrates that the potential effects of MAEB computed from the cases described in in-depth crash reports are typically a good approximation, despite limitations of postcrash investigation. Furthermore, given that MAEB intervenes very close to the point of impact, limitations of the currently available technologies were not found to have a dramatic influence on the effects of the system.

I-V characteristics of in-plane and out-of-plane strained edge-hydrogenated armchair graphene nanoribbons

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

Cartamil-Bueno, S. J., E-mail: s.j.cartamilbueno@tudelft.nl, E-mail: rbolivar@ugr.es; Rodríguez-Bolívar, S., E-mail: s.j.cartamilbueno@tudelft.nl, E-mail: rbolivar@ugr.es

2015-06-28

The effects of tensile strain on the current-voltage (I-V) characteristics of hydrogenated-edge armchair graphene nanoribbons are investigated by using DFT theory. The strain is introduced in two different ways related to the two types of systems studied in this work: in-plane strained systems (A) and out-of-plane strained systems due to bending (B). These two kinds of strain lead to make a distinction among three cases: in-plane strained systems with strained electrodes (A1) and with unstrained electrodes (A2), and out-of-plane homogeneously strained systems with unstrained, fixed electrodes (B). The systematic simulations to calculate the electronic transmission between two electrodes were focusedmore » on systems of 8 and 11 dimers in width. The results show that the differences between cases A2 and B are negligible, even though the strain mechanisms are different: in the plane case, the strain is uniaxial along its length; while in the bent case, the strain is caused by the arc deformation. Based on the study, a new type of nanoelectromechanical system solid state switching device is proposed.« less

1000-Case Reader Study of Radiologists' Performance in Interpretation of Automated Breast Volume Scanner Images with a Computer-Aided Detection System.

PubMed

Xu, Xiaojing; Bao, Lingyun; Tan, Yanjuan; Zhu, Luoxi; Kong, Fanlei; Wang, Wei

2018-05-28

The objective of our study was to assess, in a reader study, radiologists' performance in interpretation of automated breast volume scanner (ABVS) images with the aid of a computer-aided detection (CADe) system. Our study is a retrospective observer study with the purpose of investigating the effectiveness of using a CADe system as an aid for radiologists in interpretation of ABVS images. The multiple-reader, multiple-case study was designed to compare the diagnostic performance of radiologists with and without CADe. The study included 1000 cases selected from ABVS examinations in our institution in 2012. Among those cases were 206 malignant, 486 benign and 308 normal cases. The cancer cases were consecutive; the benign and normal cases were randomly selected. All malignant and benign cases were confirmed by biopsy or surgery, and normal cases were confirmed by 2-y follow-up. Reader performance was compared in terms of area under the receiver operating characteristic curve, sensitivity and specificity. Additionally, the reading time per case for each reader was recorded. Nine radiologists from our institution participated in the study. Three had more than 8 y of ultrasound experience and more than 4 y of ABVS experience (group A); 3 had more than 5 y of ultrasound experience (group B), and 3 had more than 1 y of ultrasound experience (group C). Both group B and group C had no ABVS experience. The CADe system used was the QVCAD System (QView Medical, Inc., Los Altos, CA, USA). It is designed to aid radiologists in searching for suspicious areas in ABVS images. CADe results are presented to the reader simultaneously with the ABVS images; that is, the radiologists read the ABVS images concurrently with the CADe results. The cases were randomly assigned for each reader into two equal-size groups, 1 and 2. Initially the readers read their group 1 cases with the aid of CADe and their group 2 cases without CADe. After a 1-mo washout period, they re-read their group 1 cases without CADe and their group 2 cases with CADe. The areas under the receiver operating characteristic curves of all readers were 0.784 for reading with CADe and 0.747 without CADe. Areas under the curves with and without CADe were 0.833 and 0.829 for group A, 0.757 and 0.696 for group B and 0.759 and 0.718 for group C. All differences in areas under the curve were statistically significant (p <0.05), except that for group A. The average reading time was 9.3% (p < < 0.05) faster with CADe for all readers. In summary, CADe improves radiologist performance with respect to both accuracy and reading time for the detection of breast cancer using the ABVS, with the greater benefit for those inexperienced with ABVS. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Accidental degeneracies in nonlinear quantum deformed systems

NASA Astrophysics Data System (ADS)

Aleixo, A. N. F.; Balantekin, A. B.

2011-09-01

We construct a multi-parameter nonlinear deformed algebra for quantum confined systems that includes many other deformed models as particular cases. We demonstrate that such systems exhibit the property of accidental pairwise energy level degeneracies. We also study, as a special case of our multi-parameter deformation formalism, the extension of the Tamm-Dancoff cutoff deformed oscillator and the occurrence of accidental pairwise degeneracy in the energy levels of the deformed system. As an application, we discuss the case of a trigonometric Rosen-Morse potential, which is successfully used in models for quantum confined systems, ranging from electrons in quantum dots to quarks in hadrons.

[Primary lymphoma of the central nervous system: 20 years' experience in a referral hospital].

PubMed

Calderón-Garcidueñas, A L; Pacheco-Calleros, J; Castelán-Maldonado, E; Nocedal-Rustrián, F C

Primary central nervous system lymphomas (PCNSL) are rare neoplasms. AIM. To study the clinical aspects and the immuno-phenotype of all cases of PCNSL in a 20 years lapse in a referral hospital in Northeastern Mexico. From January 1986 to December 2005 all PCNSL histologically confirmed were studied. The primary lymphomas were 1% of malignant central nervous system neoplasms. 21 cases were studied (ages from 9-70 years) with male predominance (2:1). 24% patients had immuno-suppression. The more frequent clinical data were: papilledema (71%), headache (62%), paresis (48%) and seizures (33%). 33% of patients died during the first six months after diagnosis. The T lymphomas were 19% of cases and corresponded to small cell type. PCNSL are still a diagnostic challenge. Multicenter studies are required in order to determine the best treatment protocol.

Joint-Service Integration: An Organizational Culture Study of the United States Department of Defense Voluntary Education System

ERIC Educational Resources Information Center

Benson, Martin K.

2010-01-01

The purpose of the descriptive case study with a multiple case framework was to (a) describe the organizational cultures of education programs and leaders in the United States (U.S.) Department of Defense (DoD) voluntary education system on Oahu, Hawaii; (b) determine if an overlapping common organizational culture exists; and (c) assess the…

Effects of an Incentive Based Budgeting System on Institutional Performance Indicators: An Exploratory Longitudinal Case Study of a Public University

ERIC Educational Resources Information Center

Willett, Michael S.

2013-01-01

The purpose of this exploratory longitudinal case study was to examine how the implementation of an Incentive Based Budgeting (IBB) system (i.e., Responsibility-Centered Management [RCM]) affected selected institutional performance indicators at the campus level and two comparable schools at a large Mid-Western public University. The value of…

Case Studies in Systems Chemistry. Final Report. [Includes Complete Case Study, Carboxylic Acid Equilibria

ERIC Educational Resources Information Center

Fleck, George

This publication was produced as a teaching tool for college chemistry. The book is a text for a computer-based unit on the chemistry of acid-base titrations, and is designed for use with FORTRAN or BASIC computer systems, and with a programmable electronic calculator, in a variety of educational settings. The text attempts to present computer…

Application of Cognitive Apprenticeship Model to a Graduate Course in Performance Systems Analysis: A Case Study

ERIC Educational Resources Information Center

Darabi, A. Aubteen

2005-01-01

This article reports a case study describing how the principles of a cognitive apprenticeship (CA) model developed by Collins, Brown, and Holum (1991) were applied to a graduate course on performance systems analysis (PSA), and the differences this application made in student performance and evaluation of the course compared to the previous…

An Examination of Information Security Training and Education for IT Professionals in a Community College: A Case Study

ERIC Educational Resources Information Center

Stark, Adam

2017-01-01

This case study research explored the cybersecurity systems and training and education of IT professionals at a member college of the Florida College System. Thematic analysis was utilized to analyze interview transcripts of 6 respondents. A more descriptive analysis was completed using the survey responses from 15 respondents. From this analysis…

Research on the Education System of Business English Courses Based on the Case of GDUFS

ERIC Educational Resources Information Center

Zhengguo, Zhu; Lili, Lin; Wenzhong, Zhu

2016-01-01

In order to develop a more scientific education system of Business English courses, this paper studies the case of Guangdong University of Foreign Studies (GDUFS, one of Chinese top-three foreign language universities) by questionnaires. The result shows that: 1) Most of the students hope that the school could add more business courses in the…

Game Coaching System Design and Development: A Retrospective Case Study of FPS Trainer

ERIC Educational Resources Information Center

Tan, Wee Hoe

2013-01-01

This paper is a retrospective case study of a game-based learning (GBL) researcher who cooperated with a professional gamer and a team of game developers to design and develop a coaching system for First-Person Shooter (FPS) players. The GBL researcher intended to verify the ecological validity of a model of cooperation; the developers wanted to…

Effective Schooling in Rural Africa Report 3: Case Study Briefs on Rural Schooling.

ERIC Educational Resources Information Center

World Bank, Washington, DC. Human Development Network.

This document contains 20 case study briefs about efforts to improve rural schools and teachers in Africa, Latin America, and Asia. Some reforms focus on a part of the education system or a particular population; others attempt to change the national education system. At least seven programs were begun as an alternative to government schools. Most…

Lessons for Co-Innovation in Agricultural Innovation Systems: A Multiple Case Study Analysis and a Conceptual Model

ERIC Educational Resources Information Center

Fielke, Simon J.; Botha, Neels; Reid, Janet; Gray, David; Blackett, Paula; Park, Nicola; Williams, Tracy

2018-01-01

Purpose: This paper highlights important lessons for co-innovation drawn from three ex-post case study innovation projects implemented within three sub-sectors of the primary industry sector in New Zealand. Design/methodology/approach: The characteristics that fostered co-innovation in each innovation project case study were identified from…

Langerhans cell histiocytosis of skull: a retrospective study of 18 cases.

PubMed

Zhang, Xiang-Heng; Zhang, Ji; Chen, Zheng-He; Sai, Ke; Chen, Yin-Sheng; Wang, Jian; Ke, Chao; Guo, Chen-Chen; Chen, Zhong-Ping; Mou, Yong-Gao

2017-04-01

The present study presents 18 cases of Chinese patients harboring a Langerhans cell histiocytosis (LCH) of the skull. Eighteen consecutive patients were diagnosed as LCH of the skull and confirmed pathologically between March 2002 and February 2014. In the present study, the patients of LCH without skull involvement were excluded. According to disease extent at diagnosis, the 18 LCH patients with skull involvement were divided into three groups: (I) unifocal-monosystem group, including ten cases with solitary skull lesion; (II) multifocal-monosystem group, including two cases with multiple bone lesions and no extra-skeletal involvement; (III) multisystem group, including six cases with LCH lesions involving both skeletal and extra-skeletal system. In unifocal-monosystem group, excision of the skull lesion was performed in eight of ten cases, a low dosage of local radiotherapy and a purposeful observation was accept by the remaining two cases of this group after biopsy respectively. In multifocal-monosystem group, both of the two cases were received chemotherapy. In multi-system group, all the six cases were managed with systemic chemotherapy, after their diagnoses of LCH were confirmed. The mean age at the time of diagnosis was 9.4 years. There was a male predominance in this disease male/female ratio was 3.5:1. In our cases, a skull mass with or without tenderness was the most common chief complaint (13 cases, 72.2%), and frontal bone was the most frequent affected locations of skull (6 cases, 33.3%). In unifocal-monosystem group, nine of ten remained free from LCH, the remain one lesion recurred 22 months after his surgical excision. In multifocal-monosystem group, a complete response (CR) was obtained in one of them, and a stable disease (SD) of multiple osseous lesions was obtained in another one. In the multi-system group, a CR in four cases and a partial response (PR) in one case were obtained, and a progressive disease (PD) was observed in the remaining one. The unifocal-monosystem of LCH of the skull is a clinicopathological entity with a good outcome, and resection, irradiation or purposeful observation are also can be been utilized as the choice of treatment. For the multifocal bone lesions and multisystem lesions of LCH, chemotherapy is an effective treatment as a systemic therapy. There is no enough publication literature to determine guidelines or indications for managing this disease.

A Case Study Based Analysis of Performance Metrics for Green Infrastructure

NASA Astrophysics Data System (ADS)

Gordon, B. L.; Ajami, N.; Quesnel, K.

2017-12-01

Aging infrastructure, population growth, and urbanization are demanding new approaches to management of all components of the urban water cycle, including stormwater. Traditionally, urban stormwater infrastructure was designed to capture and convey rainfall-induced runoff out of a city through a network of curbs, gutters, drains, and pipes, also known as grey infrastructure. These systems were planned with a single-purpose and designed under the assumption of hydrologic stationarity, a notion that no longer holds true in the face of a changing climate. One solution gaining momentum around the world is green infrastructure (GI). Beyond stormwater quality improvement and quantity reduction (or technical benefits), GI solutions offer many environmental, economic, and social benefits. Yet many practical barriers have prevented the widespread adoption of these systems worldwide. At the center of these challenges is the inability of stakeholders to know how to monitor, measure, and assess the multi-sector performance of GI systems. Traditional grey infrastructure projects require different monitoring strategies than natural systems; there are no overarching policies on how to best design GI monitoring and evaluation systems and measure performance. Previous studies have attempted to quantify the performance of GI, mostly using one evaluation method on a specific case study. We use a case study approach to address these knowledge gaps and develop a conceptual model of how to evaluate the performance of GI through the lens of financing. First, we examined many different case studies of successfully implemented GI around the world. Then we narrowed in on 10 exemplary case studies. For each case studies, we determined what performance method the project developer used such as LCA, TBL, Low Impact Design Assessment (LIDA) and others. Then, we determined which performance metrics were used to determine success and what data was needed to calculate those metrics. Finally, we examine risk priorities of both public and private actors to see how they varied and how risk was overcome. We synthesized these results to pull out key themes and lessons for the future. If project implementers are able to quantify the benefits and show investors how beneficial these systems can be, more will be implemented in the future.

Qualitative and Quantitative Pedigree Analysis: Graph Theory, Computer Software, and Case Studies.

ERIC Educational Resources Information Center

Jungck, John R.; Soderberg, Patti

1995-01-01

Presents a series of elementary mathematical tools for re-representing pedigrees, pedigree generators, pedigree-driven database management systems, and case studies for exploring genetic relationships. (MKR)

What Can Be Learned from a Comparison of Two Agricultural Knowledge Systems? The Case of the Netherlands and Israel.

ERIC Educational Resources Information Center

Blum, Abraham

1991-01-01

Compared the agricultural knowledge systems (AKS) of the Netherlands and Israel; analyzed the features that made the systems effective and applicable to other countries. The analysis discovered eight elements that explain the success of these AKSs and demonstrated the value of comparative case studies. (JOW)

Associative visual agnosia: a case study.

PubMed

Charnallet, A; Carbonnel, S; David, D; Moreaud, O

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

A software framework for assessing the resilience of drinking water systems to disasters with an example earthquake case study

DOE PAGES

Klise, Katherine A.; Bynum, Michael; Moriarty, Dylan; ...

2017-07-07

Water utilities are vulnerable to a wide variety of human-caused and natural disasters. The Water Network Tool for Resilience (WNTR) is a new open source PythonTM package designed to help water utilities investigate resilience of water distribution systems to hazards and evaluate resilience-enhancing actions. In this paper, the WNTR modeling framework is presented and a case study is described that uses WNTR to simulate the effects of an earthquake on a water distribution system. The case study illustrates that the severity of damage is not only a function of system integrity and earthquake magnitude, but also of the available resourcesmore » and repair strategies used to return the system to normal operating conditions. While earthquakes are particularly concerning since buried water distribution pipelines are highly susceptible to damage, the software framework can be applied to other types of hazards, including power outages and contamination incidents.« less

A software framework for assessing the resilience of drinking water systems to disasters with an example earthquake case study

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

Klise, Katherine A.; Bynum, Michael; Moriarty, Dylan

Water utilities are vulnerable to a wide variety of human-caused and natural disasters. The Water Network Tool for Resilience (WNTR) is a new open source PythonTM package designed to help water utilities investigate resilience of water distribution systems to hazards and evaluate resilience-enhancing actions. In this paper, the WNTR modeling framework is presented and a case study is described that uses WNTR to simulate the effects of an earthquake on a water distribution system. The case study illustrates that the severity of damage is not only a function of system integrity and earthquake magnitude, but also of the available resourcesmore » and repair strategies used to return the system to normal operating conditions. While earthquakes are particularly concerning since buried water distribution pipelines are highly susceptible to damage, the software framework can be applied to other types of hazards, including power outages and contamination incidents.« less

Using existing case-mix methods to fund trauma cases.

PubMed

Monakova, Julia; Blais, Irene; Botz, Charles; Chechulin, Yuriy; Picciano, Gino; Basinski, Antoni

2010-01-01

Policymakers frequently face the need to increase funding in isolated and frequently heterogeneous (clinically and in terms of resource consumption) patient subpopulations. This article presents a methodologic solution for testing the appropriateness of using existing grouping and weighting methodologies for funding subsets of patients in the scenario where a case-mix approach is preferable to a flat-rate based payment system. Using as an example the subpopulation of trauma cases of Ontario lead trauma hospitals, the statistical techniques of linear and nonlinear regression models, regression trees, and spline models were applied to examine the fit of the existing case-mix groups and reference weights for the trauma cases. The analyses demonstrated that for funding Ontario trauma cases, the existing case-mix systems can form the basis for rational and equitable hospital funding, decreasing the need to develop a different grouper for this subset of patients. This study confirmed that Injury Severity Score is a poor predictor of costs for trauma patients. Although our analysis used the Canadian case-mix classification system and cost weights, the demonstrated concept of using existing case-mix systems to develop funding rates for specific subsets of patient populations may be applicable internationally.

A Case-Based Approach Improves Science Students' Experimental Variable Identification Skills

ERIC Educational Resources Information Center

Grunwald, Sandra; Hartman, Andrew

2010-01-01

Incorporation of experimental case studies into the laboratory curriculum increases students' abilities to identify experimental variables that affect the outcome of an experiment. Here the authors describe how such case studies were incorporated using an online course management system into a biochemistry laboratory curriculum and the assessment…

Hierarchical Simulation to Assess Hardware and Software Dependability

NASA Technical Reports Server (NTRS)

Ries, Gregory Lawrence

1997-01-01

This thesis presents a method for conducting hierarchical simulations to assess system hardware and software dependability. The method is intended to model embedded microprocessor systems. A key contribution of the thesis is the idea of using fault dictionaries to propagate fault effects upward from the level of abstraction where a fault model is assumed to the system level where the ultimate impact of the fault is observed. A second important contribution is the analysis of the software behavior under faults as well as the hardware behavior. The simulation method is demonstrated and validated in four case studies analyzing Myrinet, a commercial, high-speed networking system. One key result from the case studies shows that the simulation method predicts the same fault impact 87.5% of the time as is obtained by similar fault injections into a real Myrinet system. Reasons for the remaining discrepancy are examined in the thesis. A second key result shows the reduction in the number of simulations needed due to the fault dictionary method. In one case study, 500 faults were injected at the chip level, but only 255 propagated to the system level. Of these 255 faults, 110 shared identical fault dictionary entries at the system level and so did not need to be resimulated. The necessary number of system-level simulations was therefore reduced from 500 to 145. Finally, the case studies show how the simulation method can be used to improve the dependability of the target system. The simulation analysis was used to add recovery to the target software for the most common fault propagation mechanisms that would cause the software to hang. After the modification, the number of hangs was reduced by 60% for fault injections into the real system.

Synchronization of an optomechanical system to an external drive

NASA Astrophysics Data System (ADS)

Amitai, Ehud; Lörch, Niels; Nunnenkamp, Andreas; Walter, Stefan; Bruder, Christoph

2017-05-01

Optomechanical systems driven by an effective blue-detuned laser can exhibit self-sustained oscillations of the mechanical oscillator. These self-oscillations are a prerequisite for the observation of synchronization. Here, we study the synchronization of the mechanical oscillations to an external reference drive. We study two cases of reference drives: (1) an additional laser applied to the optical cavity; (2) a mechanical drive applied directly to the mechanical oscillator. Starting from a master equation description, we derive a microscopic Adler equation for both cases, valid in the classical regime in which the quantum shot noise of the mechanical self-oscillator does not play a role. Furthermore, we numerically show that, in both cases, synchronization arises also in the quantum regime. The optomechanical system is therefore a good candidate for the study of quantum synchronization.

Timing of Surgery for Spinal Fractures Associated with Systemic Trauma: A Need for a Strategic and Systemic Approach.

PubMed

Koksal, Ismet; Alagoz, Fatih; Celik, Haydar; Yildirim, Ali Erdem; Akin, Tezcan; Guvenc, Yahya; Karatay, Mete; Erdem, Yavuz

An underestimated evaluation of systemic organs in cases with spinal fractures might jeopardize the intervention for treatment and future complications with an increased morbidity and mortality are almost warranted. In the present study, a retrospective analysis of spinal fracture cases associated with systemic trauma was performed to assess surgical success. A retrospective analysis of patients with thoracolumbar fractures who were admitted to the emergency unit between September 2012 and September 2014 was used for the study. The cases were categorized according to age, sex, reason of trauma, associated trauma, neurological condition and treatment details and results were analysed using SPSS 14.0 for Windows. The most common reason of trauma is detected as falls in 101 cases (64.3%). Radiological evaluation of spinal fractures revealed a compression fracture in 106 cases (67.5%) and other fractures in 51 cases (32.5%). Surgical treatment for spinal fracture was performed in 60.5% of the cases and conservative approach was preferred in 39.5% cases. In non-compressive spinal fractures, an associated pathology like head trauma, lower extremity fracture or neurological deficit was found to be higher in incidence (p < 0.05). Necessity for surgical intervention was found to be more prominent in this group (p < 0.05). However, the fracture type was not found to be associated with morbidity and mortality (p < 0.05). A surgical intervention for a spinal fracture necessitating surgery should rather be performed right after stabilization of the systemic condition which might be associated with decreased morbidity and mortality.

ACMV Energy Analysis for Academic Building: A Case Study

NASA Astrophysics Data System (ADS)

Hywel, R.; Tee, B. T.; Arifin, M. Y.; Tan, C. F.; Gan, C. K.; Chong, CT

2015-09-01

Building energy audit examines the ways actual energy consumption is currently used in the facility, in the case of a completed and occupied building and identifies some alternatives to reduce current energy usage. Implementation of energy audit are practically used to analyze energy consumption pattern, monitoring on how the energy used varies with time in the building, how the system element interrelate, and study the effect of external environment towards building. In this case study, a preliminary energy audit is focusing on Air-Conditioning & Mechanical Ventilation (ACMV) system which reportedly consumed 40% of the total energy consumption in typical building. It is also the main system that provides comfortable and healthy environment for the occupants. The main purpose of this study is to evaluate the current ACMV system performance, energy optimization and identifying the energy waste on UTeM's academic building. To attain this, the preliminary data is collected and then analyzed. Based on the data, economic analysis will be determined before cost-saving methods are being proposed.

Campania Region (Italy) spontaneous reporting system and preventability assessment through a case-by-case approach: a pilot study on psychotropic drugs.

PubMed

Sessa, Maurizio; Rafaniello, Concetta; Sportiello, Liberata; Mascolo, Annamaria; Scavone, Cristina; Maccariello, Alessandra; Iannaccone, Teresa; Fabrazzo, Michele; Berrino, Liberato; Rossi, Francesco; Capuano, Annalisa

2016-12-01

We conducted the first pilot Italian study to assess the preventability of adverse drug reactions involving psychotropic drugs reported through spontaneous reporting system from 01/07/2012 to 31/12/2014 in Campania Region. Preventability was assessed, case-by-case, using an adapted version of the P-method. The evaluation was performed only for those reports that had, as suspected drug, antipsychotics, mood stabilizers, antidepressants, anxiolytic and/or sedative-hypnotic. Eighty-one cases (19.2%) out of 421 reported during the study period were preventable. In seventy-seven (95.1%) out of 81 preventable cases, the underlying mechanism of the adverse drug reactions was dose-related, in four (4.9%) preventable cases the underlying mechanism of the adverse drug reactions was respectively susceptibility- (1; 1.2%), unknown- (1; 1.2%) and time-related (2; 2.5%). In the 81 preventable cases, 97 critical criteria were detected of which 29/97 (29.9%) related to healthcare professionals' practices, 0/97 (0.0%) to drug quality and 68/97 (70.1%) to patient behaviour. We proved that it was possible to apply and adapt the P-Method to assess the preventability of the adverse drug reactions involving psychotropic drugs, analysing individual case safety report sent through Campania Region spontaneous reporting system. Information acquired will be used to organize educational activities for both physicians and patients to promote a more appropriate drug use.

The Power of a Question: A Case Study of Two Organizational Knowledge Capture Systems

NASA Technical Reports Server (NTRS)

Cooper, Lynn P.

2003-01-01

This document represents a presentation regarding organizational knowledge capture systems which was delivered at the HICSS-36 conference held from January 6-9, 2003. An exploratory case study of two knowledge resources is offered. Then, two organizational knowledge capture systems are briefly described: knowledge transfer from practitioner and the use of questions to represent knowledge. Finally, the creation of a database of peer review questions is suggested as a method of promoting organizational discussions and knowledge representation and exchange.

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-08-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Incorporating ITS into corridor planning : Seattle case study

DOT National Transportation Integrated Search

1999-06-01

The goals of this study were to develop a methodology for incorporating Intelligent Transportation Systems (ITS) into the transportation planning process and apply the methodology to estimate ITS costs and benefits for one case study. A major result ...

Misconceptions about case-mix payments for nursing homes.

PubMed

Grimaldi, P L

1987-04-01

Despite the increasing use of case-mix payment systems for skilled and intermediate nursing home care (at least 10 state Medicaid programs have adopted or are considering adopting such a system), misconceptions about such systems still exist. Unless these inaccurate perceptions are corrected, a state may adopt a system that fails to realize its goals. Some of these misconceptions include the beliefs that case-mix payment systems: Apply to all nursing homes costs; Will benefit hospital-based facilities; Will resolve the access problems of heavy care public patients; Will result in higher statewide payment rates because patient characteristics are factored directly into the calculations. In fact, case-mix adjustments are applied only to costs that can be traced directly to patients' impairments. Nursing services and some ancillary services are dependent on case mix, while administrative and support services are largely independent of case mix. Capital costs usually can be ignored in formulating the case-mix adjustment. Although hospital-based facilities frequently have sicker patients than freestanding facilities, studies show that only a portion of the cost differential is explained by case-mix differences. In the case of heavy-care patients, some believe that case-mix payment systems will resolve access problems by paying higher rates in response to the higher treatment costs. Access may not improve, however, if the new rates are lower than those paid by comparable private patients. Perhaps a loosening in the certificate-of-need process will also be needed to resolve the access problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Case study of open-source enterprise resource planning implementation in a small business

NASA Astrophysics Data System (ADS)

Olson, David L.; Staley, Jesse

2012-02-01

Enterprise resource planning (ERP) systems have been recognised as offering great benefit to some organisations, although they are expensive and problematic to implement. The cost and risk make well-developed proprietorial systems unaffordable to small businesses. Open-source software (OSS) has become a viable means of producing ERP system products. The question this paper addresses is the feasibility of OSS ERP systems for small businesses. A case is reported involving two efforts to implement freely distributed ERP software products in a small US make-to-order engineering firm. The case emphasises the potential of freely distributed ERP systems, as well as some of the hurdles involved in their implementation. The paper briefly reviews highlights of OSS ERP systems, with the primary focus on reporting the case experiences for efforts to implement ERPLite software and xTuple software. While both systems worked from a technical perspective, both failed due to economic factors. While these economic conditions led to imperfect results, the case demonstrates the feasibility of OSS ERP for small businesses. Both experiences are evaluated in terms of risk dimension.

Career moves of urban science teachers: Negotiating constancy, change, and confirmation

NASA Astrophysics Data System (ADS)

Rinke, Carol Riegelman

2007-12-01

This dissertation addresses the issue of teacher retention in urban science classrooms, in which a revolving door of new teachers leads to an inexperienced teaching force and reduced academic attainment for students. Urban science teachers are particularly susceptible to attrition due to extensive professional opportunities outside the classroom. This study follows eight case study teachers in an urban school district in order to better understand how today's urban science teachers think about their careers and career moves. Based on traditional research on teacher retention and existing literature on teachers' professional lives, this study focuses in particular on urban science teachers' professional priorities, community participation, and process of career decision making in order to determine the ways in which these factors may be consequential for their career paths. The study uses a qualitative case study methodology. Data collection methods include a survey of all first, second, and third year science teachers in one urban district followed by the selection of eight case study teachers using a variety of demographic, certification, and workplace characteristics. In-depth case studies included monthly interviews and professional observations over parts of two school years. The experiences and perspectives of the eight case study teachers revealed three patterns. First, the eight case study teachers followed two distinct paths through the profession, those who aimed to integrate and were oriented toward the educational system and those who wanted to participate and oriented themselves away from the educational system. These professional trajectories were influential in shaping case study teachers' experiences in schools as well as their career directions. Second, the eight case study teachers continually considered their professional alternatives, either within or outside of the educational system. Finally, the case study teachers aimed to get past the challenges inherent in urban teaching and reach professional confirmation before moving on to new roles and responsibilities. These themes indicate the centrality of urban science teachers' professional orientations for recruitment, preparation, and retention, demonstrate the need for in-depth and longitudinal research on teacher retention, and suggest the pivotal nature of professional growth in career mobility.

A Case Study of Obsolescence Management Constraints During Development of Sustainment-Dominated Systems

NASA Astrophysics Data System (ADS)

Welch, Jonathan

This case study focused on obsolescence management constraints that occur during development of sustainment-dominated systems. Obsolescence management constraints were explored in systems expected to last 20 years or more and that tend to use commercial off-the-shelf products. The field of obsolescence has received little study, but obsolescence has a large cost for military systems. Because developing complex systems takes an average of 3 to 8 years, and commercial off-the-shelf components are typically obsolete within 3 to 5 years, military systems are often deployed with obsolescence issues that are transferred to the sustainment community to determine solutions. The main problem addressed in the study was to identify the constraints that have caused 70% of military systems under development to be obsolete when they are delivered. The purpose of the study was to use a qualitative case study to identify constraints that interfered with obsolescence management occurring during the development stages of a program. The participants of this case study were managers, subordinates, and end-users who were logistics and obsolescence experts. Researchers largely agree that proactive obsolescence management is a lower cost solution for sustainment-dominated systems. Program managers must understand the constraints and understand the impact of not implementing proactive solutions early in the development program lifecycle. The conclusion of the study found several constraints that prevented the development program from early adoption of obsolescence management theories, specifically pro-active theories. There were three major themes identified: (a) management commitment, (b) lack of details in the statement of work, and (c) vendor management. Each major theme includes several subthemes. The recommendation is future researchers should explore two areas: (a) comparing the cost of managing obsolescence early in the development process versus the costs of managing later, (b) exploring the costs and value to start a centralized obsolescence group at each major defense contractor location.

Best practices in intercultural health: five case studies in Latin America.

PubMed

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-09-05

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

A reflective lens: applying critical systems thinking and visual methods to ecohealth research.

PubMed

Cleland, Deborah; Wyborn, Carina

2010-12-01

Critical systems methodology has been advocated as an effective and ethical way to engage with the uncertainty and conflicting values common to ecohealth problems. We use two contrasting case studies, coral reef management in the Philippines and national park management in Australia, to illustrate the value of critical systems approaches in exploring how people respond to environmental threats to their physical and spiritual well-being. In both cases, we used visual methods--participatory modeling and rich picturing, respectively. The critical systems methodology, with its emphasis on reflection, guided an appraisal of the research process. A discussion of these two case studies suggests that visual methods can be usefully applied within a critical systems framework to offer new insights into ecohealth issues across a diverse range of socio-political contexts. With this article, we hope to open up a conversation with other practitioners to expand the use of visual methods in integrated research.

Base stock system for patient vs impatient customers with varying demand distribution

NASA Astrophysics Data System (ADS)

Fathima, Dowlath; Uduman, P. Sheik

2013-09-01

An optimal Base-Stock inventory policy for Patient and Impatient Customers using finite-horizon models is examined. The Base stock system for Patient and Impatient customers is a different type of inventory policy. In case of the model I, Base stock for Patient customer case is evaluated using the Truncated Exponential Distribution. The model II involves the study of Base-stock inventory policies for Impatient customer. A study on these systems reveals that the Customers wait until the arrival of the next order or the customers leaves the system which leads to lost sale. In both the models demand during the period [0, t] is taken to be a random variable. In this paper, Truncated Exponential Distribution satisfies the Base stock policy for the patient customer as a continuous model. So far the Base stock for Impatient Customers leaded to a discrete case but, in this paper we have modeled this condition into a continuous case. We justify this approach mathematically and also numerically.

Genetic Analysis of the Pathogenic Molecular Sub-phenotype Interferon Alpha Identifies Multiple Novel Loci Involved in Systemic Lupus Erythematosus

PubMed Central

Kariuki, Silvia N.; Ghodke-Puranik, Yogita; Dorschner, Jessica M.; Chrabot, Beverly S.; Kelly, Jennifer A.; Tsao, Betty P.; Kimberly, Robert P.; Alarcón-Riquelme, Marta E.; Jacob, Chaim O.; Criswell, Lindsey A.; Sivils, Kathy L.; Langefeld, Carl D.; Harley, John B.; Skol, Andrew D.; Niewold, Timothy B.

2014-01-01

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder characterized by inflammation of multiple organ systems and dysregulated interferon responses. SLE is both genetically and phenotypically heterogeneous, greatly reducing the power of case-control studies in SLE. Elevated circulating interferon alpha (IFN-α) is a stable, heritable trait in SLE, which has been implicated in primary disease pathogenesis. 40–50% of patients have high IFN-α, and high levels correspond with clinical differences. To study genetic heterogeneity in SLE, we performed a case-case study comparing patients with high vs. low IFN-α in over 1550 SLE cases, including GWAS and replication cohorts. In meta-analysis, the top associations in European ancestry were PRKG1 rs7897633 (PMeta=2.75 × 10−8) and PNP rs1049564 (PMeta=1.24 × 10−7). We also found evidence for cross-ancestral background associations with the ANKRD44 and PLEKHF2 loci. These loci have not been previously identified in case-control SLE genetic studies. Bioinformatic analyses implicated these loci functionally in dendritic cells and natural killer cells, both of which are involved in IFN-α production in SLE. As case-control studies of heterogeneous diseases reach a limit of feasibility with respect to subject number and detectable effect size, the study of informative pathogenic subphenotypes becomes an attractive strategy for genetic discovery in complex disease. PMID:25338677

Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

PubMed

Kneale, Laura; Choi, Yong; Demiris, George

2016-01-01

Home health nurses and clients experience unmet information needs when transitioning from hospital to home health. Personal health records (PHRs) support consumer-centered information management activities. Previous work has assessed PHRs associated with healthcare providers, but these systems leave home health nurses unable to access necessary information. To evaluate the ability of publically available PHRs to accept, manage, and share information from a home health case study. Two researchers accessed the publically available PHRs on myPHR.com, and attempted to enter, manage, and share the case study data. We qualitatively described the PHR features, and identified gaps between the case study information and PHR functionality. Eighteen PHRs were identified in our initial search. Seven systems met our inclusion criteria, and are included in this review. The PHRs were able to accept basic medical information. Gaps occurred when entering, managing, and/or sharing data from the acute care and home health episodes. The PHRs that were reviewed were unable to effectively manage the case study information. Therefore, increasing consumer health literacy through these systems may be difficult. The PHRs that we reviewed were also unable to electronically share their data. The gap between the existing functionality and the information needs from the case study may make these PHRs difficult to use for home health environments. Additional work is needed to increase the functionality of the PHR systems to better fit the data needs of home health clients.

Evaluation of dissemination studies with FDG whole-body positron emission tomography in patients with suspected metastatic tumours of brain and spine.

PubMed

Go, K G; Pruim, J; Que, T H; Vaalburg, W; Haaxma-Reiche, H

2000-01-01

In the preoperative diagnosis of malignant brain tumours there is often uncertainty regarding their metastatic or primary nature, requiring dissemination studies. Currently FDG-wbPET is being used for the efficient detection of systemic tumours. It therefore may become a substitute for the conventional dissemination studies if it allows an earlier diagnosis. In this descriptive and preliminary study a population of 14 patients with suspected or proven metastatic lesions, [18F]-fluoro-2-deoxy-D-glucose whole body positron emission tomography (FDG-wbPET) was conducted and verified by additional conventional dissemination studies. FINDINGS AND THEIR INTERPRETATION: The entire series of dissemination studies required an average of 30 days with a range of 4-73 days. The FDG-wbPET was corroborated by the other dissemination studies in 10 of the 14 patients. In 7 of these 10 patients both PET and dissemination studies showed systemic abnormal findings, but in one case the presence of high pulmonary activity on the FDG-wbPET and the abnormal findings on the chest X-rays proved to be Aspergillus infection at autopsy. In the other 2 cases the negative PET findings corresponded to the absence of systemic dissemination. In 5 cases there was disagreement of the results of the FDG-wbPET with other evidence, among which there were 2 cases of glioblastoma in which systemic metastases were most unlikely, and the foci of activity on the FDG-wbPET had to be considered as false positives. In the remaining 3 cases the systemic presence of high activity on the FDG-wbPET indicated the systemic presence of tumour, whereas the other dissemination studies disclosed no tumour. The results warrant the use of FDG-wbPET as a screening method for the search of metastases, allowing other studies to be focussed on the lesion. But from the cost/benefit point of view this would make the method less suitable as a substitute for dissemination studies in general, although it may speed up the diagnostic process.

Improving health care costing with resource consumption accounting.

PubMed

Ozyapici, Hasan; Tanis, Veyis Naci

2016-07-11

Purpose - The purpose of this paper is to explore the differences between a traditional costing system (TCS) and resource consumption accounting (RCA) based on a case study carried out in a hospital. Design/methodology/approach - A descriptive case study was first carried out to identify the current costing system of the case hospital. An exploratory case study was then conducted to reveal how implementing RCA within the case hospital assigns costs differently to gallbladder surgeries than the current costing system (i.e. a TCS). Findings - The study showed that, in contrast to a TCS, RCA considers the unused capacity, which is the difference between the work that can be performed based on current resources and the work that is actually being performed. Therefore, it assigns lower total costs to open and laparoscopic gallbladder surgeries. The study also showed that by separating costs into fixed and variable RCA allows managers to benefit from a pricing strategy based on the difference between the service's selling price and variable costs incurred in providing that service. Research limitations/implications - The limitation of this study is that, because of time constraints, the implementation was performed in the general surgery department only. However, since RCA is an advanced system that has the same application procedures for any department inside in a hospital, managers need only time gaps to implement this system to all parts of the hospital. Practical implications - This study concluded that RCA is better than a TCS for use in health care settings that have high overhead costs because it accurately assigns overhead costs to services by considering unused capacities incurred by a hospital. Consequently, this study provides insight into both measuring and managing unused capacities within the health care sector. This study also concluded that RCA helps health care administrators increase their competitive advantage by allowing them to determine the lowest service price. Originality/value - Since the literature review found no study comparing RCA with TCS in a real-life health care setting, little is known about differences arising from applying these systems in this context. Thus, the current study fills this gap in the literature by comparing RCA with TCS for both open and laparoscopic gallbladder surgeries.

Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand

PubMed Central

2016-01-01

Background In moving toward malaria elimination, one strategy is to implement an active surveillance system for effective case management. Thailand has developed and implemented the electronic Malaria Information System (eMIS) capturing individualized electronic records of suspected or confirmed malaria cases. Objective The main purpose of this study was to determine how well the eMIS improves the quality of Thailand’s malaria surveillance system. In particular, the focus of the study was to evaluate the effectiveness of the eMIS in terms of the system users’ perception and the system outcomes (ie, quality of data) regarding the management of malaria patients. Methods A mixed-methods technique was used with the framework based on system effectiveness attributes: data quality, timeliness, simplicity, acceptability, flexibility, stability, and usefulness. Three methods were utilized: data records review, survey of system users, and in-depth interviews with key stakeholders. From the two highest endemic provinces, paper forms matching electronic records of 4455 noninfected and 784 malaria-infected cases were reviewed. Web-based anonymous questionnaires were distributed to all 129 eMIS data entry staff throughout Thailand, and semistructured interviews were conducted with 12 management-level officers. Results The eMIS is well accepted by system users at both management and operational levels. The data quality has enabled malaria personnel to perform more effective prevention and control activities. There is evidence of practices resulting in inconsistencies and logical errors in data reporting. Critical data elements were mostly completed, except for a few related to certain dates and area classifications. Timeliness in reporting a case to the system was acceptable with a delay of 3-4 days. The evaluation of quantitative and qualitative data confirmed that the eMIS has high levels of simplicity, acceptability, stability, and flexibility. Conclusions Overall, the system implemented has achieved its objective. The results of the study suggested that the eMIS helps improve the quality of Thailand’s malaria surveillance system. As the national malaria surveillance system, the eMIS’s functionalities have provided the malaria staff working at the point of care with close-to-real-time case management data quality, covering case detection, case investigation, drug compliance, and follow-up visits. Such features has led to an improvement in the quality of the malaria control program; the government officials now have quicker access to both individual and aggregated data to promptly react to possible outbreak. The eMIS thus plays one of the key roles in moving toward the national goal of malaria elimination by the next decade. PMID:27227156

Primary lymphoma of the central nervous system and HTLV-I infection.

PubMed

Calderón, Enrique J; Japón, Miguel A; Chinchón, Isidoro; Soriano, Vicente; Capote, Francisco J

2002-01-01

Only a few cases of AIDS-related primary lymphomas of the central nervous system (CNS) show a T-cell phenotype. We have recently studied two intravenous drug users with HIV infection who had primary CNS T-cell lymphomas. In both cases, the enzyme immunoassay (EIA) for HTLV gave a positive result. In the first case, study by western-blot (WB) and specific PCR confirmed the human T-cell lymphotropic virus type I (HTLV-I) infection and serological study by EIA for HTLV of his mother was negative. In the second case, analysis of ante-mortem serum samples by two different WBs showed an indeterminate pattern suggestive of HTLV-I infection, but adequate samples for PCR were not available. We speculate about the possibility that the horizontal transmission of HTLV-I infection could have facilitated the devepolment of a primary CNS T-cell lymphoma in these HIV patients, although they cannot be strictly considered as ATLL cases.

Sources of information on lymphoma associated with anti-tumour necrosis factor agents: comparison of published case reports and cases reported to the French pharmacovigilance system.

PubMed

Théophile, Hélène; Schaeverbeke, Thierry; Miremont-Salamé, Ghada; Abouelfath, Abdelilah; Kahn, Valentine; Haramburu, Françoise; Bégaud, Bernard

2011-07-01

Anti-tumour necrosis factor (TNF) agents, through their intense immunoregulatory effect, have been suspected to increase the risk of malignant lymphoma. However, the classical epidemiological approaches conducted over about the last 10 years have not totally succeeded in addressing the question of a causal or artifactual association. Therefore, the analysis of a substantial set of case reports, although usually considered as poorly generalizable to the general population, could be particularly informative. Two main sources of case reports in postmarketing settings are available; publications in medical journals and reports to pharmacovigilance systems. The aim of the study was to compare the characteristics of case reports from both these sources in order to understand whether they provided the same information for the investigation of the causal link between lymphoma and anti-TNF agents. All case reports of malignant lymphoma in patients treated with an anti-TNF agent published in MEDLINE and all reports to the French pharmacovigilance system up to 1 February 2010 were identified. Cases of malignant lymphoma identified in postmarketing surveillance from both sources were compared regarding the following variables: age, sex, anti-TNF agent involved, indication for use, type of lymphoma, prior or concomitant immunosuppressive drugs and time to onset of lymphoma. A total of 81 published case reports and 61 cases reported to the French pharmacovigilance system were compared. In published reports, patients were younger (p = 0.03) and more frequently receiving a first anti-TNF treatment (p = 0.03), particularly infliximab (p = 0.03). Conversely, in the pharmacovigilance system reports, a succession of different anti-TNFs (p = 0.03) and adalimumab (p < 0.0001) were more frequently reported. Lymphomas in patients treated with anti-TNF agents for Crohn's disease were more prevalent in published cases than in pharmacovigilance reports (p < 0.0001), and in particular involved hepatosplenic T-cell lymphoma. Conversely, rheumatoid arthritis was the main indication for anti-TNF agents in pharmacovigilance reports (p = 0.01). Time to onset was markedly shorter in published cases (median 12 months) than in pharmacovigilance reports (median 30 months; p = 0.0001). Characteristics of published cases and those reported to the French pharmacovigilance system differed markedly for all characteristics tested, except sex and the use of prior or concomitant immunosuppressive drugs. Published case reports favoured convincing arguments for drug causation whereas cases reported to the pharmacovigilance system were more disparate but could describe more accurately the reality of lymphoma occurrence in this particular population. These results argue for the use of the pharmacovigilance reports when case reports are used to investigate the causal link between lymphoma and anti-TNF agents at the population level. Data from cases notified to the French pharmacovigilance system did not indicate an increased risk of lymphoma during the early phase of anti-TNF treatment. To confirm this hypothesis, a study combining pharmacovigilance reports from several countries, or, if feasible, a cohort study both with a large sample size and a long duration of follow-up would be required.

A Case Study of Environmental, Health and Safety Issues Involving the Burlington, Massachusetts Public School System. "Tips, Suggestions, and Resources for Investigating and Resolving EHS Issues in Schools."

ERIC Educational Resources Information Center

Dresser, Todd H.

An investigation was initiated concerning the environmental health within the Burlington, Massachusetts public school system to determine what specific environmental hazards were present and determine ways of eliminating them. This report presents 20 case studies that detail the environmental health issues involved, the approaches taken in…

A Qualitative Case Study Comparing a Computer-Mediated Delivery System to a Face-to-Face Mediated Delivery System for Teaching Creative Writing Fiction Workshops

ERIC Educational Resources Information Center

Daniels, Mindy A.

2012-01-01

The purpose of this case study was to compare the pedagogical and affective efficiency and efficacy of creative prose fiction writing workshops taught via asynchronous computer-mediated online distance education with creative prose fiction writing workshops taught face-to-face in order to better understand their operational pedagogy and…

Associative Visual Agnosia: A Case Study

PubMed Central

Charnallet, A.; Carbonnel, S.; David, D.; Moreaud, O.

2008-01-01

We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4]. PMID:18413915

Financing and Educational Policy in Sri Lanka (Ceylon). Financing Educational Systems: Country Case Studies-1.

ERIC Educational Resources Information Center

Hallak, Jacques

The retrospective case study presented is part of a research project undertaken to determine ways in which developing nations can best allocate resources to education in light of their social and economic levels. Past socioeconomic trends in Sri Lanka and its economy in the 1970's are considered first. The case study then moves into descriptions…

Educational Cost Analysis in Action: Case Studies for Planners -- I.

ERIC Educational Resources Information Center

Coombs, Philip H.; Hallak, Jacques

This document is the first in a series of three documents, which together contains 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, or how to get the best value from…

Educational Cost Analysis in Action: Case Studies for Planners -- III.

ERIC Educational Resources Information Center

Coombs, Philip H.; Hallak, Jacques

This document is the third in a series of three documents, which together contain 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, and to get the best value from…

Evaluating the automated blood glucose pattern detection and case-retrieval modules of the 4 Diabetes Support System.

PubMed

Schwartz, Frank L; Vernier, Stanley J; Shubrook, Jay H; Marling, Cynthia R

2010-11-01

We have developed a prototypical case-based reasoning system to enhance management of patients with type 1 diabetes mellitus (T1DM). The system is capable of automatically analyzing large volumes of life events, self-monitoring of blood glucose readings, continuous glucose monitoring system results, and insulin pump data to detect clinical problems. In a preliminary study, manual entry of large volumes of life-event and other data was too burdensome for patients. In this study, life-event and pump data collection were automated, and then the system was reevaluated. Twenty-three adult T1DM patients on insulin pumps completed the five-week study. A usual daily schedule was entered into the database, and patients were only required to upload their insulin pump data to Medtronic's CareLink® Web site weekly. Situation assessment routines were run weekly for each participant to detect possible problems, and once the trial was completed, the case-retrieval module was tested. Using the situation assessment routines previously developed, the system found 295 possible problems. The enhanced system detected only 2.6 problems per patient per week compared to 4.9 problems per patient per week in the preliminary study (p=.017). Problems detected by the system were correctly identified in 97.9% of the cases, and 96.1% of these were clinically useful. With less life-event data, the system is unable to detect certain clinical problems and detects fewer problems overall. Additional work is needed to provide device/software interfaces that allow patients to provide this data quickly and conveniently. © 2010 Diabetes Technology Society.

Multimodal neurophysiological and psychometric evaluation among patients with systemic lupus erythematosus

PubMed Central

Shehata, Ghaydaa A; Elserogy, Yasser MB; Ahmad, Hossam Eddin K; Abdel-Kareem, Mohamed I; Al-kabeer, Ashraf M; Rayan, Mohamed M; El-Baky, Mohamed ES Abd

2011-01-01

Objective: To determine some of the neuropsychiatric manifestations of systemic lupus erythematosus (SLE) by applying multimodal neurophysiological and psychometric studies. Patients and methods: Twenty-six SLE patients were evaluated for neurological and psychiatric disorders and compared with 26 healthy controls matched for age, sex, education, and social class. The severity of SLE disease was assessed. Each subject was subjected to the following examinations: laboratory, neurophysiology, magnetic resonance imaging of the brain, transcranial duplex, Modified Mini-mental State Examination, Cognitive Assessment Scale Inventory, Hamilton Depression Scale, and Hamilton Anxiety Scale. Results: The mean age of subjects was 25.9 ± 8.9 years. The most prevalent neurological manifestations were (in order of frequency) anxiety in 17 cases (65.4%), depression in 15 cases (57.7%), headache in 10 cases (38.5%), peripheral neuropathy in 7 cases (26.9%), seizures in 6 cases (23.1%), psychosis in 5 cases (19.2%), dementia in 4 cases (15.4%), radiculopathy in 4 cases (15.4%), myositis in 3 cases (11.5%), and stroke in 2 cases (7.7%). There was a significant affection in amplitude of the ulnar nerve, cognitive function impairment, and electroencephalography changes. There was a significant increased mean velocity and decreased Pulsatility Index of the most studied intracranial vessels in the patients. Conclusion: The use of multimodal neurophysiological, transcranial duplex, and psychometric scales increases the sensitivity for detecting nervous system involvement. PMID:21674025

Nanostructure control: Nucleation and diffusion studies for predictable ultra thin film morphologies

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

Hershberger, Matthew

This thesis covers PhD research on two systems with unique and interesting physics. The first system is lead (Pb) deposited on the silicon (111) surface with the 7x7 reconstruction. Pb and Si are mutually bulk insoluble resulting in this system being an ideal case for studying metal and semiconductor interactions. Initial Pb deposition causes an amorphous wetting layer to form across to surface. Continued deposition results in Pb(111) island growth. Classic literature has classified this system as the Stranski-Krastanov growth mode although the system is not near equilibrium conditions. Our research shows a growth mode distinctly different than classical expectationsmore » and begins a discussion of reclassifying diffusion and nucleation for systems far away from the well-studied equilibrium cases.« less

Delays in the operating room: signs of an imperfect system.

PubMed

Wong, Janice; Khu, Kathleen Joy; Kaderali, Zul; Bernstein, Mark

2010-06-01

Delays in the operating room have a negative effect on its efficiency and the working environment. In this prospective study, we analyzed data on perioperative system delays. One neurosurgeon prospectively recorded all errors, including perioperative delays, for consecutive patients undergoing elective procedures from May 2000 to February 2009. We analyzed the prevalence, causes and impact of perioperative system delays that occurred in one neurosurgeon's practice. A total of 1531 elective surgical cases were performed during the study period. Delays were the most common type of error (33.6%), and more than half (51.4%) of all cases had at least 1 delay. The most common cause of delay was equipment failure. The first cases of the day and cranial cases had more delays than subsequent cases and spinal cases, respectively. A delay in starting the first case was associated with subsequent delays. Delays frequently occur in the operating room and have a major effect on patient flow and resource utilization. Thorough documentation of perioperative delays provides a basis for the development of solutions for improving operating room efficiency and illustrates the principles underlying the causes of operating room delays across surgical disciplines.

Application of grounded theory to content definition: a case study.

PubMed

Audiss, D; Roth, T

1999-02-01

Successful implementation of a clinical information system requires clinician involvement throughout the process of content definition and system development to ensure acceptance of the automated care process. In these times of downsizing, however, clinicians are not always able to participate fully in the dontent definition phase of system development and often become frustrated with their inability to obtain the patient information they need from the system. The qualitative research principles of grounded theory afford clinicians the opportunity to participate in content definition for information systems. This article presents a case study of the application of grounded theory to develop systematically the content definition for a clinical information system in preparation for implementation on four medical-surgical units.

Implementing maternal death surveillance and response: a review of lessons from country case studies.

PubMed

Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

2017-07-17

Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in the health system.

Economic feasibility of solar thermal industrial applications and selected case studies

NASA Astrophysics Data System (ADS)

Montelione, A.; Boyd, D.; Branz, M.

1981-12-01

The economic feasibility is assessed of utilizing solar energy to augment an existing fossil fuel system to generate industrial process heat. Several case studies in the textile and food processing industries in the southern United States were analyzed. Sensitivity analyses were performed, and comparisons illustrating the effects of the Economic Recovery Tax Act of 1981 were made. The economic desirability of the proposed solar systems varied with the type of system selected, location of the facility, state tax credits, and type of fuel displaced. For those systems presently not economical, the projected time to economic feasibility was ascertained.

Systematic review of general thoracic surgery articles to identify predictors of operating room case durations.

PubMed

Dexter, Franklin; Dexter, Elisabeth U; Masursky, Danielle; Nussmeier, Nancy A

2008-04-01

Previous studies of operating room (OR) information systems data over the past two decades have shown how to predict case durations using the combination of scheduled procedure(s), individual surgeon and assistant(s), and type of anesthetic(s). We hypothesized that the accuracy of case duration prediction could be improved by the use of other electronic medical record data (e.g., patient weight or surgeon notes using standardized vocabularies). General thoracic surgery was used as a model specialty because much of its workload is elective (scheduled) and many of its cases are long. PubMed was searched for thoracic surgery papers reporting operative time, surgical time, etc. The systematic literature review identified 48 papers reporting statistically significant differences in perioperative times. There were multiple reports of differences in OR times based on the procedure(s), perioperative team including primary surgeon, and type of anesthetic, in that sequence of importance. All such detail may not be known when the case is originally scheduled and thus may require an updated duration the day before surgery. Although the use of these categorical data from OR systems can result in few historical data for estimating each case's duration, bias and imprecision of case duration estimates are unlikely to be affected. There was a report of a difference in case duration based on additional information. However, the incidence of the procedure for the diagnosis was so uncommon as to be unlikely to affect OR management. Matching findings of prior studies using OR information system data, multiple case series show that it is important to rely on the precise procedure(s), surgical team, and type of anesthetic when estimating case durations. OR information systems need to incorporate the statistical methods designed for small numbers of prior surgical cases. Future research should focus on the most effective methods to update the prediction of each case's duration as these data become available. The case series did not reveal additional data which could be cost-effectively integrated with OR information systems data to improve the accuracy of predicted durations for general thoracic surgery cases.

Context Matters: Increasing Understanding with Interactive Clicker Case Studies

ERIC Educational Resources Information Center

Lundeberg, Mary A.; Kang, Hosun; Wolter, Bjorn; delMas, Robert; Armstrong, Norris; Borsari, Bruno; Boury, Nancy; Brickman, Peggy; Hannam, Kristi; Heinz, Cheryl; Horvath, Thomas; Knabb, Maureen; Platt, Terry; Rice, Nancy; Rogers, Bill; Sharp, Joan; Ribbens, Eric; Maier, Kimberly S.; Deschryver, Mike; Hagley, Rodney; Goulet, Tamar; Herreid, Clyde F.

2011-01-01

Although interactive technology is presumed to increase student understanding in large classes, no previous research studies have empirically explored the effects of Clicker Cases on students' performance. A Clicker Case is a story (e.g., a problem someone is facing) that uses clickers (student response systems) to engage students in understanding…

Stochastic Robust Mathematical Programming Model for Power System Optimization

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

Liu, Cong; Changhyeok, Lee; Haoyong, Chen

2016-01-01

This paper presents a stochastic robust framework for two-stage power system optimization problems with uncertainty. The model optimizes the probabilistic expectation of different worst-case scenarios with ifferent uncertainty sets. A case study of unit commitment shows the effectiveness of the proposed model and algorithms.

Integration of QR codes into an anesthesia information management system for resident case log management.

PubMed

Avidan, Alexander; Weissman, Charles; Levin, Phillip D

2015-04-01

Quick response (QR) codes containing anesthesia syllabus data were introduced into an anesthesia information management system. The code was generated automatically at the conclusion of each case and available for resident case logging using a smartphone or tablet. The goal of this study was to evaluate the use and usability/user-friendliness of such system. Resident case logging practices were assessed prior to introducing the QR codes. QR code use and satisfactions amongst residents was reassessed at three and six months. Before QR code introduction only 12/23 (52.2%) residents maintained a case log. Most of the remaining residents (9/23, 39.1%) expected to receive a case list from the anesthesia information management system database at the end of their residency. At three months and six months 17/26 (65.4%) and 15/25 (60.0%) residents, respectively, were using the QR codes. Satisfaction was rated as very good or good. QR codes for residents' case logging with smartphones or tablets were successfully introduced in an anesthesia information management system and used by most residents. QR codes can be successfully implemented into medical practice to support data transfer. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Web Tools for Distributed Clinical Case Conferencing

PubMed Central

Lober, WB; Li, H; Trigg, LJ; Stewart, BK; Chou, D

2001-01-01

We have developed an information system to support distributed clinical case conferences held via video conferencing. The system has been designed by studying physicians of several specialties presenting hematology-oncology patients at Tumor Board. However, the principles of clinical case presentation are similar across many medical specialties, and we believe our approach has general applicability for presenting image and other clinical information, and organizing it for subsequent re-use in teaching files.

MULTIPLE CONTAMINANTS CASE STUDIES

EPA Science Inventory

The presentation provides information taken from the arsenic demonstration program projects that have treatment systems removing multiply contaminants from drinking water. The case studies sited in the presentation consist of projects that have arsenic along with either nitrate, ...

Expert system development methodology and the transition from prototyping to operations: FIESTA, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

Expert system development methodology and the transition from prototyping to operations - Fiesta, a case study

NASA Technical Reports Server (NTRS)

Happell, Nadine; Miksell, Steve; Carlisle, Candace

1989-01-01

A major barrier in taking expert systems from prototype to operational status involves instilling end user confidence in the operational system. The software of different life cycle models is examined and the advantages and disadvantages of each when applied to expert system development are explored. The Fault Isolation Expert System for Tracking and data relay satellite system Applications (FIESTA) is presented as a case study of development of an expert system. The end user confidence necessary for operational use of this system is accentuated by the fact that it will handle real-time data in a secure environment, allowing little tolerance for errors. How FIESTA is dealing with transition problems as it moves from an off-line standalone prototype to an on-line real-time system is discussed.

An evaluation of the discriminating power of an Integrated Ballistics Identification System® Heritage™system with the NIST standard cartridge case (Standard Reference Material 2461).

PubMed

Morris, Keith B; Law, Eric F; Jefferys, Roger L; Dearth, Elizabeth C; Fabyanic, Emily B

2017-11-01

Through analysis and comparison of firing pin, breech face, and ejector impressions, where appropriate, firearm examiners may connect a cartridge case to a suspect firearm with a certain likelihood in a criminal investigation. When a firearm is not present, an examiner may use the Integrated Ballistics Identification System (IBIS ® ), an automated search and retrieval system coupled with the National Integrated Ballistics Information Network (NIBIN), a database of images showing the markings on fired cartridge cases and bullets from crime scenes along with test fired firearms. For the purpose of measurement quality control of these IBIS ® systems the National Institute of Standards and Technology (NIST) initiated the Standard Reference Material (SRM) 2460/2461 standard bullets and cartridge cases project. The aim of this study was to evaluate the overall performance of the IBIS ® system by using NIST standard cartridge cases. By evaluating the resulting correlation scores, error rates, and percent recovery, both the variability between and within examiners when using IBIS ® , in addition to any inter- and intra-variability between SRM cartridge cases was observed. Copyright © 2017 Elsevier B.V. All rights reserved.

Systemic arterial embolization in patients with hemoptysis: initial experience with ethylene vinyl alcohol copolymer in 15 cases.

PubMed

Khalil, Antoine; Fartoukh, Muriel; Bazot, Marc; Parrot, Antoine; Marsault, Claude; Carette, Marie-France

2010-01-01

The purpose of this study was a preliminary evaluation of the use of ethylene vinyl alcohol copolymer to treat patients with hemoptysis of systemic arterial origin. We reviewed the cases of 15 consecutively registered patients (10 men, five women; mean age, 53.7 years) who underwent endovascular administration of ethylene vinyl alcohol copolymer in the management of hemoptysis. The indications, immediate control of hemoptysis, and clinical tolerability were analyzed. The indications for embolization were mainly early recurrence of hemoptysis with reperfusion of systemic arteries in seven cases; unstable microcatheter in two cases; large ectopic bronchial artery in two cases; and, in one case each, bronchial arterial bleeding through a small anastomotic network, aneurysm of the left internal thoracic artery in a patient with invasive aspergillosis, a potentially risky connection between the bronchial and right coronary arteries, and occlusion of a systemic artery due to Pryce type 1 intralobar lung sequestration. Hemoptysis was controlled in all but one case and did not recur in the other 14 cases. The injection procedure was well tolerated. Ethylene vinyl alcohol copolymer embolization for hemoptysis of systemic arterial origin is feasible. The agent seems beneficial in the care of patients with recurrent hemoptysis after previous bronchial arterial embolization, patients who would be at high risk during embolization with microparticles, and patients who need embolization of large systemic arteries through small-caliber anastomoses.

Incidence of childhood pneumonia: facility-based surveillance estimate compared to measured incidence in a South African birth cohort study

PubMed Central

le Roux, David M; Myer, Landon; Nicol, Mark P; Zar, Heather J

2015-01-01

Background Pneumonia is the leading cause of childhood mortality and a major contributor to childhood morbidity, but accurate measurement of pneumonia incidence is challenging. We compared pneumonia incidence using a facility-based surveillance system to estimates from a cohort study conducted contemporaneously in the same community in Cape Town, South Africa. Methods A surveillance system was developed in six public sector primary care clinics and in a regional referral hospital, to detect childhood pneumonia cases. Nurses recorded all children presenting to facilities who met WHO case definitions of pneumonia, and hospital records were reviewed. Estimates of pneumonia incidence and severity were compared with incidence rates based on active surveillance in the Drakenstein Child Health Study. Results From June 2012 until September 2013, the surveillance system detected 306 pneumonia episodes in children under 1 year of age, an incidence of 0.20 episodes/child-year (e/cy) (95% CI 0.17 to 0.22 e/cy). The incidence in the cohort study from the same period was 0.27 e/cy (95% CI 0.23 to 0.32 e/cy). Pneumonia incidence in the surveillance system was almost 30% lower than in the birth cohort; incidence rate ratio 0.72 (95% CI 0.58 to 0.89). In the surveillance system, 18% were severe pneumonia cases, compared to 23% in the birth cohort, rate ratio 0.81 (95% CI 0.55 to 1.18). Conclusions In this setting, facility-based pneumonia surveillance detected fewer cases of pneumonia, and fewer severe cases, compared to the corresponding cohort study. Facility pneumonia surveillance using data collected by local healthcare workers provides a useful estimate of the epidemiology of childhood pneumonia but may underestimate incidence and severity. PMID:26685027

Clinico-epidemiological study of tinea incognito with microbiological correlation.

PubMed

Dutta, Bornali; Rasul, Elmy Samsul; Boro, Bobita

2017-01-01

Tinea incognito is a dermatophytic infection with a clinical presentation that is modified due to previous treatment with topical or systemic steroids, as well as topical immunomodulators. It tends to mimic other dermatological conditions. To evaluate the various clinical manifestations, sites, predisposing factors and causative agents of tinea incognito. A prospective observational study was done on one hundred clinically suspected cases of tinea incognito, with a history of topical or systemic steroid use for a period of at least six weeks. They were subject to direct microscopy and fungal culture, and re-evaluated at the end of the third and sixth week. Eczema-like conditions were the most common clinical manifestation, followed by inflammatory, autoimmune and infective conditions. The face was the most commonly affected site. Direct microscopy was positive in 85% of cases, and fungal culture was positive in 63% of cases. Trichophyton rubrum was the most common species isolated. Pharmacists were responsible for 78% of tinea incognito cases, and betamethasone dipropionate was the most common drug used. As this was a hospital outpatient-based study, cases with severe systemic problems could have attended other departments. Cases involving the hair and nails were negligible. Tinea incognito is a commonly encountered, yet poorly reported entity in the study population. An increased level of awareness and vigilance on the sale of steroid containing compounds will help control this dermatological condition.

Performance Evaluation of Wearable Sensor Systems: A Case Study in Moderate-Scale Deployment in Hospital Environment.

PubMed

Sun, Wen; Ge, Yu; Zhang, Zhiqiang; Wong, Wai-Choong

2015-09-25

A wearable sensor system enables continuous and remote health monitoring and is widely considered as the next generation of healthcare technology. The performance, the packet error rate (PER) in particular, of a wearable sensor system may deteriorate due to a number of factors, particularly the interference from the other wearable sensor systems in the vicinity. We systematically evaluate the performance of the wearable sensor system in terms of PER in the presence of such interference in this paper. The factors that affect the performance of the wearable sensor system, such as density, traffic load, and transmission power in a realistic moderate-scale deployment case in hospital are all considered. Simulation results show that with 20% duty cycle, only 68.5% of data transmission can achieve the targeted reliability requirement (PER is less than 0.05) even in the off-peak period in hospital. We then suggest some interference mitigation schemes based on the performance evaluation results in the case study.

SU-E-T-511: Inter-Rater Variability in Classification of Incidents in a New Incident Reporting System

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

Pappas, D; Reis, S; Ali, A

Purpose To determine how consistent the results of different raters are when reviewing the same cases within the Radiation Oncology Incident Learning System (ROILS). Methods Three second-year medical physics graduate students filled out incident reports in spreadsheets set up to mimic ROILS. All students studied the same 33 cases and independently entered their assessments, for a total of 99 reviewed cases. The narratives for these cases were obtained from a published International Commission on Radiological Protection (ICRP) report which included shorter narratives selected from the Radiation Oncology Safety Information System (ROSIS) database. Each category of questions was reviewed to seemore » how consistent the results were by utilizing free-marginal multirater kappa analysis. The percentage of cases where all raters shared full agreement or full disagreement was recorded to show which questions were answered consistently by multiple raters for a given case. The consistency among the raters was analyzed between ICRP and ROSIS cases to see if either group led to more reliable results. Results The categories where all raters agreed 100 percent in their choices were the event type (93.94 percent of cases 0.946 kappa) and the likelihood of the event being harmful to the patient (42.42 percent of cases 0.409 kappa). The categories where all raters disagreed 100 percent in their choices were the dosimetric severity scale (39.39 percent of cases 0.139 kappa) and the potential future toxicity (48.48 percent of cases 0.205 kappa). ROSIS had more cases where all raters disagreed than ICRP (23.06 percent of cases compared to 15.58 percent, respectively). Conclusion Despite reviewing the same cases, the results among the three raters was widespread. ROSIS narratives were shorter than ICRP, which suggests that longer narratives lead to more consistent results. This study shows that the incident reporting system can be optimized to yield more consistent results.« less

Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

2013-05-01

The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Hemangiopericytoma in the central nervous system. A study of eight cases.

PubMed

Mekni, A; Kourda, J; Chelly, I; Ferchichi, L; Bellil, K; Hammouda, K B; Kchir, N; Zitouna, M; Khaldi, M; Haouet, S

2008-02-01

Most hemangiopericytomas (HPC) are located in the musculoskeletal system and the skin, while the location in the central nervous system (CNS) is rare. The latter represents 2 to 4% in large series of meningeal tumors, thus accounting for less than 1% of all CNS tumors. In the central nervous system, tumors with a hemangiopericytomatous histolopathological pattern can be either hemangiopericytomas or solitary fibrous tumors. CNS-HPCs have a relentless tendency for local recurrence and metastases outside the CNS. Metastasis can also appear many years after adequate treatment of the primary tumor. We present a pathological study of eight patients with CNS-HPC and compare our results with corresponding published data. The CNS-HPC group consisted of three males and five females with a mean age of 36.75 years. The tumors were supratentorial in four cases, infratentorial in two cases, tentorial in one case and located in the spinal cord in the last one. Histologically, CNS-HPCs were similar to their soft tissue counterparts. One case demonstrated increased cellularity, marked nuclear hyperchromasia and marked cellular pleomorphism with infiltration of the cerebellum. All patients underwent surgery with gross-total resection in all cases. No patients received postoperative radiation therapy. Only four patients recurred locally after six, seven and eight months, and five years. Our study presents the pathological features of CNS-HPC as a distinct entity from both meningioma and solitary fibrous tumors. A comparative review of literature with our results is discussed.

A case-based reasoning system based on weighted heterogeneous value distance metric for breast cancer diagnosis.

PubMed

Gu, Dongxiao; Liang, Changyong; Zhao, Huimin

2017-03-01

We present the implementation and application of a case-based reasoning (CBR) system for breast cancer related diagnoses. By retrieving similar cases in a breast cancer decision support system, oncologists can obtain powerful information or knowledge, complementing their own experiential knowledge, in their medical decision making. We observed two problems in applying standard CBR to this context: the abundance of different types of attributes and the difficulty in eliciting appropriate attribute weights from human experts. We therefore used a distance measure named weighted heterogeneous value distance metric, which can better deal with both continuous and discrete attributes simultaneously than the standard Euclidean distance, and a genetic algorithm for learning the attribute weights involved in this distance measure automatically. We evaluated our CBR system in two case studies, related to benign/malignant tumor prediction and secondary cancer prediction, respectively. Weighted heterogeneous value distance metric with genetic algorithm for weight learning outperformed several alternative attribute matching methods and several classification methods by at least 3.4%, reaching 0.938, 0.883, 0.933, and 0.984 in the first case study, and 0.927, 0.842, 0.939, and 0.989 in the second case study, in terms of accuracy, sensitivity×specificity, F measure, and area under the receiver operating characteristic curve, respectively. The evaluation result indicates the potential of CBR in the breast cancer diagnosis domain. Copyright © 2017 Elsevier B.V. All rights reserved.

Mechanism of case processing in the brain: an fMRI study.

PubMed

Yokoyama, Satoru; Maki, Hideki; Hashimoto, Yosuke; Toma, Masahiko; Kawashima, Ryuta

2012-01-01

In sentence comprehension research, the case system, which is one of the subsystems of the language processing system, has been assumed to play a crucial role in signifying relationships in sentences between noun phrases (NPs) and other elements, such as verbs, prepositions, nouns, and tense. However, so far, less attention has been paid to the question of how cases are processed in our brain. To this end, the current study used fMRI and scanned the brain activity of 15 native English speakers during an English-case processing task. The results showed that, while the processing of all cases activates the left inferior frontal gyrus and posterior part of the middle temporal gyrus, genitive case processing activates these two regions more than nominative and accusative case processing. Since the effect of the difference in behavioral performance among these three cases is excluded from brain activation data, the observed different brain activations would be due to the different processing patterns among the cases, indicating that cases are processed differently in our brains. The different brain activations between genitive case processing and nominative/accusative case processing may be due to the difference in structural complexity between them.

Developing a regional ITS architecture : a cross-cutting study : building a framework for regional ITS integration

DOT National Transportation Integrated Search

1999-09-01

This report highlights cross-cutting findings and perspectives gleaned from a series of case studies that examined the development processes of regional and statewide Intelligent Transportation Systems (ITS) architectures. Each of the case studies is...

Tuberculosis and systemic lupus erythematosus: a case-control study in Mexico City.

PubMed

Torres-González, Pedro; Romero-Díaz, Juanita; Cervera-Hernández, Miguel Enrique; Ocampo-Torres, Mario; Chaires-Garza, Luis Gerardo; Lastiri-González, Ernesto Alejandro; Atisha-Fregoso, Yemil; Bobadilla-Del-Valle, Miriam; Ponce-de-León, Alfredo; Sifuentes-Osornio, José

2018-04-20

To determine, among systemic lupus erythematosus patients, factors associated with active tuberculosis. We performed a case-control study, in a tertiary-care center in Mexico City. We defined cases as systemic lupus erythematosus patients with active tuberculosis and matched them 1:1 with systemic lupus erythematosus patients without tuberculosis (controls) by age, date of systemic lupus erythematosus diagnosis, and disease duration. We analyzed clinical variables, lupus disease activity (SLEDAI-2K), and accumulated damage (SLICC/ARC-DI). We performed a nonconditional logistic regression to determine factors associated with tuberculosis. We identified 72 tuberculosis cases among systemic lupus erythematosus patients, 58% were culture confirmed. Thirty-three percent (24/72) were pulmonary only, 47.2% (34/72) extrapulmonary only, and 19.4% both. After adjustment for age, gender, and socioeconomic status, SLEDAI-2K and SLICC/ARC-DI, a 1-year cumulative dose of prednisone ≥ 3 g (odds ratios (OR), 18.85; 95% confidence interval (95% CI), 6.91-51.45) was associated with tuberculosis, and the antimalarial treatment was protective (OR, 0.13; 95% CI, 0.04-0.36). Among systemic lupus erythematosus patients, cumulative dose of prednisone is associated with tuberculosis. Further research is required to elucidate the protective effect of antimalarial drugs for tuberculosis. Preventive strategies must be implemented in patients at risk.

[CT-guided intervention by means of a laser marking and targeting aid].

PubMed

Klöppel, R; Wilke, W; Weisse, T; Steinecke, R

1997-08-01

The present study evaluates the use of a laser guidance system for CT-guided intervention. 94 cases of diagnostic biopsies and lumbar sympathectomies (54 cases with laser guidance system and 40 without) were compared. Using the laser guidance system, the number of control scans decreased by 30 to 50%, and necessary corrections of needle location were reduced by a maximum of 30%. The average target deviation of the needle decreased to less than 5 mm in 50% of cases. The laser guidance system is strongly recommended in CT-guided interventions for quality assurance and higher efficiency. The advantage is especially marked if the target area is small.

Second Language Learning of Complex Inflectional Systems

ERIC Educational Resources Information Center

Kempe, Vera; Brooks, Patricia J.

2008-01-01

This study explored learning and generalization of parts of the Russian case-marking paradigm, an inflecting-fusional system in which affixes simultaneously mark several grammatical features (case, gender, number, animacy). In Experiment 1, adult English speakers (N = 43) were exposed to nouns with transparent gender marking in the nominative case…

Creative Work: The Case of Charles Darwin.

ERIC Educational Resources Information Center

Gruber, Howard E.; Wallace, Doris B.

2001-01-01

Describes the evolving systems approach (ESA) to creative work, which emerged from a case study of Charles Darwin. Explains how the ESA differs from other approaches and describes various facets of creative work (networks of enterprise, uniqueness, insight, pluralism, and evolving belief systems and ensembles of metaphor). Emphasizes the…

The Redesign of Urban School Systems: Case Studies in District Governance

ERIC Educational Resources Information Center

McAdams, Donald R., Ed.; Katzir, Dan, Ed.

2013-01-01

"The Redesign of Urban School Systems" provides a uniquely valuable resource for anyone involved in preparing education leaders for the political and practical realities of district-based school reform. Edited by two leading experts in education reform, this absorbing volume brings together twelve teaching cases on urban school…

EPIDEMIOLOGY OF HONEYBEE STING CASES IN THE STATE OF CEARÁ, NORTHEASTERN BRAZIL.

PubMed

Diniz, Ana Gilza Quaresma; Belmino, José Franscidavid Barbosa; Araújo, Kaliany Adja Medeiros de; Vieira, Aluska Tavares; Leite, Renner de Souza

2016-01-01

In the American continent, honeybee envenomation is a public health problem due to the high incidence and severity of the cases. Despite its medical importance, there is a lack of epidemiological studies on this topic in Brazil, especially referring to the Northeastern states. The present study has aimed to describe the epidemiological features of honeybee envenomation cases in the state of the Ceará, Northeastern Brazil, from 2007 to 2013. Data were collected from the Injury Notification Information System database of the Health Department of Ceará. A total of 1,307 cases were analyzed. Cases were shown to be distributed in all the months of the studied years, reaching higher frequencies in August. The majority of cases occurred in urban areas and involved men aged between 20 and 29 years. Victims were mainly stung on the head and torso, and they received medical assistance predominantly within 3 hours after being stung. Local manifestations were more frequent than systemic ones. Most cases were classified as mild and progressed to cure. The high number of honeybee sting cases shows that Ceará may be an important risk area for such injuries. Moreover, the current study provides data for the development of strategies to promote control and prevention of bee stings in this area.

IVHS Institutional Issues and Case Studies: Transcom/Transmit Case Study

DOT National Transportation Integrated Search

1994-04-01

The Transportation Operations Coordinating Committee (TRANSCOM) is a coalition of 15 traffic, transit, and police agencies in the New York, New Jersey, and Connecticut metropolitan area. TRANSCOM's IVHS operational field test, the TRANSCOM System for...

Seasat-A ASVT: Commercial demonstration experiments. Results analysis methodology for the Seasat-A case studies

NASA Technical Reports Server (NTRS)

1979-01-01

The SEASAT-A commercial demonstration program ASVT is described. The program consists of a set of experiments involving the evaluation of a real time data distributions system, the SEASAT-A user data distribution system, that provides the capability for near real time dissemination of ocean conditions and weather data products from the U.S. Navy Fleet Numerical Weather Central to a selected set of commercial and industrial users and case studies, performed by commercial and industrial users, using the data gathered by SEASAT-A during its operational life. The impact of the SEASAT-A data on business operations is evaluated by the commercial and industrial users. The approach followed in the performance of the case studies, and the methodology used in the analysis and integration of the case study results to estimate the actual and potential economic benefits of improved ocean condition and weather forecast data are described.

The Development of Technical and Vocational Education in India--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

ERIC Educational Resources Information Center

Mishra, Arun K.

Education has a place of high priority on India's development agenda. The technical/vocational education (TVE) system is multisectoral with each ministry responsible for labor force development in that sector. The TVE programs in the formal education system are either state delivered or financed. The higher secondary vocational education program…

The Incidental Leader: The Role of Reading Recovery (RTM) Training in the Professional Lives of Teachers in a Rural Alabama School System. A Multiple Case Study

ERIC Educational Resources Information Center

Bounds, Sharon L.

2013-01-01

This qualitative multiple case study was undertaken to answer the following question: How did Reading® (RR) teachers and former Reading Recovery teachers in a mid-sized rural school system in the southeastern United States describe the influences of their Reading Recovery training as it related to their current professional lives? Additional…

Satellites for Commonwealth Education: Some Policy Issues. Case Studies: AUSSAT, Australia; Knowledge Network, Canada; INSAT, India; University of the South Pacific; University of the West Indies.

ERIC Educational Resources Information Center

Bates, A. W.

This report presents case studies on the use of satellites for education in five Commonwealth countries: Australia, Canada, India, Fiji, and Jamaica. Information provided in each of the case studies includes geography, production, the distribution system, regulation and management, and costs. Additional information given for the Australian…

Applying Asynchronous Solutions to the Multi-Tasking Realities of a Teacher Education Faculty Unit: Case Study

ERIC Educational Resources Information Center

Moffett, David W.; Claxton, Melba S.; Jordan, Skye L.; Mercer, Patricia P.; Reid, Barbara K.

2007-01-01

The case study describes the early stages of building and using a learning management system (LMS) to aid in the productivity of an education faculty unit. Little to no research exists regarding teacher education units using LMSs to create an online web group for work purposes. The literature review preceding the case study illuminated some of the…

Using Faculty Evaluation to Improve Teaching Quality: A Longitudinal Case Study of Higher Education in Southeast Asia

ERIC Educational Resources Information Center

Hallinger, Philip

2010-01-01

This paper presents a case study of implementation of a new system of faculty teaching evaluation at a graduate school of business in Thailand. The research employed a non-experimental, longitudinal case study design in the analysis of student course evaluation data gathered over a period of 21 terms during a seven-year period. The report…

Systems-Oriented Workplace Learning Experiences for Early Learners: Three Models.

PubMed

O'Brien, Bridget C; Bachhuber, Melissa R; Teherani, Arianne; Iker, Theresa M; Batt, Joanne; O'Sullivan, Patricia S

2017-05-01

Early workplace learning experiences may be effective for learning systems-based practice. This study explores systems-oriented workplace learning experiences (SOWLEs) for early learners to suggest a framework for their development. The authors used a two-phase qualitative case study design. In Phase 1 (spring 2014), they prepared case write-ups based on transcribed interviews from 10 SOWLE leaders at the authors' institution and, through comparative analysis of cases, identified three SOWLE models. In Phase 2 (summer 2014), studying seven 8-week SOWLE pilots, the authors used interview and observational data collected from the seven participating medical students, two pharmacy students, and site leaders to construct case write-ups of each pilot and to verify and elaborate the models. In Model 1, students performed specific patient care activities that addressed a system gap. Some site leaders helped students connect the activities to larger systems problems and potential improvements. In Model 2, students participated in predetermined systems improvement (SI) projects, gaining experience in the improvement process. Site leaders had experience in SI and often had significant roles in the projects. In Model 3, students worked with key stakeholders to develop a project and conduct a small test of change. They experienced most elements of an improvement cycle. Site leaders often had experience with SI and knew how to guide and support students' learning. Each model could offer systems-oriented learning opportunities provided that key elements are in place including site leaders facile in SI concepts and able to guide students in SOWLE activities.

Investigating potential transferability of place-based research in land system science

NASA Astrophysics Data System (ADS)

Václavík, Tomáš; Langerwisch, Fanny; Cotter, Marc; Fick, Johanna; Häuser, Inga; Hotes, Stefan; Kamp, Johannes; Settele, Josef; Spangenberg, Joachim H.; Seppelt, Ralf

2016-09-01

Much of our knowledge about land use and ecosystem services in interrelated social-ecological systems is derived from place-based research. While local and regional case studies provide valuable insights, it is often unclear how relevant this research is beyond the study areas. Drawing generalized conclusions about practical solutions to land management from local observations and formulating hypotheses applicable to other places in the world requires that we identify patterns of land systems that are similar to those represented by the case study. Here, we utilize the previously developed concept of land system archetypes to investigate potential transferability of research from twelve regional projects implemented in a large joint research framework that focus on issues of sustainable land management across four continents. For each project, we characterize its project archetype, i.e. the unique land system based on a synthesis of more than 30 datasets of land-use intensity, environmental conditions and socioeconomic indicators. We estimate the transferability potential of project research by calculating the statistical similarity of locations across the world to the project archetype, assuming higher transferability potentials in locations with similar land system characteristics. Results show that areas with high transferability potentials are typically clustered around project sites but for some case studies can be found in regions that are geographically distant, especially when values of considered variables are close to the global mean or where the project archetype is driven by large-scale environmental or socioeconomic conditions. Using specific examples from the local case studies, we highlight the merit of our approach and discuss the differences between local realities and information captured in global datasets. The proposed method provides a blueprint for large research programs to assess potential transferability of place-based studies to other geographical areas and to indicate possible gaps in research efforts.

Diagnosis-related groups for stroke in Europe: patient classification and hospital reimbursement in 11 countries.

PubMed

Peltola, Mikko; Quentin, Wilm

2013-01-01

Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and national DRG authorities should consider how other countries' DRG systems classify stroke patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement. In future, quantitative research is needed to verify whether the most important determinants of cost are considered in different patient classification systems, and whether differences between systems reflect country-specific differences in treatment patterns and, most importantly, what influence they have on patient outcomes. Copyright © 2013 S. Karger AG, Basel.

A Randomized Controlled Trial of Consensus-Based Child Abuse Case Management

ERIC Educational Resources Information Center

Goldbeck, L.; Laib-Koehnemund, A.; Fegert, J. M.

2007-01-01

Objective: This study evaluates the effects of expert-assisted child abuse and neglect case management in the German child welfare and healthcare system as perceived by the case workers themselves. Methods: Case workers with different professions (social workers, counselors, clinic-based and office-based psychotherapists, and physicians)…

Models of Shelter Management Training and Delivery Systems.

DTIC Science & Technology

1980-05-31

case study can be pre- sented orally, in writing, through a dramatization, or on film. Advantages: the case can be designed to focus on a problem or...develop a good, complex case study ; it may not be possible to use a case with more than one group (Ax & Kohls, 1977; Bauman, 1977; U.S. Civil Service...Although public information on self-protection continued to be distributed, the shelter program remained incomplete (e.g., an AIR study in 1966 noted that

Case mix adjusted nursing-home reimbursement: a critical review of the evidence.

PubMed

Weissert, W G; Musliner, M C

1992-01-01

Nursing-home case mix adjusted payment systems typically base payments on estimates of patients' care needs, but to date the data on their effectiveness are ambiguous. Studies mainly show that access for patients most in need of care appears to improve under these systems. Case mix based payment systems have both positive and negative effects on quality of care and require compensating mechanisms for the potentially harmful incentives they can generate. On the positive side, nursing homes are paid more equitably; the negative aspect is reflected in higher costs, particularly for administration. A Health Care Financing Administration (HCFA) demonstration project may provide insights, but its limited number of predominantly small, rural, participating states, its tandem quality assurance system, and potentially confounding market variables may restrict the value of this project. We do not yet have the data to assess the impact of instituting case mix adjustment systems.

Structural and practical identifiability analysis of S-system.

PubMed

Zhan, Choujun; Li, Benjamin Yee Shing; Yeung, Lam Fat

2015-12-01

In the field of systems biology, biological reaction networks are usually modelled by ordinary differential equations. A sub-class, the S-systems representation, is a widely used form of modelling. Existing S-systems identification techniques assume that the system itself is always structurally identifiable. However, due to practical limitations, biological reaction networks are often only partially measured. In addition, the captured data only covers a limited trajectory, therefore data can only be considered as a local snapshot of the system responses with respect to the complete set of state trajectories over the entire state space. Hence the estimated model can only reflect partial system dynamics and may not be unique. To improve the identification quality, the structural and practical identifiablility of S-system are studied. The S-system is shown to be identifiable under a set of assumptions. Then, an application on yeast fermentation pathway was conducted. Two case studies were chosen; where the first case is based on a larger state trajectories and the second case is based on a smaller one. By expanding the dataset which span a relatively larger state space, the uncertainty of the estimated system can be reduced. The results indicated that initial concentration is related to the practical identifiablity.

Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock.

PubMed

Li, Albert S; Berger, Kenneth I; Schwartz, David R; Slater, William R; Goldfarb, David S

2014-04-12

In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists-a cardiologist, a pulmonologist, and a nephrologist-jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient's presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students' minds.

Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock

PubMed Central

2014-01-01

Background In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. Methods An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists—a cardiologist, a pulmonologist, and a nephrologist—jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient’s presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. Results Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. Conclusions Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students’ minds. PMID:24725336

Decision support systems and the healthcare strategic planning process: a case study.

PubMed

Lundquist, D L; Norris, R M

1991-01-01

The repertoire of applications that comprises health-care decision support systems (DSS) includes analyses of clinical, financial, and operational activities. As a whole, these applications facilitate developing comprehensive and interrelated business and medical models that support the complex decisions required to successfully manage today's health-care organizations. Kennestone Regional Health Care System's use of DSS to facilitate strategic planning has precipitated marked changes in the organization's method of determining capital allocations. This case study discusses Kennestone's use of DSS in the strategic planning process, including profiles of key DSS modeling components.

Determining system boundaries on commercial broiler chicken production system using ISO 14040/14044 guideline: A case Study

NASA Astrophysics Data System (ADS)

Sidek, ‘A. A.; Suffian, S. A.; Al-Hazza, M. H. F.; Yusof, H. M.

2018-01-01

The demand of poultry product in Malaysia market shows an escalation throughout the year and expected to increase in the future. The expansion of poultry production has led to environmental concern in relation to their operational impact to environmentAt present, assessment of waste management of poultry production in Malaysia is lacking. A case study research was conducted in a commercial broiler farm to identify and assess the system boundaries in the lifecycle supply chain of broiler chicken production using ISO 14040/44 guidelines. ISO 14040/44 standard includes Life Cycle Assessment (LCA) framework guidelines to evaluate environmental influence associated with a product/process throughout its life span. All attributes associated with broiler operation is defined and the system boundaries is determined to identify possible inputs and outputs in the case study. This paper discuss the initial stage in the LCA process, which set the context of the research and prepare for the stage of Life Cycle Inventory.

Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study.

PubMed

Doki, Shotaro; Sasahara, Shinichiro; Hirai, Yasuhito; Oi, Yuichi; Matsuzaki, Ichiyo

2016-11-01

The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan. This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism. A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively). The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

Power Factor Study Reduces Energy Costs at Aluminum Extrusion Plant (Alcoa North American Extrusions)

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

None

2001-08-01

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

Best practices in intercultural health: five case studies in Latin America

PubMed Central

Mignone, Javier; Bartlett, Judith; O'Neil, John; Orchard, Treena

2007-01-01

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria. PMID:17803820

The Economics of Interactive Instruction: The Case of South Africa. LearnTech Case Study Series, No. 7.

ERIC Educational Resources Information Center

Cobbe, James

"English in Action," (EIA) an interactive audio instructional system using instructional cassette or radio, when available, was implemented in first and second grade classrooms in South Africa, in 1993 and 1994, respectively. This case study looks at the economics of alternative ways to implement and expand the "English in…

Using Podcasting to Facilitate Student Learning: A Constructivist Perspective

ERIC Educational Resources Information Center

Ng'ambi, Dick; Lombe, Annette

2012-01-01

The paper employs two case studies to develop an approach for using podcasts to enhance student learning. The case studies involve two cohorts of postgraduate students enrolled on a blended course, over two years. In both cases, the institutional learning management system was used as a server to host the podcasts, giving students discretion on…

The Unani traditional medical system in India: a case study in health behaviour.

PubMed

Izhar, N

1989-01-01

The study examines the practice of Unani traditional medicine in India. The case study is based on the Unani Clinic situated in Aligarh Town; patients, practitioner of Unani medicine, and para-medical staff were interviewed about their patterns of patients' health behaviour, of particular interest was the utilization of Unani medical facilities by people of different age groups and belonging to different socio-economic strata. Observations are made regarding effectiveness of the Unani medical system.

Developing a dashboard to help measure and achieve the triple aim: a population-based cohort study.

PubMed

Seow, Hsien-Yeang; Sibley, Lyn M

2014-08-30

Health system planners aim to pursue the three goals of Triple Aim: 1) reduce health care costs; 2) improve population health; and 3) improve the care experience. Moreover, they also need measures that can reliably predict future health care needs in order to manage effectively the health system performance. Yet few measures exist to assess Triple Aim and predict future needs at a health system level. The purpose of this study is to explore the novel application of a case-mix adjustment method in order to measure and help improve the Triple Aim of health system performance. We applied a case-mix adjustment method to a population-based analysis to assess its usefulness as a measure of health system performance and Triple Aim. The study design was a retrospective, cohort study of adults from Ontario, Canada using administrative databases: individuals were assigned a predicted illness burden score using a case-mix adjustment system from diagnoses and health utilization data in 2008, and then followed forward to assess the actual health care utilization and costs in the following year (2009). We applied the Johns Hopkins Adjusted Clinical Group (ACG) Case-Mix System to categorize individuals into 60 levels of healthcare need, called ACGs. The outcomes were: 1) Number of individuals per ACG; 2) Total system costs per ACG; and 3) Mean cost per person per ACG, which together formed a health system "dashboard". We identified 11.4 million adults. 16.1% were aged 65 or older, 3.2 million (28%) did not use health care services that year, and 45,000 (0.4%) were in the highest acuity ACG category using 12 times more than an average adult. The sickest 1%, 5% and 15% of the population use about 10%, 30% and 50% of total health system costs respectively. The dashboard measures 2 dimensions of Triple Aim: 1) reduced costs: when total system costs per ACG or when average costs per person is reduced; and 2) improved population health: when more people move into healthier rather than sicker ACGs. It can help to achieve the third aim, improved care experience, when ACG utilization predictions are reported to providers to proactively develop care plans. The dashboard, developed via case-mix methods, measures 2 of the Triple Aim goals and can help health system planners better manage their health delivery systems.

Reading efficiency can be improved by minor modification of assigned duties; a pilot study on a small team of general radiologists.

PubMed

Yokota, Hajime; Goto, Mariko; Bamba, Chisa; Kiba, Maki; Yamada, Kei

2017-05-01

To assess whether alterations in the type of duty assignment system can affect the reading efficiency and stress level of diagnostic radiologists. Fourteen board-certified diagnostic radiologists were enrolled. We investigated three different reading systems for 1 week each. System 1 is our default, in which there are no assigned duties and everyone finishes when all cases are done. In system 2, two late shift readers are assigned every day, and, after everyone else leaves at a fixed time (5:30 p.m.), they take all remaining cases until they are finished. In system 3, a dedicated single reader is assigned to finish 30 cases, and everyone else will read all remaining cases. The total time required for reading and the number of cases read were recorded. In addition, participants completed two questionnaires regarding work-related stress. There was a trend toward shorter finishing time in system 2 and 3 compared to system 1 (P = 0.072 and 0.012). In terms of working stress, the subjective burden was lighter when systems 2 or 3 were employed. Minor modification of the duty assignment system has the potential to improve working efficiency and may reduce the work-related stress of diagnostic radiologists.

Equitable science education in urban middle schools: Do reform efforts make a difference?

NASA Astrophysics Data System (ADS)

Hewson, Peter W.; Butler Kahle, Jane; Scantlebury, Kathryn; Davies, Darleen

2001-12-01

A central commitment of current reforms in science education is that all students, regardless of culture, gender, race, and/ or socioeconomic status, are capable of understanding and doing science. The study Bridging the Gap: Equity in Systemic Reform assessed equity in systemic reform using a nested research design that drew on both qualitative and quantitative methodologies. As part of the study, case studies were conducted in two urban middle schools in large Ohio cities. The purpose of the case studies was to identify factors affecting equity in urban science education reform. Data were analyzed using Kahle's (1998) equity metric. That model allowed us to assess progress toward equity using a range of research-based indicators grouped into three categories critical for equitable education: access to, retention in, and achievement in quality science education. In addition, a fourth category was defined for systemic indicators of equity. Analyses indicated that the culture and climate of the case study schools differentially affected their progress toward equitable reform in science education.

Retrocochlear impairments in systemic sclerosis: a case report study.

PubMed

Valente, Julia de Souza Pinto; Corona, Ana Paula

2017-12-07

To report three cases of patients with Systemic Sclerosis (SSc) and retrocochlear impairments. This is a case report of three individuals with SSc and retrocochlear impairments assisted at a rheumatology outpatient clinic. All individuals underwent Brainstem Auditory Evoked Potential (BAEP) and, when necessary, audiometry. All three individuals presented sensorineural hearing loss. Although no retrocochlear impairment was identified in the basic audiologic evaluation, the BAEP results were altered. Retrocochlear impairments were present in the individuals under study, both in the absolute latencies and interpeak interval, thereby demanding the attention of rheumatologists and speech-language pathologists to such changes during the monitoring of SSc patients. The results also show a need for epidemiological studies on the theme.

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

Im, Piljae; Liu, Xiaobing

High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This paper highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects, a ground-source variable refrigerant flow (GS-VRF) system installed at the Human Health Building at Oakland University in Rochester, Michigan.more » This case study is based on the analysis of measured performance data, maintenance records, construction costs, and simulations of the energy consumption of conventional central heating, ventilation, and air-conditioning (HVAC) systems providing the same level of space conditioning as the demonstrated GS-VRF system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GS-VRF system, pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the GS-VRF system compared with conventional HVAC systems. This case study also identified opportunities for reducing uncertainties in the performance evaluation, improving the operational efficiency, and reducing the installed cost of similar GSHP systems in the future.« less

System Dynamic Model for the Accumulation of Renewable Electricity using Power-to-Gas and Power-to-Liquid Concepts

NASA Astrophysics Data System (ADS)

Blumberga, Andra; Timma, Lelde; Blumberga, Dagnija

2015-12-01

When the renewable energy is used, the challenge is match the supply of intermittent energy with the demand for energy therefore the energy storage solutions should be used. This paper is dedicated to hydrogen accumulation from wind sources. The case study investigates the conceptual system that uses intermitted renewable energy resources to produce hydrogen (power-to-gas concept) and fuel (power-to-liquid concept). For this specific case study hydrogen is produced from surplus electricity generated by wind power plant trough electrolysis process and fuel is obtained by upgrading biogas to biomethane using hydrogen. System dynamic model is created for this conceptual system. The developed system dynamics model has been used to simulate 2 different scenarios. The results show that in both scenarios the point at which the all electricity needs of Latvia are covered is obtained. Moreover, the methodology of system dynamics used in this paper is white-box model that allows to apply the developed model to other case studies and/or to modify model based on the newest data. The developed model can be used for both scientific research and policy makers to better understand the dynamic relation within the system and the response of system to changes in both internal and external factors.

Study of a Secondary Power System Based on an Intermediate Bus Converter and POLs

NASA Astrophysics Data System (ADS)

Santoja, Almudena; Fernandez, Arturo; Tonicello, Ferdinando

2014-08-01

Secondary power systems in satellites are everything but standard nowadays. All sorts of options can be found and, in the end, a new custom design is used in most of the cases. Even though this might be interesting in some specific cases, for most of them it would be more convenient to have a straightforward system based on standard components. One of the options to achieve this is to design the secondary power system with an Intermediate Bus Converter (IBC) and Point of Load converters (POLs). This paper presents a study of this architecture and some experimental verifications to establish some basic rules devoted to achieve an optimum design of this system.

Study design and hierarchy of evidence for surgical decision making.

PubMed

Sprague, Sheila; McKay, Paula; Thoma, Achilleas

2008-04-01

This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

An Investigation of GeoBase Mission Data Set Design, Implementation, and Usage Within Air Force Civil Engineer Electrical and Utilities Work Centers

DTIC Science & Technology

2005-03-01

ethnography , grounded theory , phenomenological , case study , and content analysis. As ethnography is based upon a longitudinal study in...a qualitative methodology consisting of a case study strategy is warranted for this research project. Yin (2003) lists five components of research ...systems. Journal of End User Computing, 12(3), 14. Yin, R. K. (2003). Case Study Research : Design and

The diffusion of medical technology, local conditions, and technology re-invention: a comparative case study on coronary stenting.

PubMed

Hashimoto, Hideki; Noguchi, Haruko; Heidenreich, Paul; Saynina, Olga; Moreland, Abigail; Miyazaki, Shunichi; Ikeda, Shunya; Kaneko, Yoshihiro; Ikegami, Naoki

2006-12-01

Innovation of medical technology is a major driving force behind the increase in medical expenditures in developed countries. Previous studies identified that the diffusion of medical technology varied across countries according to the characteristics of regulatory policy and payment systems. Based on Roger's diffusion of innovation theory, this study purported to see how local practice norms, the evolving nature of diffusing technology, and local clinical needs in addition to differences in politico-economic systems would affect the process of innovation diffusion. Taking a case of coronary stenting, an innovative therapeutic technology in early 1990s, we provided a case study of hospital-based data between two teaching high-tech hospitals in Japan and the US for discussion. Stenting began to be widely used in both countries when complementary new technology modified its clinical efficacy, but the diffusion process still differed between the two hospitals due to (1) distinctive payment systems for hospitals and physicians, (2) practice norms in favor of percutaneous intervention rather than bypass surgery that was shaped by payment incentives and cultural attitudes, and (3) local patient's clinical characteristics that the technology had to be tailored for. The case study described the diffusion of stent technology as a dynamic process between patients, physicians, hospitals, health care systems, and technology under global and local conditions.

Electronic Performance Support for Operational Systems: A Case Study of the Link Monitor and Control Operator Assistant

NASA Technical Reports Server (NTRS)

Hill, Randall W., Jr.; Cooper, Lynne P.

1993-01-01

For complex operational systems, help needs to come from the inside out. It is often not realistic to call a help desk for problems that need immediate attention, especially for tasks that put a heavy cognitive load on the system operator. This session addresses the issues associated with providing electronic performance support for operational systems, including situations where the system is already fielded and can only change through evolution rather than revolution. We present a case study based on our experiences in developing the Link Monitor and Control Operator Assistant for NASA's Deep Space Network (DSN). The goals of the Operator Assistant are to improve the operability of the system and increase the efficiency of mission operations.

Health region development from the perspective of system theory - an empirical cross-regional case study.

PubMed

Volgger, Michael; Mainil, Tomas; Pechlaner, Harald; Mitas, Ondrej

2015-01-01

Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann's system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann's system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Design and bidding of UV disinfection equipment -- Case study

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

Akyurek, M.

1998-07-01

Ultraviolet (UV) disinfection systems are being widely considered for application to treated wastewaters, in lieu of conventional chlorination facilities. The number of UV systems operating in the US was approximately 50 in 1984. In 1990 there were over 500 systems, a ten-fold increase. The use of UV disinfection has increased since 1990, and will likely to increase in the future. It is anticipated that as many chlorine disinfection facilities reach their useful life, most of them will be replaced with UV disinfection systems. Several manufacturers offer different UV disinfection equipment. Each offers something different for the designer. There are alsomore » different approaches used in estimating the number of lamps needed for the disinfection system. The lack of standardization in determination of the number of lamps for a UV system poses problems for the designer. Such was the case during the design of the disinfection system for the Watertown, SD Wastewater Treatment Plant (WWRP). The purpose of this paper is to present a case study for the design and bidding of UV disinfection equipment.« less

BNSF San Bernardino case study : positive train control risk assessment.

DOT National Transportation Integrated Search

2014-09-01

The Federal Railroad Administration funded the BNSF San Bernardino Case Study to verify its Generalized Train Movement : Simulator (GTMS) risk assessment capabilities on a planned implementation of the I-ETMS PTC system. The analysis explicitly : sim...

Corporate Energy Conservation Program for Alcoa North American Extrusions

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

None

2001-08-01

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

Case studies in geographic information systems for internet portals

DOT National Transportation Integrated Search

2012-06-30

The following report investigates the experiences of transportation agencies in the deployment of Internet-based mapping portals based on GIS. It presents background information, a series of case studies, and a summary of conclusions given the experi...

Crescent Evaluation : appendix B : state case study evaluation report

DOT National Transportation Integrated Search

1994-02-01

The state case study evaluation approach uniquely captured an understanding of the potential of such a system by documenting the experiences, issues, and opportunities of selected key state government personnel from a cross-section of involved agenci...

A case study evaluation of a Critical Care Information System adoption using the socio-technical and fit approach.

PubMed

Yusof, Maryati Mohd

2015-07-01

Clinical information systems have long been used in intensive care units but reports on their adoption and benefits are limited. This study evaluated a Critical Care Information System implementation. A case study summative evaluation was conducted, employing observation, interview, and document analysis in operating theatres and 16-bed adult intensive care units in a 400-bed Malaysian tertiary referral centre from the perspectives of users (nurses and physicians), management, and information technology staff. System implementation, factors influencing adoption, fit between these factors, and the impact of the Critical Care Information System were evaluated after eight months of operation. Positive influences on system adoption were associated with technical factors, including system ease of use, usefulness, and information relevancy; human factors, particularly user attitude; and organisational factors, namely clinical process-technology alignment and champions. Organisational factors such as planning, project management, training, technology support, turnover rate, clinical workload, and communication were barriers to system implementation and use. Recommendations to improve the current system problems were discussed. Most nursing staff positively perceived the system's reduction of documentation and data access time, giving them more time with patients. System acceptance varied among doctors. System use also had positive impacts on timesaving, data quality, and clinical workflow. Critical Care Information Systems is crucial and has great potentials in enhancing and delivering critical care. However, the case study findings showed that the system faced complex challenges and was underutilised despite its potential. The role of socio-technical factors and their fit in realizing the potential of Critical Care Information Systems requires continuous, in-depth evaluation and stakeholder understanding and acknowledgement. The comprehensive and specific evaluation measures of the Human-Organisation-Technology Fit framework can flexibly evaluate Critical Care Information Systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mechatronic system design course for undergraduate programmes

NASA Astrophysics Data System (ADS)

Saleem, A.; Tutunji, T.; Al-Sharif, L.

2011-08-01

Technology advancement and human needs have led to integration among many engineering disciplines. Mechatronics engineering is an integrated discipline that focuses on the design and analysis of complete engineering systems. These systems include mechanical, electrical, computer and control subsystems. In this paper, the importance of teaching mechatronic system design to undergraduate engineering students is emphasised. The paper offers the collaborative experience in preparing and delivering the course material for two universities in Jordan. A detailed description of such a course is provided and a case study is presented. The case study used is a final year project, where students applied a six-stage design procedure that is described in the paper.

Tool for simplifying the complex interactions within resilient communities

NASA Astrophysics Data System (ADS)

Stwertka, C.; Albert, M. R.; White, K. D.

2016-12-01

In recent decades, scientists have observed and documented impacts from climate change that will impact multiple sectors, will be impacted by decisions from multiple sectors, and will change over time. This complex human-engineered system has a large number of moving, interacting parts, which are interdependent and evolve over time towards their purpose. Many of the existing resilience frameworks and vulnerability frameworks focus on interactions between the domains, but do not include the structure of the interactions. We present an engineering systems approach to investigate the structural elements that influence a community's ability to be resilient. In this presentation we will present and analyze four common methods for building community resilience, utilizing our common framework. For several existing case studies we examine the stress points in the system and identify the impacts on the outcomes from the case studies. In ongoing research we will apply our system tool to a new case in the field.

Electro-oculography of smooth pursuit and optokinetic nystagmus eye movements in type I Duane's retraction syndrome.

PubMed

Melek, Nélida B; Blanco, Susana; Garcia, Horacio

2006-01-01

These two eye movements have not been previously studied in this condition by this method. Five cases were studied. Both visual acuity and eye examination of anterior and posterior segments were normal. A Nicolet Nystar Plus system with chloride silver electrodes was used to record the EOG. Of the two systems under study, the smooth pursuit system showed the most relevant anomalies, both in the Duane's eye and in the apparently healthy eye. No correlation was found between the pursuit and optokinetic nystagmus disorders. In some cases, more significant abnormalities were observed in the clinically normal eye. The results clearly demonstrated a significant impairment of the pursuit system. This suggests that this motor disorder is not exclusively caused by hypoplasia or aplasia of the nucleus of the abducens nerve (VIth cranial nerve). These abnormalities might be related to a poor development of the rhombencephalon since both supramotor nuclei as well as the pathways of this system arise from this region of the embryonic brain. In the particular case of OKN, the supramotor nuclei have a different origin. Therefore, these systems might be affected differently.

Toward Creating Synergy Among Policy, Procedures, and Implementation of Evidence-Based Models in Child Welfare Systems: Two Case Examples.

PubMed

Chamberlain, Patricia

2017-03-01

Over the past four to five decades, multiple randomized controlled trials have verified that preventive interventions targeting key parenting skills can have far-reaching effects on improving a diverse array of child outcomes. Further, these studies have shown that parenting skills can be taught, and they are malleable. Given these advances, prevention scientists are in a position to make solid empirically based recommendations to public child service systems on using parent-mediated interventions to optimize positive outcomes for the children and families that they serve. Child welfare systems serve some of this country's most vulnerable children and families, yet they have been slow (compared to juvenile justice and mental health systems) to adopt empirically based interventions. This paper describes two child-welfare-initiated, policy-based case studies that have sought to scale-up research-based parenting skills into the routine services that caseworkers deliver to the families that they serve. In both case studies, the child welfare system leaders worked with evaluators and model developers to tailor policy, administrative, and fiscal system practices to institutionalize and sustain evidence-based practices into usual foster care services. Descriptions of the implementations, intervention models, and preliminary results are described.

Prader-Willi Disease: A Case Study.

ERIC Educational Resources Information Center

Forbus, William R., III

A case study focuses on the characteristics and physical management of a 15-year-old with Prader-Willi Syndrome, a birth defect associated with hypotonia, insatiable appetite, hypogonadism, central nervous system dysfunction, and abnormal growth and development . A literature review addresses studies dealing with behavior modification of obesity…

Simulation of shoreline development in a groyne system, with a case study Sanur Bali beach

NASA Astrophysics Data System (ADS)

Gunawan, P. H.; Pudjaprasetya, S. R.

2018-03-01

The process of shoreline changes due to transport of sediment by littoral drift is studied in this paper. Pelnard-Considère is the commonly adopted model. This model is based on the principle of sediment conservation, without diffraction. In this research, we adopt the Pelnard-Considère equation with diffraction, and a numerical scheme based on the finite volume method is implemented. Shoreline development in a groyne system is then simulated. For a case study, the Sanur Bali Beach, Indonesia is considered, in which from Google Earth photos, the beach experiences changes of coastline caused by sediment trapped in a groyne system.

Sensitivity of the Dengue Surveillance System in Brazil for Detecting Hospitalized Cases

PubMed Central

2016-01-01

We evaluated the sensitivity of the dengue surveillance system in detecting hospitalized cases in ten capital cities in Brazil from 2008 to 2013 using a probabilistic record linkage of two independent information systems hospitalization (SIH-SUS) adopted as the gold standard and surveillance (SINAN). Sensitivity was defined as the proportion of cases reported to the surveillance system amid the suspected hospitalized cases registered in SIH-SUS. Of the 48,174 hospitalizations registered in SIH-SUS, 24,469 (50.7%) were reported and registered in SINAN, indicating an overall sensitivity of 50.8% (95%CI 50.3–51.2). The observed sensitivity for each of the municipalities included in the study ranged from 22.0% to 99.1%. The combination of the two data sources identified 71,161 hospitalizations, an increase of 97.0% over SINAN itself. Our results allowed establishing the proportion of underreported dengue hospitalizations in the public health system in Brazil, highlighting the use of probabilistic record linkage as a valuable tool for evaluating surveillance systems. PMID:27192405

Quantifying the Triangle of Coordination: A Case Study of Higher Education in China

ERIC Educational Resources Information Center

Xioahui, Zuo; Pratt, John

2006-01-01

In 1983, Burton Clark published a study that was to become a classic work on the organisation and government of higher education systems (Clark 1983). He constructed three "ideal types" of system--state system, market system and professional system, and summarised the way that national systems of higher education are dependent on the…

Investigating Approaches to Achieve Modularity Benefits in the Acquisition Ecosystem

DTIC Science & Technology

2017-06-09

actions and that of others, and how the assessments are affected by their actions. • Case study approach based on best practices, tacit knowledge... case study -derived exemplars, and items requiring further research on identifying additional enablers and useful knowledge constructs. All of these... case studies that document the effective use of modularity in system design for some or all of innovation, competition, cost, technology and

[Case allocation of extensive operations on head and neck within the German DRG system 2004-2007: what is the net result of the continued developments in case allocation?].

PubMed

Franz, D; Franz, K; Roeder, N; Hörmann, K; Fischer, R-J; Alberty, Jürgen

2007-07-01

When the German DRG system was implemented there was some doubt about whether patients with extensive head and neck surgery would be properly accounted for. Significant efforts have therefore been invested in analysis and case allocation of those in this group. The object of this study was to investigate whether the changes within the German DRG system have led to improved case allocation. Cost data received from 25 ENT departments on 518 prospective documented cases of extensive head and neck surgery were compared with data from the German institute dealing with remuneration in hospitals (InEK). Statistical measures used by InEK were used to analyse the quality of the overall system and the homogeneity of the individual case groups. The reduction of variance of inlier costs improved by about 107.3% from the 2004 version to the 2007 version of the German DRG system. The average coefficient of cost homogeneity rose by about 9.7% in the same period. Case mix index and DRG revenues were redistributed from less extensive to the more complex operations. Hospitals with large numbers of extensive operations and university hospitals will gain most benefit from this development. Appropriate case allocation of extensive operations on the head and neck has been improved by the continued development of the German DRG system culminating in the 2007 version. Further adjustments will be needed in the future.

User-Design: A Case Application in Health Care Training.

ERIC Educational Resources Information Center

Carr-Chellman, Alison; Cuyar, Craig; Breman, Jeroen

1998-01-01

Discussion of user-design as a theoretical process for creating training, software, and computer systems focuses on a case study that describes user-design methodology in home health care through the context of diffusing a new laptop patient-record-keeping system with home nurses. Research needs and implications for the design process are…

Collective Approach to Complex Food System Issues, the Case of the Ohio State University

ERIC Educational Resources Information Center

Fox, Julie

2017-01-01

Urban universities are uniquely positioned to make powerful and lasting contributions to the grand challenge of food security. To better understand the various dimensions related to the university's role in food systems, this case study explores intentional linkages, significant developments, natural tensions, and emerging impacts at the Ohio…

Communication in a Web-Based Conferencing System: The Quality of Computer-Mediated Interactions.

ERIC Educational Resources Information Center

Angeli, Charoula; Valanides, Nicos; Bonk, Curtis J.

2003-01-01

Describes a study of undergraduates that investigated the extent to which an electronic conferencing system, COW (Conferencing on the Web) facilitated preservice teachers' communication outside their classroom when discussing teaching cases from their field experiences, and the potential of COW and case-based instruction to foster quality…

Suicide and Mass Urban Transit.

ERIC Educational Resources Information Center

Berman, Alan L., Ed.

1991-01-01

Presents case consultation in which consultants respond to issues of urban planning for mass transit (subway) system and how to maximize prevention of intentional injury within subway stations. Also asks what type of research study should be used and what type of data collected once system is operating. Case is discussed by Morton M. Silverman and…

Electronic Sentinel Surveillance of Influenza-like Illness. Experience from a pilot study in New Zealand.

PubMed

Adnan, Mehnaz; Peterkin, Donald; Lopez, Liza; Mackereth, Graham

2017-02-01

Electronic reporting of Influenza-like illness (eILI) from primary care was implemented and evaluated in three general medical practices in New Zealand during May to September 2015. To measure the uptake of eILI and to identify the system's strength and limitations. Analysis of transactional data from the eILI system; comparative study of influenza-like illness cases reported using manual methods and eILI; questionnaire administered to clinical and operational stakeholders. Over the study period 66% of total ILI cases were reported using eILI. Reporting timeliness improved significantly compared to manual reporting with an average of 24 minutes from submission by the clinician to processing in the national database. Users found the system to be user-friendly. eILI assists clinicians to report ILI cases to public health authorities within a stipulated time period and is associated with faster, more reliable and improved information transfer.

A Stability Enhancement Method for Centrifugal Compressors using Active Control Casing Treatment System

NASA Astrophysics Data System (ADS)

Zhao, Yuanyang; Xiao, Jun; Li, Liansheng; Yang, Qichao; Liu, Guangbin; Wang, Le

2015-08-01

The centrifugal compressors are widely used in many fields. When the centrifugal compressors operate at the edge of the surge line, the compressor will be unstable. In addition, if the centrifugal compressor runs at this situation long time, the damage will be occurred on compressor. There are some kinds of method to improve and enlarge the range of the centrifugal compressors, such as inlet guide vane, and casing treatment. For casing treatment method, some structures have been researched, such as holed recirculation, basic slot casing treatment and groove casing treatment. All these researches are the passive methods. This paper present a new stability enhancement method based Active Control Casing Treatment (ACCT). All parts of this new method are introduced in detail. The control strategy of the system is mentioned in the paper. As a research sample, a centrifugal compressor having this system is researched using CFD method. The study focuses on the effect of the active control system on the impeller flow. The vortex in impeller is changed by the active control system. And this leads to the suppression of the extension of vortex blockage in impeller and to contribute to the enhancement of the compressor operating range.

Evaluation of the benefit and use of the new terminology in endometrial cytology reporting system.

PubMed

Shinagawa, Akiko; Kurokawa, Tetsuji; Yamamoto, Makoto; Onuma, Toshimichi; Tsuyoshi, Hideaki; Chino, Yoko; Iwasaki, Kazumi; Mori, Masaki; Imamura, Yoshiaki; Yoshio, Yoshida

2018-04-01

The introduction and establishment of a new classification system for endometrial cytology, the "New Terminology in Endometrial Cytology (NTEMC) system," which is based on the Bethesda System for uterine cervical cytology, has recently been reported. However, the clinical management for new categories in the NTEMC system, particularly atypical endometrial cells (ATEC), has not been clarified. The objective of the present study is to determine how the ATEC category should be treated and whether the introduction of the system has decreased the number of unnecessary endometrial biopsies. Fifty-nine cases were diagnosed as "suspicious positive" according to the three-tier reporting (TTR) system, which was adopted in Japan. The specimens were re-evaluated according to the NTEMC system. Thirty-seven of the 59 patients underwent endometrial biopsy. We correlated the pathological diagnosis with the NTEMC system category. The 59 cases were classified according to the NTEMC system as follows: 36 cases were classified as ATEC of undetermined significance (ATEC-US), 21 cases were classified as ATEC for which atypical endometrial hyperplasia or worse cannot be excluded (ATEC-A), and 2 cases were classified as endometrial hyperplasia. The ratio of atypical endometrial hyperplasia or malignancy in ATEC-US category was significantly lower than that in ATEC-A category. Fifteen cases in ATEC-US category did not show atypical endometrial hyperplasia lesions or malignancy after 3 months. These data suggest that patients with ATEC-US results can be followed up for at least three months, and the introduction of the NTEMC system decreased the number of unnecessary endometrial biopsies. © 2018 Wiley Periodicals, Inc.

A fuzzy-ontology-oriented case-based reasoning framework for semantic diabetes diagnosis.

PubMed

El-Sappagh, Shaker; Elmogy, Mohammed; Riad, A M

2015-11-01

Case-based reasoning (CBR) is a problem-solving paradigm that uses past knowledge to interpret or solve new problems. It is suitable for experience-based and theory-less problems. Building a semantically intelligent CBR that mimic the expert thinking can solve many problems especially medical ones. Knowledge-intensive CBR using formal ontologies is an evolvement of this paradigm. Ontologies can be used for case representation and storage, and it can be used as a background knowledge. Using standard medical ontologies, such as SNOMED CT, enhances the interoperability and integration with the health care systems. Moreover, utilizing vague or imprecise knowledge further improves the CBR semantic effectiveness. This paper proposes a fuzzy ontology-based CBR framework. It proposes a fuzzy case-base OWL2 ontology, and a fuzzy semantic retrieval algorithm that handles many feature types. This framework is implemented and tested on the diabetes diagnosis problem. The fuzzy ontology is populated with 60 real diabetic cases. The effectiveness of the proposed approach is illustrated with a set of experiments and case studies. The resulting system can answer complex medical queries related to semantic understanding of medical concepts and handling of vague terms. The resulting fuzzy case-base ontology has 63 concepts, 54 (fuzzy) object properties, 138 (fuzzy) datatype properties, 105 fuzzy datatypes, and 2640 instances. The system achieves an accuracy of 97.67%. We compare our framework with existing CBR systems and a set of five machine-learning classifiers; our system outperforms all of these systems. Building an integrated CBR system can improve its performance. Representing CBR knowledge using the fuzzy ontology and building a case retrieval algorithm that treats different features differently improves the accuracy of the resulting systems. Copyright © 2015 Elsevier B.V. All rights reserved.

Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

NASA Technical Reports Server (NTRS)

Kratz, Jonathan L.; Culley, Dennis E.; Chapman, Jeffryes W.

2017-01-01

The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

Approximation of Engine Casing Temperature Constraints for Casing Mounted Electronics

NASA Technical Reports Server (NTRS)

Kratz, Jonathan; Culley, Dennis; Chapman, Jeffryes

2016-01-01

The performance of propulsion engine systems is sensitive to weight and volume considerations. This can severely constrain the configuration and complexity of the control system hardware. Distributed Engine Control technology is a response to these concerns by providing more flexibility in designing the control system, and by extension, more functionality leading to higher performing engine systems. Consequently, there can be a weight benefit to mounting modular electronic hardware on the engine core casing in a high temperature environment. This paper attempts to quantify the in-flight temperature constraints for engine casing mounted electronics. In addition, an attempt is made at studying heat soak back effects. The Commercial Modular Aero Propulsion System Simulation 40k (C-MAPSS40k) software is leveraged with real flight data as the inputs to the simulation. A two-dimensional (2-D) heat transfer model is integrated with the engine simulation to approximate the temperature along the length of the engine casing. This modification to the existing C-MAPSS40k software will provide tools and methodologies to develop a better understanding of the requirements for the embedded electronics hardware in future engine systems. Results of the simulations are presented and their implications on temperature constraints for engine casing mounted electronics is discussed.

Integrated Safety Risk Reduction Approach to Enhancing Human-Rated Spaceflight Safety

NASA Astrophysics Data System (ADS)

Mikula, J. F. Kip

2005-12-01

This paper explores and defines the current accepted concept and philosophy of safety improvement based on a Reliability enhancement (called here Reliability Enhancement Based Safety Theory [REBST]). In this theory a Reliability calculation is used as a measure of the safety achieved on the program. This calculation may be based on a math model or a Fault Tree Analysis (FTA) of the system, or on an Event Tree Analysis (ETA) of the system's operational mission sequence. In each case, the numbers used in this calculation are hardware failure rates gleaned from past similar programs. As part of this paper, a fictional but representative case study is provided that helps to illustrate the problems and inaccuracies of this approach to safety determination. Then a safety determination and enhancement approach based on hazard, worst case analysis, and safety risk determination (called here Worst Case Based Safety Theory [WCBST]) is included. This approach is defined and detailed using the same example case study as shown in the REBST case study. In the end it is concluded that an approach combining the two theories works best to reduce Safety Risk.

Development of the NEDO implantable ventricular assist device with Gyro centrifugal pump.

PubMed

Yoshikawa, M; Nonaka, K; Linneweber, J; Kawahito, S; Ohtsuka, G; Nakata, K; Takano, T; Schulte-Eistrup, S; Glueck, J; Schima, H; Wolner, E; Nosé, Y

2000-06-01

The Gyro centrifugal pump, PI (permanently implantable) series, is being developed as a totally implantable artificial heart. Our final goal is to establish a "functional TAH," a totally implantable biventricular assist system (BiVAS) with centrifugal pumps. A plastic prototype pump, Gyro PI 601, was evaluated through in vitro and in vivo studies as a single ventricular assist device (VAD). Based upon these results, the pump head material was converted to a titanium alloy, and the actuator was modified. These titanium Gyro pumps, PI 700 series, also were subjected to in vitro and in vivo studies. The Gyro PI 601 and PI 700 series have the same inner dimensions and characteristics, such as the eccentric inlet port, double pivot bearing system, secondary vane, and magnet coupling system; however, the material of the PI 700 is different from the PI 601. The Gyro PI series is driven by the Vienna DC brushless motor actuator. The inlet cannula of the right ventricular assist system (RVAS) specially made for this system consists of 2 parts: a hat-shaped silicone tip biolized with gelatin and an angled wire reinforced tube made of polyvinylchloride. The pump-actuator package was implanted into 8 calves in the preperitoneal space, bypassing from the left ventricle apex to the descending aorta for the left ventricular assist system (LVAS) and bypassing the right ventricle to the main pulmonary artery for the RVAS. According to the PI 601 feasibility protocol, 2 LVAS cases were terminated after 2 weeks, and 1 LVAS case and 1 RVAS were terminated after 1 month. The PI 700 series was implanted into 4 cases: 3 LVAS cases survived for a long term, 2 of them over 200 days (72-283 days), and 1 RVAS case survived for 1 month and was terminated according to the protocol for a short-term antithrombogenic screening and system feasibility study. Regarding power consumption, the plastic pump cases demonstrated from 6.2 to 12.1 W as LVAS and 7.3 W as RVAS, the titanium pump cases showed from 10.4 to 14.2 W as LVAS and 15.8 W as RVAS. All cases exhibited low hemolysis. The renal function and the liver function were maintained normally in all cases throughout these experimental periods. In the 2 RVAS cases, pulmonary function was normally maintained. No calves demonstrated thromboembolic signs or symptoms throughout the experiments except Case 1 with the plastic pump. However, in the plastic pump cases, bilateral renal infarction was suspected in 2 cases during necropsy whereas no abnormal findings were revealed in the titanium pump cases. There were also no blood clots inside the PI 700 series. As for the 601, the explanted pumps demonstrated slight thrombus formations at the top and bottom pivots except in 1 case. The Gyro PI series, especially the PI 700 series, demonstrated superior performance, biocompatibility, antithrombogenicity and low hemolysis. Also, the durability of the actuator was demonstrated. Based on these results, this titanium centrifugal pump is suitable as an implantable LVAS and RVAS. It is likely that the Gyro PI series is a feasible component of the BiVAS functional TAH.

Problems in the Context Evaluation of Individualized Courses

ERIC Educational Resources Information Center

Plomp, Tjeerd; Van der Meer, Adri

1977-01-01

The development of the Individualized Study System (ISS) in The Netherlands from 1970 to 1975 is reviewed and a case study for first-year engineering is described. A classification of ISS courses illustrates the complexity of the system, with advice offered on the management of individualized study systems. (Author/LBH)

Toll facilities in the United States : bridges, roads, tunnels, ferries

DOT National Transportation Integrated Search

1994-06-01

Minnesota Guidestar's Travlink and Genesis operational tests were chosen by the FHWA to be the subjects of case studies. The case studies were performed under the Intelligent Vehicle Highway Systems Institutional and Legal Issues Program, which was d...

Alcoa North American Extrusions Implements Energy Use Assessments at Multiple Facilities

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

None

2001-08-01

This case study is the latest in a series on industrial firms who are implementing energy efficient technologies and system improvements into their manufacturing processes. The case studies document the activities, savings, and lessons learned on these projects.

IVHS Institutional Issues And Case Studies: Help/Cresent Case Study

DOT National Transportation Integrated Search

1997-04-01

This report presents the results of research on procurement-related legal and non-technical issues which may be viewed as constraints to the deployment of Intelligent Transportation Systems (ITS). It focuses on state and local practices when federal ...

Applications of geographic information systems (GIS) for livability : case studies of select transportation agencies

DOT National Transportation Integrated Search

2011-03-31

This report synthesizes the findings from four case studies that assess how select organizations (the City of Boulder, Colorado's Transportation Division, the Center for Neighborhood Technology, the University of Oregon and the Oregon Transportation ...

Management Information Systems for Higher Education. Studies in Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Hussain, K. M., Ed.

Contents include an introduction to information systems (basic concepts and life-cycle); development of an information system (design, implementation, testing, and conversion); operation (evaluation and maintenance, quality control, and economics); and case studies of such systems at the New University of Lisbon, Bath University, Laval University…

Learner's Satisfaction: A Case Study on IGNOU's Engineering Diploma Program

ERIC Educational Resources Information Center

Venkateshwarlu, Neelam; Agarwal, Ashish

2016-01-01

Open and Distance Learning (ODL) system is different from conventional education system. ODL system imparts education through multiple media and techniques to equalize the class room education. Unlike the conventional system, the distant learners (students, adults, employed persons, etc.) may face some problems during their course of study. In…

Systematic review of human listeriosis in China, 1964-2010.

PubMed

Feng, Yanfang; Wu, Shuyu; Varma, Jay K; Klena, John D; Angulo, Frederick J; Ran, Lu

2013-10-01

Listeria is an important foodborne pathogen with severe manifestations and high case-fatality rate. However, listeriosis is not yet a notifiable disease in China, and there is no national monitoring system for cases. We conducted a systematic review to better understand the clinical and epidemiologic features of listeriosis in China. Both electronic and manual retrieval systems were used to search Chinese literature for cases and isolates of human listeriosis reported between 1964 and 2010. We recorded and analysed demographic, clinical and laboratory information available for reported cases. A total of 147 clinical cases, 479 Listeria isolates and 82 outbreak-related cases were reported in 28 (90%) provinces in China from January 1964 to December 2010. Of the clinical cases, 45 (31%) were central nervous system infections, 68 (46%) were septicaemia and 34 (23%) were focal infections or gastroenteritis. The overall case-fatality rate was 26% (34/130) among clinical cases with known outcomes and 46% (21/46) among neonatal cases. Listeriosis cases occurred in China throughout the study period between 1964 and 2010. Case-fatality was similar to published data from other countries. China should consider requiring notification of listeriosis cases to improve estimates of incidence, identification of risk factors and design of preventive measures. © 2013 John Wiley & Sons Ltd.

Tubing misconnections: normalization of deviance.

PubMed

Simmons, Debora; Symes, Lene; Guenter, Peggi; Graves, Krisanne

2011-06-01

Accidental connection of an enteral system to an intravenous (IV) system frequently results in the death of the patient. Misconnections are commonly attributed to the presence of universal connectors found in the majority of patient care tubing systems. Universal connectors allow for tubing misconnections between physiologically incompatible systems. The purpose of this review of case studies of tubing misconnections and of current expert recommendations for safe tubing connections was to answer the following questions: In tubing connections that have the potential for misconnections between enteral and IV tubing, what are the threats to safety? What are patient outcomes following misconnections between enteral and IV tubing? What are the current recommendations for preventing misconnections between enteral and IV tubing? Following an extensive literature search and guided by 2 models of threats and errors, the authors analyzed case studies and expert opinions to identify technical, organizational, and human errors; patient-related threats; patient outcomes; and recommendations. A total of 116 case studies were found in 34 publications. Each involved misconnections of tubes carrying feedings, intended for enteral routes, to IV lines. Overwhelmingly, the recommendations were for redesign to eliminate universal connectors and prevent misconnections. Other recommendations were made, but the analysis indicates they would not prevent all misconnections. This review of the published case studies and current expert recommendations supports a redesign of connectors to ensure incompatibility between enteral and IV systems. Despite the cumulative evidence, little progress has been made to safeguard patients from tubing misconnections.

Does Cloud Computing in the Atmospheric Sciences Make Sense? A case study of hybrid cloud computing at NASA Langley Research Center

NASA Astrophysics Data System (ADS)

Nguyen, L.; Chee, T.; Minnis, P.; Spangenberg, D.; Ayers, J. K.; Palikonda, R.; Vakhnin, A.; Dubois, R.; Murphy, P. R.

2014-12-01

The processing, storage and dissemination of satellite cloud and radiation products produced at NASA Langley Research Center are key activities for the Climate Science Branch. A constellation of systems operates in sync to accomplish these goals. Because of the complexity involved with operating such intricate systems, there are both high failure rates and high costs for hardware and system maintenance. Cloud computing has the potential to ameliorate cost and complexity issues. Over time, the cloud computing model has evolved and hybrid systems comprising off-site as well as on-site resources are now common. Towards our mission of providing the highest quality research products to the widest audience, we have explored the use of the Amazon Web Services (AWS) Cloud and Storage and present a case study of our results and efforts. This project builds upon NASA Langley Cloud and Radiation Group's experience with operating large and complex computing infrastructures in a reliable and cost effective manner to explore novel ways to leverage cloud computing resources in the atmospheric science environment. Our case study presents the project requirements and then examines the fit of AWS with the LaRC computing model. We also discuss the evaluation metrics, feasibility, and outcomes and close the case study with the lessons we learned that would apply to others interested in exploring the implementation of the AWS system in their own atmospheric science computing environments.

Effect of prospective reimbursement on nursing home costs.

PubMed Central

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-01-01

OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. STUDY DESIGN. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. PRINCIPAL FINDINGS. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. CONCLUSIONS. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems. PMID:8463109

Impact and Estimation of Balance Coordinate System Rotations and Translations in Wind-Tunnel Testing

NASA Technical Reports Server (NTRS)

Toro, Kenneth G.; Parker, Peter A.

2017-01-01

Discrepancies between the model and balance coordinate systems lead to biases in the aerodynamic measurements during wind-tunnel testing. The reference coordinate system relative to the calibration coordinate system at which the forces and moments are resolved is crucial to the overall accuracy of force measurements. This paper discusses sources of discrepancies and estimates of coordinate system rotation and translation due to machining and assembly differences. A methodology for numerically estimating the coordinate system biases will be discussed and developed. Two case studies are presented using this methodology to estimate the model alignment. Examples span from angle measurement system shifts on the calibration system to discrepancies in actual wind-tunnel data. The results from these case-studies will help aerodynamic researchers and force balance engineers to better the understand and identify potential differences in calibration systems due to coordinate system rotation and translation.

Center for the Built Environment: Research on Building Envelope Systems

Science.gov Websites

Studies Facade and Perimeter Zone Field Study Facades and Thermal Comfort Facade Symposium Mixed-Mode Research Adaptive Comfort Model Mixed-Mode Case Studies Operable Windows and Thermal Comfort Occupant thermal preferences in naturally ventilated as sealed buildings? Case Study Research of Mixed-Mode Office

State Structures for the Governance of Higher Education: Michigan Case Study Summary.

ERIC Educational Resources Information Center

Bracco, Kathy Reeves

This case study, part of the State Structures for the Governance of Higher Education study, focuses on governance and related issues in Michigan's higher education system. The study's overall purpose was to examine differences among states in their governance structures, and to determine if differences in performance were related to governing…

Effects of a Case-Based Reasoning System on Student Performance in a Java Programming Course

ERIC Educational Resources Information Center

Schmidt, Cecil

2007-01-01

The purpose of this study was to determine if a case-based reasoning tool would improve a student's understanding of the complex concepts in a Java programming course. Subjects for the study were randomly assigned from two sections of an introductory Java programming course. Posttests were used to measure the effects of the case-based reasoning…

The problem of resonance in technology usage

NASA Technical Reports Server (NTRS)

Sayani, H. H.; Svoboda, C. P.

1981-01-01

Various information system tools and techniques are analyzed. A case study is presented which draws together the issues raised in three distinct cases. This case study shows a typical progression from the selection of an analysis methodology, to the adoption of an automated tool for specification and documentation, and the difficulty of fitting these into an existing life cycle development methodology.

Legal issues in governing genetic biobanks: the Italian framework as a case study for the implications for citizen's health through public-private initiatives.

PubMed

Piciocchi, Cinzia; Ducato, Rossana; Martinelli, Lucia; Perra, Silvia; Tomasi, Marta; Zuddas, Carla; Mascalzoni, Deborah

2018-04-01

This paper outlines some of the challenges faced by regulation of genetic biobanking, using case studies coming from the Italian legal system. The governance of genetic resources in the context of genetic biobanks in Italy is discussed, as an example of the stratification of different inputs and rules: EU law, national law, orders made by authorities and soft law, which need to be integrated with ethical principles, technological strategies and solutions. After providing an overview of the Italian legal regulation of genetic data processing, it considers the fate of genetic material and IP rights in the event of a biobank's insolvency. To this end, it analyses two case studies: a controversial bankruptcy case which occurred in Sardinia, one of the first examples of private and public partnership biobanks. Another case study considered is the Chris project: an example of partnership between a research institute in Bolzano and the South Tyrolean Health System. Both cases seem to point in the same direction, suggesting expediency of promoting and improving public-private partnerships to manage biological tissues and biotrust to conciliate patent law and public interest.

Occupational Lymphohematopoietic Cancer in Korea

PubMed Central

Lee, Won Jin; Son, Mia; Kang, Seong-Kyu

2010-01-01

The purpose of this study was to review the existing studies on lymphohematopoietic (LHP) cancer in Korea, estimate the prevalence of workers exposed to carcinogens, and determine the population attributable fraction (PAF) of leukemia. Two case series and 4 case reports were reviewed. Using official statistics, the prevalence of benzene exposure and ionizing radiation exposure was estimated. Based on the prevalence of exposure and the relative risk, The PAF of leukemia was calculated. Between 1996 and 2005, 51 cases of LHP cancer were reported from the compensation system. Greater than 50% of occupational LHP cancer was leukemia, and the most important cause was benzene. In a cohort study, the standardized incidence ratio was 2.71 (95% CI, 0.56-7.91). The prevalence of exposure was 2.5% and 2.2% in 1995 and 2000, respectively. Using the 1995 prevalence, 3.6-4.8% and 0.1% of cases with leukemia were attributable to benzene and ionizing radiation exposure, respectively, which resulted in 39.7-51.4 cases per year. Benzene is the most important cause of occupational leukemia in Korea. Considering the estimated PAF in this study, the annual number of occupational LHP cancer (51 cases during 10-yr period), might be underreported within the compensation system. PMID:21258598

Nursing home case-mix reimbursement in Mississippi and South Dakota.

PubMed

Arling, Greg; Daneman, Barry

2002-04-01

To evaluate the effects of nursing home case-mix reimbursement on facility case mix and costs in Mississippi and South Dakota. Secondary data from resident assessments and Medicaid cost reports from 154 Mississippi and 107 South Dakota nursing facilities in 1992 and 1994, before and after implementation of new case-mix reimbursement systems. The study relied on a two-wave panel design to examine case mix (resident acuity) and direct care costs in 1-year periods before and after implementation of a nursing home case-mix reimbursement system. Cross-lagged regression models were used to assess change in case mix and costs between periods while taking into account facility characteristics. Facility-level measures were constructed from Medicaid cost reports and Minimum Data Set-Plus assessment records supplied by each state. Resident case mix was based on the RUG-III classification system. Facility case-mix scores and direct care costs increased significantly between periods in both states. Changes in facility costs and case mix were significantly related in a positive direction. Medicare utilization and the rate of hospitalizations from the nursing facility also increased significantly between periods, particularly in Mississippi. The case-mix reimbursement systems appeared to achieve their intended goals: improved access for heavy-care residents and increased direct care expenditures in facilities with higher acuity residents. However, increases in Medicare utilization may have influenced facility case mix or costs, and some facilities may have been unprepared to care for higher acuity residents, as indicated by increased rates of hospitalization.

A Nation-Wide Cancer Registry-Based Study of Adenosquamous Carcinoma in Taiwan

PubMed Central

Lan, Yuan-Tzu; Huang, Kuo-Hung; Liu, Chien-An; Tai, Ling-Chen; Chen, Ming-Huang; Chao, Yee; Li, Anna Fen-Yau; Chiou, Shih-Hwa; Shyr, Yi-Ming; Wu, Chew-Wun; Fang, Wen-Liang

2015-01-01

Background Adenosqamous carcinoma (ASC) is a rare disease involving various organs, yet there are no large-scale population-based comparative studies on ASC among different organs. Methods The incidence and overall survival of ASC among various organs in cases diagnosed in Taiwan from January 1, 2003 to December 31, 2010 were calculated and compared using data from the Taiwan Cancer Registry (TCR). The various organs were classified and divided into three different systems: the female reproductive, respiratory, and alimentary systems. Survival analysis were also compared among 30,850 patients diagnosed as ASC, adenocarcinoma (AC) or squamous cell carcinoma (SCC) in organs with frequent ASC. Results During the study period, a total of 576 ASC cases were diagnosed in Taiwan. The most common primary system was respiratory (73.8%), followed by alimentary (16.2%) and female reproductive (10%). The overall survival were significantly higher for cases involving the female reproductive system, followed by the respiratory and alimentary systems (P = 0.016). The median overall survival were worse in males than females for cases involving the respiratory system (22.4 vs. 31.8 months, P = 0.044). Multivariate analysis showed that age≧65, more advanced T and N categories were independent unfavorable prognostic factors of overall survival in ASC. ASC histology is an independent unfavorable prognostic factor compared with AC and SCC. Conclusions ASC at an old age and more advanced T and N categories were found to be associated with a poor prognosis. PMID:26445240

Mid-term financial impact of animal welfare improvements in Dutch broiler production.

PubMed

Gocsik, E; Lansink, A G J M Oude; Saatkamp, H W

2013-12-01

This study used a stochastic bioeconomic simulation model to simulate the business and financial risk of different broiler production systems over a 5-yr period. Simulation analysis was conducted using the @Risk add-in in MS Excel. To compare the impact of different production systems on economic feasibility, 2 cases were considered. The first case focused on the economic feasibility of a completely new system, whereas the second examined economic feasibilities when a farm switches from a conventional to an animal welfare-improving production system. A sensitivity analysis was conducted to assess the key drivers of economic feasibility and to reveal systematic differences across production systems. The study shows that economic feasibility of systems with improved animal welfare predominantly depends on the price that farmers receive. Moreover, the study demonstrates the importance of the level and variation of the price premium for improved welfare, particularly in the first 5 yr after conversion. The economic feasibility of the production system increases with the level of welfare improvements for a sufficiently high price level for broiler meat and low volatility in producer prices. If this is not the case, however, risk attitudes of farmers become important as well as the use of potential risk management instruments.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria

2014-12-01

As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.

Distributed Deliberative Recommender Systems

NASA Astrophysics Data System (ADS)

Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

Overcoming rule-based rigidity and connectionist limitations through massively-parallel case-based reasoning

NASA Technical Reports Server (NTRS)

Barnden, John; Srinivas, Kankanahalli

1990-01-01

Symbol manipulation as used in traditional Artificial Intelligence has been criticized by neural net researchers for being excessively inflexible and sequential. On the other hand, the application of neural net techniques to the types of high-level cognitive processing studied in traditional artificial intelligence presents major problems as well. A promising way out of this impasse is to build neural net models that accomplish massively parallel case-based reasoning. Case-based reasoning, which has received much attention recently, is essentially the same as analogy-based reasoning, and avoids many of the problems leveled at traditional artificial intelligence. Further problems are avoided by doing many strands of case-based reasoning in parallel, and by implementing the whole system as a neural net. In addition, such a system provides an approach to some aspects of the problems of noise, uncertainty and novelty in reasoning systems. The current neural net system (Conposit), which performs standard rule-based reasoning, is being modified into a massively parallel case-based reasoning version.

Load-bearing masonry system adoption and performance: A case study of construction company in a developing country

NASA Astrophysics Data System (ADS)

Ramli, Nor Azlinda; Abdullah, Che Sobry; Nawi, Mohd Nasrun Mohd; Bahaudin, Ahmad Yusni

2016-08-01

This study addresses the factors that influence the adoption of load-bearing masonry (LBM) system. A case study of the load-bearing masonry (LBM) system adoption is conducted through an interview to explore the situation of the technology adoption in a construction company. The finding indicates the factors influence the adoption of LBM system for the construction company are: organizational resources, usefulness, less maintenance, reduce construction time and cost. From the findings, these factors consistent with previous literature. Furthermore, the performance of the company was measured by looking into the financial and non-financial aspects. The LBM system brings good performance as it increased the profits of the company, a good quality of product and attracts more demand from customers. Thus, these factors should be considered for the other companies that are interested in implementing the LBM system in their projects.

Creative work. The case of Charles Darwin.

PubMed

Gruber, H E; Wallace, D B

2001-04-01

The evolving systems approach (ESA) addresses the need for direct study of the creative process in recognized creators at work, in contrast to indirect methods, such as those used in psychometric studies. The ESA emerged from H. E. Gruber's prolonged study of Charles Darwin's manuscripts, especially the notebooks he kept after the Beagle voyage. Gruber's interviews with J. Piaget about the latter's creative processes, as well as many doctoral dissertations, also helped shape the authors' approach. Using Gruber's (1974/1981) study of Darwin, the authors describe some facets of creative work identified in the course of their work. Among these are networks of enterprise, ensembles of metaphors, insights, and evolving belief systems. Although the ESA emphasizes cognitive processes, social, affective, and esthetic aspects of the case are not neglected. Each creative case is unique, otherwise the individual would not meet the criterion of originality. Uniqueness does not mean isolation; people who differ must and do work together. The integration of all these facets into a plausible system for each creator remains the authors' central task.

Exploring the Use of Enterprise Content Management Systems in Unification Types of Organizations

NASA Astrophysics Data System (ADS)

Izza Arshad, Noreen; Mehat, Mazlina; Ariff, Mohamed Imran Mohamed

2014-03-01

The aim of this paper is to better understand how highly standardized and integrated businesses known as unification types of organizations use Enterprise Content Management Systems (ECMS) to support their business processes. Multiple case study approach was used to study the ways two unification organizations use their ECMS in their daily work practices. Arising from these case studies are insights into the differing ways in which ECMS is used to support businesses. Based on the comparisons of the two cases, this study proposed that unification organizations may use ECMS in four ways, for: (1) collaboration, (2) information sharing that supports a standardized process structure, (3) building custom workflows that support integrated and standardized processes, and (4) providing links and access to information systems. These findings may guide organizations that are highly standardized and integrated in fashion, to achieve their intended ECMS-use, to understand reasons for ECMS failures and underutilization and to exploit technologies investments.

[Comparative study of less invasive stabilization system (LISS) and the condylar support plates for the treatment of AO type C distal femoral fractures in adults].

PubMed

Chen, Yu-tao; Yang, Jiang-wei; Hou, Hai-bin; Wang, Chun-sheng; Wang, Kun-zheng

2015-02-01

To summarize the complications and the early clinical effect of less invasive stabilization system and the femoral condylar support plates in the treatment of AO type C distal femoral fractures. From September 2007 to February 2012, 46 patients with AO type C distal femoral fractures were retrospectively studied. Of all patients 25 were treated with less invasive stabilization system including 14 males and 11 females with a mean age of (56.3±4.2) years old; according to AO classification, there were 14 cases of C1, 8 cases of C2 and 3 cases of C3 with a mean hospital stay of (15.6±1.7) days. While 21 cases were treated with femoral condylar support plates fixation including 12 males and 9 females with a mean age of (53.8±5.1) years old;there were 13 cases of C1, 6 cases of C2 and 2 cases of C3 with a mean hospital stay of (17.8±2.2) days. Comparative analysis was performed from the operation related index,postoperative complications and Evanich score of the knee joint function between the two groups at follow-up. All 46 patients were followed up from 13 to 38 months with a mean time of 19.6 months after surgery. Complications included 1 case with infection,3 cases with internal fixation failure, 1 case with nonunion and 1 case with activity limitation of the affected knee. The differences in the incision length, blood loss, fracture healing time were significant between two groups (P<0.05), while there was no significant difference in the duration of operations, hospital stays and the incidence of postoperative complications between two groups (P>0.05). The statistical significance was also found in the Evanich score at last follow-up between two groups (P<0.05). Patients with less invasive stabilization system fixation had the characteristics of less trauma, shorter fracture healing time and better functional recovery. Less invasive stabilization system had became one of the ideal internal fixations in the treatment of AO type C distal femoral fractures.

A study of the transferability of influenza case detection systems between two large healthcare systems

PubMed Central

Wagner, Michael M.; Cooper, Gregory F.; Ferraro, Jeffrey P.; Su, Howard; Gesteland, Per H.; Haug, Peter J.; Millett, Nicholas E.; Aronis, John M.; Nowalk, Andrew J.; Ruiz, Victor M.; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

Objectives This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. Methods A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients’ diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Results Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution’s cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. Conclusion We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser. PMID:28380048

A study of the transferability of influenza case detection systems between two large healthcare systems.

PubMed

Ye, Ye; Wagner, Michael M; Cooper, Gregory F; Ferraro, Jeffrey P; Su, Howard; Gesteland, Per H; Haug, Peter J; Millett, Nicholas E; Aronis, John M; Nowalk, Andrew J; Ruiz, Victor M; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

2017-01-01

This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01), and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001). We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser.

The role of Fizeau interferometry in planetary science

NASA Astrophysics Data System (ADS)

Conrad, Albert R.

2016-08-01

Historically, two types of interferometer have been used to the study of solar system objects: coaxial and Fizeau. While coaxial interferometers are well-suited to a wide range of galactic and extra-galactic science cases, solar system science cases are, in most cases, better carried out with Fizeau imagers. Targets of interest in our solar system are often bright and compact, and the science cases for these objects often call for a complete, or nearly complete, image at high angular resolution. For both methods, multiple images must be taken at varying baselines to reconstruct an image. However, with the Fizeau technique that number is far fewer than it is for the aperture synthesis method employed by co-axial interferometers. In our solar system, bodies rotate and their surfaces are sometimes changing over yearly, or even weekly, time scales. Thus, the need to be able to exploit the high angular resolution of an interferometer with only a handful of observations taken on a single night, as is the case for Fizeau interferometers, gives a key advantage to this technique. The aperture of the Large Binocular Telescope (LBT), two 8.4 circular mirrors separated center-to-center by 14.4 meters, is optimal for supporting Fizeau interferometry. The first of two Fizeau imagers planned for LBT, the LBT Interferometer (LBTI),1 saw first fringes in 2010 and has proven to be a valuable tool for solar system studies. Recent studies of Jupiters volcanic moon Io have yielded results that rely on the angular resolution provided by the full 23-meter baseline of LBT Future studies of the aurora at Jupiters poles and the shape and binarity of asteroids are planned. While many solar system studies can be carried out on-axis (i.e., using the target of interest as the beacon for both adaptive optics correction and fringe tracking), studies such as Io-in-eclipse, full disk of Jupiter and Mars, and binarity of Kuiper belt objects, require off-axis observations (i.e., using one or more nearby guide-moons or stars for adaptive optics correction and fringe tracking). These studies can be plagued by anisoplanatism, or cone effect. LINC-NIRVANA (LN),2 the first multi-conjugate adaptive optics system (MCAO) on an 8-meter class telescope in the northern hemisphere, provides a solution to the ill-effects of anisoplanatism. One of the LN ground layer wave front sensors was tested on LBT during 2014.3-5 Longer term, an upgrade planned for LN will establish its original role as the second LBT Fizeau imager. The full-disk study of several solar system bodies, most notably large and/or nearby bodies such as Jupiter and Mars which span tens of arcseconds, would be best studied with LN. We will review the past accomplishments of Fizeau interferometry with LBTI, present plans for using that instrument for future solar system studies, and, lastly, explore the unique solar system studies that require the LN MCAO system combined with Fizeau interferometry.

Enterprise architecture availability analysis using fault trees and stakeholder interviews

NASA Astrophysics Data System (ADS)

Närman, Per; Franke, Ulrik; König, Johan; Buschle, Markus; Ekstedt, Mathias

2014-01-01

The availability of enterprise information systems is a key concern for many organisations. This article describes a method for availability analysis based on Fault Tree Analysis and constructs from the ArchiMate enterprise architecture (EA) language. To test the quality of the method, several case-studies within the banking and electrical utility industries were performed. Input data were collected through stakeholder interviews. The results from the case studies were compared with availability of log data to determine the accuracy of the method's predictions. In the five cases where accurate log data were available, the yearly downtime estimates were within eight hours from the actual downtimes. The cost of performing the analysis was low; no case study required more than 20 man-hours of work, making the method ideal for practitioners with an interest in obtaining rapid availability estimates of their enterprise information systems.

New-onset asthma after exposure to the steam system additive 2-diethylaminoethanol. A descriptive study.

PubMed

Gadon, M E; Melius, J M; McDonald, G J; Orgel, D

1994-06-01

Through a leak in the steam heating system, the anticorrosive agent 2-diethylaminoethanol was released into the air of a large office building. Irritative symptoms were experienced by most of the 2500 employees, and 14 workers developed asthma within 3 months of exposure. This study was undertaken to review clinical characteristics of these asthmatics. Environmental exposure monitoring data and medical records were reviewed. Seven of 14 cases were defined as "confirmed" and 7 of 14 as "suspect," using the National Institute for Occupational Safety and Health surveillance case definition of occupational asthma. Spirometry was positive in 4 of 14 of the cases and peak flow testing in 10 of 14. Three cases were diagnosed on the basis of work-related symptoms and physical examination alone. The study suggests that acute exposure to the irritating steam additive 2-diethylaminoethanol was a contributing factor in the development of clinical asthma in this population.

COMPLEMENT DEVIATION IN SCARLET FEVER WITH COMPARATIVE STUDIES OF THE WASSERMANN AND NOGUCHI SYSTEMS

PubMed Central

Kolmer, John A.

1911-01-01

The Wassermann reaction in scarlet fever per se is uniformly negative. The antigen of scarlet fever liver yields practically the same results as that of luetic liver, and both fail to deviate complement with scarlet fever antibodies. The Noguchi reaction in scarlet fever is practically negative. Sixteen cases, or 6.4 per cent. of 250 cases, were positive when active serum was used; with inactivated serum, but eleven, or 4.4 per cent., remained positive. Five of these eleven cases were also positive with the Wassermann system. In other words, sixteen cases, or 6.4 per cent., were positive according to the Noguchi system with active or inactivated serum or both, whereas with the Wassermann system only 2 per cent. were positive. The presence of anti-sheep hemolysin normally in human serum is one of the main disturbing factors in the Wassermann system; for this reason, complement and hemolysin (made by immunization of rabbits) require careful titration. A positive Wassermann reaction usually indicates the presence of syphilitic antibodies, and a negative Noguchi reaction, their absence, and both systems should be used in the examination of all cases. PMID:19867467

Analysis of postural load during tasks related to milking cows-a case study.

PubMed

Groborz, Anna; Tokarski, Tomasz; Roman-Liu, Danuta

2011-01-01

The aim of this study was to analyse postural load during tasks related to milking cows of 2 farmers on 2 different farms (one with a manual milk transport system, the other with a fully automated milk transport system) as a case study. The participants were full-time farmers, they were both healthy and experienced in their job. The Ovako Working Posture Analyzing System (OWAS) was used to evaluate postural load and postural risk. Postural load was medium for the farmer on the farm with a manual milk transport system and high for the farmer working on the farm with a fully automated milk transport system. Thus, it can be concluded that a higher level of farm mechanization not always mean that the farmer's postural load is lower, but limitation of OWAS should be considered.

Design Of Bioremediation Systems For Groundwater (Aerobic and Anaerobic Plus Representative Case Studies)

EPA Science Inventory

The attached presentation discusses the fundamentals of bioremediation in the subsurface. The basics of aerobic, cometabolic, and anaerobic bioremediation are presented. Case studies from the Delaware Sand & Gravel Superfund Site, Dover Cometabolic Research Project and the SABR...

ITS institutional and legal issues program : review of the Travelaid operational test

DOT National Transportation Integrated Search

1995-01-01

The TravelAid operational test was chosen by the Federal Highway Administration to be the subject of a case study. Several case studies were performed under the Intelligent Transportation Systems (ITS) Institutional and Legal Issues Program, which wa...

ITS institutional and legal issues program : review of the SmartTraveler operational test

DOT National Transportation Integrated Search

1994-12-01

The SmarTraveler operational test was chosen by the Federal Highway Administration to be the subject of a case study. Several case studies were performed under the Intelligent Transportation Systems (ITS) Institutional and Legal Issues Program, which...

The Balkanization of Nigeria's Federal System: A Case Study in the Political Geography of Africa

ERIC Educational Resources Information Center

Rogge, John R.

1977-01-01

By means of a case study of Nigeria, this paper examines the issue of national unity and identity in the face of tribally based regionalism, diversity, and suspicion. Maps and tables accompany the article. (Author/AV)

WMOST v2 Case Study: Monponsett Ponds

EPA Science Inventory

This webinar presents an overview of the preliminary results of a case study application of EPA's Watershed Management Optimization Support Tool v2 (WMOST) for stakeholders in the Monponsett Ponds Watershed Workgroup. Monponsett Ponds is a large water system consisting of two ba...

EVALUATION OF GROUNDWATER EXTRACTION REMEDIES - VOLUME II

EPA Science Inventory

This volume was prepared as part of an evaluation of groundwater extraction remedies completed under EPA Contract No. 68-W8-0098. It presents 19 case studies of individual sites where ground-water extraction systems have been implemented. These case studies present site characte...

Internationalizing the California State University: Case Studies.

ERIC Educational Resources Information Center

Sutter Richard L., Ed.; And Others

The 18 case studies in this volume represent a sample of the internationalization activities of the California State University system. Part 1 presents five papers on organizing for international education: "Internationalization of CSULB [California State University Long Beach]" by Dorothy Abrahamse et al.; "Institutional…

Physical Science Connected Classrooms: Case Studies

ERIC Educational Resources Information Center

Irving, Karen; Sanalan, Vehbi; Shirley, Melissa

2009-01-01

Case-study descriptions of secondary and middle school classrooms in diverse contexts provide examples of how teachers implement connected classroom technology to facilitate formative assessment in science instruction. Connected classroom technology refers to a networked system of handheld devices designed for classroom use. Teachers were…

Hunting stability analysis of high-speed train bogie under the frame lateral vibration active control

NASA Astrophysics Data System (ADS)

Yao, Yuan; Wu, Guosong; Sardahi, Yousef; Sun, Jian-Qiao

2018-02-01

In this paper, we study a multi-objective optimal design of three different frame vibration control configurations and compare their performances in improving the lateral stability of a high-speed train bogie. The existence of the time-delay in the control system and its impact on the bogie hunting stability are also investigated. The continuous time approximation method is used to approximate the time-delay system dynamics and then the root locus curves of the system before and after applying control are depicted. The analysis results show that the three control cases could improve the bogie hunting stability effectively. But the root locus of low- frequency hunting mode of bogie which determinates the system critical speed is different, thus affecting the system stability with the increasing of speed. Based on the stability analysis at different bogie dynamics parameters, the robustness of the control case (1) is the strongest. However, the case (2) is more suitable for the dynamic performance requirements of bogie. For the case (1), the time-delay over 10 ms may lead to instability of the control system which will affect the bogie hunting stability seriously. For the case (2) and (3), the increasing time-delay reduces the hunting stability gradually over the high-speed range. At a certain speed, such as 200 km/h, an appropriate time-delay is favourable to the bogie hunting stability. The mechanism is proposed according to the root locus analysis of time-delay system. At last, the nonlinear bifurcation characteristics of the bogie control system are studied by the numerical integration methods to verify the effects of these active control configurations and the delay on the bogie hunting stability.

An Analysis Of The Gps R and D Program As A Case Study Illustrating Dod R and D And Its Associated Successes To Justify The Continued Investments Into And Sustainment Of Dod R and D Budgets

DTIC Science & Technology

2016-09-01

Global Positioning System (GPS). • DOD R&D budget analysis • GPS case study analysis These research areas will support the thesis on the defense... CASE STUDY ANALYSIS As successful as GPS has been on both the battlefield and in worldwide civilian life, the end state wasn’t realized when the...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA JOINT APPLIED PROJECT AN ANALYSIS OF THE GPS R&D PROGRAM AS A CASE STUDY

Integrated Comprehensive Care - A Case Study in Nursing Leadership and System Transformation.

PubMed

Wheatley, Laura; Doyle, Winnie; Evans, Cheryl; Gosse, Carolyn; Smith, Kevin

2017-01-01

Calls for transformational change of our healthcare system are increasingly clear, persuasive and insistent. They resonate at all levels, with those who fund, deliver, provide and receive care, and they are rooted in a deep understanding that the system, as currently rigidly structured, most often lacks the necessary flexibility to comprehensively meet the needs of patients across the continuum of care. The St. Joseph's Health System (SJHS) Integrated Comprehensive Care (ICC) Program, which bundles care and funding across the hospital to home continuum, has reduced fragmentation of care, and it has delivered improved outcomes for patients, providers and the system. This case study explores the essential contribution of nursing leadership to this successful transformation of healthcare service delivery.

Responses of many-species predator-prey systems to perturbations

NASA Astrophysics Data System (ADS)

Esmaily, Shadi; Pleimling, Michel

2015-03-01

We study the responses of many-species predator-prey systems, both in the well-mixed case as well as on a two-dimensional lattice, to permanent and transient perturbations. In the case of a weak transient perturbation the system returns to the original steady state, whereas a permanent perturbation pushes the system into a new steady state. Using Monte Carlo simulations, we monitor the approach to stationarity after a perturbation through a variety of quantities, as for example time-dependent particle densities and correlation functions. Different types of perturbations are studied, ranging from a change in reaction rates to the injection of additional individuals into the system, the latter perturbation mimicking immigration. This work is supported by the US National Science Foundation through Grant DMR-1205309.

Health information systems in the Islamic Republic of Iran: a case study in Kerman Province.

PubMed

Zolala, F

2011-09-01

Health information systems provide information for decision-making at all levels, from planning and management to evaluation of health services. Registration of vital events is the most basic level of any health information system. This case study used in-depth interviews, observations and examination of documents to explore the system of births and deaths registration in Kerman province. The findings were evaluated under 3 headings: data input, data processing and data usage. A range of problems were identified concerning legal requirements, staffing, data checking and publication of data. Different approaches are suggested to strengthen the system, such as introducing regulations to oblige different data sources to provide data and allocating sufficient resources, including human resources, and an improved technology infrastructure.

The modified pancreatic stent system for prevention of post-ERCP pancreatitis: a case-control study.

PubMed

Zhang, Cheng; Yang, Yu-Long; Ma, Yue-Feng; Zhang, Hong-Wei; Li, Jing-Yi; Lin, Mei-Ju; Shi, Li-Jun; Qi, Chun-Chun

2017-10-18

Prophylactic pancreatic stents after endoscopic retrograde cholangiopancreatography (ERCP) can help prevent post-ERCP pancreatitis. However most of the pancreatic stents need to be removed by another ERCP. The aim of this observational study was to investigate the feasibility and effectiveness of the modified pancreatic stent system for prevention of post-ERCP pancreatitis. From November 2013 to November 2015, a total of 230 patients who had prophylactic pancreatic stent placed for prevention of post-ERCP pancreatitis at a single institution were identified and stratified. In this case-control design, 150 patients received an ordinary pancreatic stent, and 80 patients received the modified pancreatic stent. The main outcome measures were the difficulty level and complications of pancreatic stent placement and extraction between the two groups. In ordinary group, the average time of pancreatic stent and nasal biliary drainage placement was 3.5 ± 0.6 min. There were 13 cases of stent proximal migration (8.7%), 20 cases of stent spontaneous abscission (13.3%), 5 cases of acute pancreatitis (3.3%) (2 cases for stent abscission) and 7 cases of hyperamylasemia (4.7%) after ERCP. One hundred thirty patients received extra duodenoscope (86.7%) to remove the stent, and 4 cases had acute pancreatitis and 5 patients had hyperamylasemia after removing the proximal migratory stents. In modified group, the average time of pancreatic stent system placement was 4.9 ± 0.7 min, but there was only one case of stent abscission (1.3%), 2 cases of acute pancreatitis (2.5%) and 3 cases of hyperamylasemia (3.8%). The new pancreatic stents were removed directly under x-ray without complication. The modified pancreatic stent system has the same effect of preventing post-ERCP pancreatitis, lower rate of stents proximal migration and spontaneous abscission, and the advantage of easier removed compared with ordinary pancreatic stent.

Potential effect of CAD systems on the detection of actionable nodules in chest CT scans during routine reporting

NASA Astrophysics Data System (ADS)

Wormanns, Dag; Beyer, Florian; Butzbach, Arnauld; Zierott, Livia; Heindel, Walter

2006-03-01

The purpose of the presented study was to determine the impact of two different CAD systems used as concur-rent reader for detection of actionable nodules (>4 mm) on the interpretation of chest CT scans during routine reporting. Fifty consecutive MDCT scans (1 mm or 1.25 mm slice thickness, 0.8 mm reconstruction increment) were se-lected from clinical routine. All cases were read by a resident and a staff radiologist, and a written report was available in the radiology information system (RIS). The RIS report mentioned at least one actionable pulmonary nodule in 18 cases (50%) and did not report any pulmonary nodule in the remaining 32 cases. Two different recent CAD systems were independently applied to the 50 CT scans as concurrent reader with two radiologists: Siemens LungCare NEV and MEDIAN CAD-Lung. Two radiologists independently reviewed the CAD results and determined if a CAD result was a true positive or a false positive finding. Patients were classified into two groups: in group A if at least one actionable nodule was detected and in group B if no actionable nodules were found. The effect of CAD on routine reporting was simulated as set union of the findings of routine reporting and CAD thus applying CAD as concurrent reader. According to the RIS report group A (patients with at least one actionable nodule) contained 18 cases (36% of all 50 cases), and group B contained 32 cases. Application of a CAD system as concurrent reader resulted in detec-tion of additional CT scans with actionable nodules and reclassification into group A in 16 resp. 18 cases (radi-ologist 1 resp. radiologist 2) with Siemens NEV and in 19 resp. 18 cases with MEDIAN CAD-Lung. In seven cases MEDIAN CAD-Lung and in four cases Siemens NEV reclassified a case into group A while the other CAD system missed the relevant finding. Sensitivity on a nodule (>4 mm) base was .45 for Siemens NEV and .55 for MEDIAN CAD-Lung; the difference was not yet significant (p=.077). In our study use of CAD as second reader in routine reporting doubled the percentage of patients with actionable nodules larger than 4 mm.

Technology Solutions Case Study: Balancing Hydronic Systems in Multifamily Buildings, Chicago, Illinois

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

None

2014-09-01

In multifamily building hydronic systems, temperature imbalance may be caused by undersized piping, improperly adjusted balancing valves, inefficient water temperature and flow levels, and owner/occupant interaction with the boilers, distribution and controls. The effects of imbalance include tenant discomfort, higher energy use intensity and inefficient building operation. In this case study , Partnership for Advanced Residential Retrofit and Elevate Energy. explores cost-effective distribution upgrades and balancing measures in multifamily hydronic systems, providing a resource to contractors, auditors, and building owners on best practices to improve tenant comfort and lower operating costs.

[Quantitative morphological characteristics of the changes in the effector component of the immune system in dyshormonal hyperplasias and breast cancer].

PubMed

Abrakova, E L

1982-01-01

The effector component of immune system was studied in 39 cases of fibroadenomatosis by morphometric and histochemical methods. Signs of immunosuppression (decreased fraction of free cells of stroma and disturbances in their cooperation) were identified in cases of precancerous changes and cancer. A considerable difference in nucleic acid level in fibroadenomatosis and cancer was established. It is suggested that quantitative morphological study of the effector component of immune system may provide more diagnostic criteria for identification of prognostically unfavorable forms of fibroadenomatosis and cancer.

Beyond Earth's boundaries: Human exploration of the Solar System in the 21st Century

NASA Technical Reports Server (NTRS)

1991-01-01

This is an annual report describing work accomplished in developing the knowledge base that will permit informed recommendations and decisions concerning national space policy and the goal of human expansion into the solar system. The following topics are presented: (1) pathways to human exploration; (2) human exploration case studies; (3) case study results and assessment; (4) exploration program implementation strategy; (5) approach to international cooperation; (6) recommendations; and (7) future horizons.

Passive fire building protection system evaluation (case study: millennium ict centre)

NASA Astrophysics Data System (ADS)

Rahman, Vinky; Stephanie

2018-03-01

Passive fire protection system is a system that refers to the building design, both regarding of architecture and structure. This system usually consists of structural protection that protects the structure of the building and prevents the spread of fire and facilitate the evacuation process in case of fire. Millennium ICT Center is the largest electronic shopping center in Medan, Indonesia. As a public building that accommodates the crowd, this building needs a fire protection system by the standards. Therefore, the purpose of this study is to evaluate passive fire protection system of Millennium ICT Center building. The study was conducted to describe the facts of the building as well as direct observation to the research location. The collected data is then processed using the AHP (Analytical Hierarchy Process) method in its weighting process to obtain the reliability value of passive fire protection fire system. The results showed that there are some components of passive fire protection system in the building, but some are still unqualified. The first section in your paper

The impact and societal benefits of using earth observation for ground water policies in the agricultural sector

NASA Astrophysics Data System (ADS)

Pearlman, Francoise; Bernknopf, Richard; Pearlman, Jay; Rigby, Michael

2017-04-01

Assessment of the impact and societal benefit of Earth Observation (EO) is a multidisciplinary task that involves the social, economic and environmental knowledge to formulate indicators and methods. The value of information (VOI) of EO is based on case studies that document the value in use of the information in a specific decision. A case study is an empirical inquiry investigating a phenomenon. It emphasizes detailed contextual analysis of a limited number of events or conditions and their relationships. Quantitative estimates of the benefits and costs of the geospatial information derived from EO data document and demonstrate its economic value. A case study was completed to examine some of the technical perspectives of adapting and coupling satellite imagery and in situ water quality measurements to forecast changes in groundwater quality in the agricultural sector in Iowa. The analysis was conducted to identify the ability of EO to assist in improving agricultural land management and regulation of balancing production and groundwater contamination. The Iowa case study described the application of Landsat data in a land adaptation strategy to maintain agricultural production and groundwater water quality. Results demonstrated that Landsat information facilitates spatiotemporal analysis of the impact of nitrates (fertilizer application) on groundwater resources and that crop production could be retained while groundwater quality is maintained. To transition to the operational use of the geospatial information, the Landsat data should be applied in a use case where Interaction of various stakeholders within a decision process are addressed. The objective is to design implementation experiments of a system from the user's and contributor's perspective, and to communicate system behavior in their terms. A use case requires communication of system requirements, how the system operates and may be used, the roles that all participants play and what value the user will receive from the system. The use case must be broader than simply a technical demonstration of capability and involves scientific experts, farmers and their representatives, and the Government. Decisions will ultimately need to take into account some level of uncertainty in the scientific "measurement". The data also have statistical variability which affects the confidence in the value of information. These issues are concerns when implementing remote sensing technology and must be examined from an end user perspective and their impact discussed and understood. The study team held meetings with subject experts from Iowa State University and the Iowa Farm Bureau to explore the next steps in developing the use case. A meeting between the study team and the Iowa Farm Bureau centered on the need for efficient regulation of land use and regulation of agrochemical application in the Midwest. This presentation will describe the results of the case study and the ongoing investigation into directions into the broader application of the use case and the application of economic indicators that have applications across fields of interest.

Interpreting participatory Fuzzy Cognitive Maps as complex networks in the social-ecological systems of the Amazonian forests

NASA Astrophysics Data System (ADS)

Varela, Consuelo; Tarquis, Ana M.; Blanco-Gutiérrez, Irene; Estebe, Paloma; Toledo, Marisol; Martorano, Lucieta

2015-04-01

Social-ecological systems are linked complex systems that represent interconnected human and biophysical processes evolving and adapting across temporal and spatial scales. In the real world, social-ecological systems pose substantial challenges for modeling. In this regard, Fuzzy Cognitive Maps (FCMs) have proven to be a useful method for capturing the functioning of this type of systems. FCMs are a semi-quantitative type of cognitive map that represent a system composed of relevant factors and weighted links showing the strength and direction of cause-effects relationships among factors. Therefore, FCMs can be interpreted as complex system structures or complex networks. In this sense, recent research has applied complex network concepts for the analysis of FCMs that represent social-ecological systems. Key to FCM the tool is its potential to allow feedback loops and to include stakeholder knowledge in the construction of the tool. Also, previous research has demonstrated their potential to represent system dynamics and simulate the effects of changes in the system, such as policy interventions. For illustrating this analysis, we have developed a series of participatory FCM for the study of the ecological and human systems related to biodiversity conservation in two case studies of the Amazonian region, the Bolivia lowlands of Guarayos and the Brazil Tapajos National forest. The research is carried out in the context of the EU project ROBIN1 and it is based on the development of a series of stakeholder workshops to analyze the current state of the socio-ecological environment in the Amazonian forest, reflecting conflicts and challenges for biodiversity conservation and human development. Stakeholders included all relevant actors in the local case studies, namely farmers, environmental groups, producer organizations, local and provincial authorities and scientists. In both case studies we illustrate the use of complex networks concepts, such as the adjacency matrix and centrality properties (e.g.: centrality, page-rank, betweenness centrality). Different measures of network centrality evidence that deforestation and loss of biodiversity are the most relevant factors in the FCM of the two case studies analyzed. In both cases agricultural expansion emerges as a key driver of deforestation. The lack of policy coordination and a weak implementation and enforcement are also highly influential factors. The analysis of the system's dynamics suggest that in the case of Bolivia forest fires and deforestation are likely to continue in the immediate future as illegal activities are maintained and poverty increases. In the case of Brazil a decrease in available viable economic activities is driving further deforestation and ecosystem services loss. Overall, the research evidences how using FCMs together with complex network analysis can support policy development by identifying key elements and processes upon which policy makers and institutions can take action. Acknowledgements The authors would like to acknowledge the EU project ROBIN (The Role of Biodiversity in Climate Change Mitigation, from the EC FP7, no 283093) and the Spanish project AL14-PID-12 (Biodiversidad y cambio climático en la Amazonía: Perspectivas socio-económicas y ambientales) of the UPM Latin America Cooperation Program for funding this research.

FoodCASE: A system to manage food composition, consumption and TDS data.

PubMed

Presser, Karl; Weber, David; Norrie, Moira

2018-01-01

Food and nutrition scientists, nowadays, need to manage an increasing amount of data regarding food composition, food consumption and Total Diet Studies (TDS). The corresponding datasets can contain information about several thousand different foods, in different versions from different studies. FoodCASE is a system that has been developed to manage these different datasets. It also support flexible means of linking between datasets and generally provide support for the different processes involved in the acquisition, management and processing of data. In this paper, the most important concepts to implement existing guidelines and standards for proper food data management are presented, as well as different use cases of data import and proofs of concepts demonstrating the ability to manage data in FoodCASE. Copyright © 2016 Elsevier Ltd. All rights reserved.

Causality Analysis: Identifying the Leading Element in a Coupled Dynamical System

PubMed Central

BozorgMagham, Amir E.; Motesharrei, Safa; Penny, Stephen G.; Kalnay, Eugenia

2015-01-01

Physical systems with time-varying internal couplings are abundant in nature. While the full governing equations of these systems are typically unknown due to insufficient understanding of their internal mechanisms, there is often interest in determining the leading element. Here, the leading element is defined as the sub-system with the largest coupling coefficient averaged over a selected time span. Previously, the Convergent Cross Mapping (CCM) method has been employed to determine causality and dominant component in weakly coupled systems with constant coupling coefficients. In this study, CCM is applied to a pair of coupled Lorenz systems with time-varying coupling coefficients, exhibiting switching between dominant sub-systems in different periods. Four sets of numerical experiments are carried out. The first three cases consist of different coupling coefficient schemes: I) Periodic–constant, II) Normal, and III) Mixed Normal/Non-normal. In case IV, numerical experiment of cases II and III are repeated with imposed temporal uncertainties as well as additive normal noise. Our results show that, through detecting directional interactions, CCM identifies the leading sub-system in all cases except when the average coupling coefficients are approximately equal, i.e., when the dominant sub-system is not well defined. PMID:26125157

Optimal Control for Quantum Driving of Two-Level Systems

NASA Astrophysics Data System (ADS)

Qi, Xiao-Qiu

2018-01-01

In this paper, the optimal quantum control of two-level systems is studied by the decompositions of SU(2). Using the Pontryagin maximum principle, the minimum time of quantum control is analyzed in detail. The solution scheme of the optimal control function is given in the general case. Finally, two specific cases, which can be applied in many quantum systems, are used to illustrate the scheme, while the corresponding optimal control functions are obtained.

The Development of Instructional Systems

DTIC Science & Technology

1970-12-01

of the behaviorsI which were the objectives of the system, the system is an effective one . In many cases , the results of the administration of all...of Maintenance Staff (including conference on duties located and "laying on " interview requir~mnts) 2. Study of Nominee Records 3. Selection of Job...unnecessary burden on supervisory personnel for on -the-job training. In such cases , the training program is not serving the enterprise as it should. On

Computer simulation of surface and film processes

NASA Technical Reports Server (NTRS)

Tiller, W. A.

1981-01-01

A molecular dynamics technique based upon Lennard-Jones type pair interactions is used to investigate time-dependent as well as equilibrium properties. The case study deals with systems containing Si and O atoms. In this case a more involved potential energy function (PEF) is employed and the system is simulated via a Monte-Carlo procedure. This furnishes the equilibrium properties of the system at its interfaces and surfaces as well as in the bulk.

Multispecies reaction-diffusion systems

NASA Astrophysics Data System (ADS)

Aghamohammadi, A.; Fatollahi, A. H.; Khorrami, M.; Shariati, A.

2000-10-01

Multispecies reaction-diffusion systems, for which the time evolution equations of correlation functions become a closed set, are considered. A formal solution for the average densities is found. Some special interactions and the exact time dependence of the average densities in these cases are also studied. For the general case, the large-time behavior of the average densities has also been obtained.

The Design of Secondary Schools--A Case Study, Singapore.

ERIC Educational Resources Information Center

Liew Kok-Pun, Michael; And Others

Land scarcity dominates the thinking of school planners in Singapore. Techniques for optimizing the use of land for schools include (1) the construction of multi-storied or high-rise schools; (2) operation of a double-shift system and, in some cases, a triple-shift system; (3) multiple use of educational spaces; and (4) construction of several…

Clinicopathological study of 81 cases of localized and systemic scleroderma.

PubMed

Succaria, F; Kurban, M; Kibbi, A-G; Abbas, O

2013-02-01

Scleroderma is a connective tissue disease that includes localized and systemic forms. Our recent encounter with a morphea case exhibiting prominent perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with morphea/scleroderma at our institution. To describe the clinicopathological features of all patients diagnosed with morphea/scleroderma at American University of Beirut Medical Center (AUB-MC) between 1999 and 2010, and compare our findings with those published in the literature. A total of 81 cases (63 women and 18 men) were identified, of which 73 were localized (morphea) and eight were systemic scleroderma. Clinically, plaque type morphea was the most common variant both in adults and children, and seven (9%) cases of morphea were associated with lichen sclerosis et atrophicus (LSA). Histopathologically, perineural inflammation was observed in 49% of cases, and may serve, in addition to other features including lichen sclerosis-like changes (observed in exclusively nine cases of morphea), more diffuse dermal and less subcutaneous sclerosis, and intense inflammation, as clues favouring diagnosis of morphea over systemic sclerosis. The features of morphea/scleroderma patients in this study are generally comparable to those published in the literature, with few differences. Clinically, plaque type morphea was the most common variant both in adults and children and LSA was a frequent association. Histopathologically, perineural inflammation was commonly observed and may serve in addition to lichen sclerosis-like changes and intense inflammation as clues favouring diagnosis of morphea over systemic sclerosis. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Evaluation of a digital drainage system (Thopaz) in over 250 cases at a single site: A retrospective case-control study.

PubMed

Arai, Hiromasa; Tajiri, Michihiko; Kameda, Yohei; Shiino, Kimihisa; Ando, Kohei; Okudela, Koji; Masuda, Munetaka

2018-04-01

The aim of this study was to evaluate the efficacy of the Thopaz system, a new drainage system in management of general thoracic surgery, based on a review of our clinical practice and a comparison of the utility of the Thopaz device compared with a standard drainage system. A review of 540 thoracic surgeries at our hospital was performed. These cases were divided into 275 treated with the Thopaz system from April 2014 to March 2015 and 265 treated with a standard system from April 2013 to March 2014. The characteristics of patients and outcomes after surgery were compared in these 2 groups. The characteristics of the patients were similar in the 2 groups. Outcomes after surgery, including types of operation, period of chest tube placement, chest tube reinsertion rate and clamping test rate also did not differ significantly between the groups. The non-inferiority of the Thopaz system compared to a standard system was verified statistically. With advantages of providing objective data as a small portable system, in addition to the quietness of the unit and the ease of setup and operation, Thopaz system is likely to become mainstream in postoperative management in general thoracic surgery. © 2017 John Wiley & Sons Ltd.

[Digestive system manifestations in children infected with novel influenza A (H1N1) virus].

PubMed

Wei, Ju-Rong; Lu, Zhi-Wei; Tang, Zheng-Zhen; Wang, He-Ping; Zheng, Yue-Jie

2010-10-01

To study the digestive system manifestations in children infected with novel influenza A (H1N1) virus. A prospective study of 153 children infected with novel influenza A (H1N1) virus in Shenzhen Children's Hospital from November 2009 to January 2010 was conducted. The clinical features and outcomes of 69 children with digestive system manifestations were analyzed. The children presenting with digestive system manifestations accounted for 45% (69 cases) in the 153 hospitalized children with novel influenza A (H1N1) infection. Gastrointestinal manifestations were observed in 50 cases (33%) and liver function abnormality in 19 cases (12%). The incidence rate of coma, neurological complications, increase in creative kinase level, ICU admission, and death in the patients with digestive system manifestations were significantly higher than those without digestive system manifestations (P<0.05). In the 69 patients with digestive system manifestations, 5 died from severe complications and 64 recovered fully. Gastrointestinal manifestations disappeared through 1 to 3 days and abnormal liver function recovered through 4 to 7 days. Digestive system manifestations are common in children infected with novel influenza A (H1N1) virus. Neurological system involvements are more common in the patients with digestive system manifestations than those without.

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care.

PubMed

Huffhines, Lindsay; Tunno, Angela M; Cho, Bridget; Hambrick, Erin P; Campos, Ilse; Lichty, Brittany; Jackson, Yo

2016-08-01

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care☆

PubMed Central

Huffhines, Lindsay; Tunno, Angela M.; Cho, Bridget; Hambrick, Erin P.; Campos, Ilse; Lichty, Brittany; Jackson, Yo

2016-01-01

State social service agency case files are a common mechanism for obtaining information about a child’s maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child’s maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed. PMID:28138207

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

A review of medical malpractice issues in Malaysia under tort litigation system.

PubMed

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-04-07

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability.

Review of Medical Malpractice Issues in Malaysia under Tort Litigation System

PubMed Central

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-01-01

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability. PMID:24999124

Investigating Coherence among Turkish Elementary Science Teachers' Teaching Belief Systems, Pedagogical Content Knowledge and Practice

ERIC Educational Resources Information Center

Bahcivan, Eralp; Cobern, William W.

2016-01-01

This study investigated comprehensive science teaching belief systems and their relation to science teachers' pedagogical content knowledge and teaching practices. Rokeach's (1968) belief system was used as a framework for representing the hierarchy among in-service teachers' teaching beliefs. This study employed a multiple case study design with…

OMC Compressor Case

NASA Technical Reports Server (NTRS)

Humphrey, W. Donald

1997-01-01

This report summarizes efforts expended in the development of an all-composite compressor case. Two pre-production units have been built, one utilizing V-CAP and one utilizing AFR-700B resin systems. Both units have been rig tested at elevated temperatures well above design limit loads. This report discusses the manufacturing processes, test results, and Finite Element Analysis performed. The V-CAP unit was funded by NASA-Lewis Research Center in 1994 under contract number NAS3- 27442 for Development of an All-Composite OMC Compressor Case. This contract was followed by an Air Force study in 1996 to build and identical unit using the AFR-700B resin system in place of the V-CAP system. The second compressor case was funded under U.S. Air Force contract F33615-93-D-5326, Advanced Materials for Aerospace Structures Special Studies (AMAS3), Delivery Order 0021 entitled "Advanced Polymeric Composite Materials and Structures Technology for Advanced High Temperature Gas Turbine Engines.' Initial studies using the V-CAP resin system were undertaken in 1993 under a NASA Lewis contract (NAS3-26829). A first prototype unit was developed in a joint program between Textron-Lycoming (now Allied Signal) and Brunswick (now Lincoln Composites). This unit included composite end closures using low density, high temperature molded end closures. The units was similar in size and shape to a titanium case currently used on the PT-21 0 engine and was funded as part of the integrated High Performance Turbine Engine Technology (EHPTET) initiative of DOD and NASA.

Methodology on Investigating the Influences of Automated Material Handling System in Automotive Assembly Process

NASA Astrophysics Data System (ADS)

Saffar, Seha; Azni Jafar, Fairul; Jamaludin, Zamberi

2016-02-01

A case study was selected as a method to collect data in actual industry situation. The study aimed to assess the influences of automated material handling system in automotive industry by proposing a new design of integration system through simulation, and analyze the significant effect and influence of the system. The method approach tool will be CAD Software (Delmia & Quest). The process of preliminary data gathering in phase 1 will collect all data related from actual industry situation. It is expected to produce a guideline and limitation in designing a new integration system later. In phase 2, an idea or concept of design will be done by using 10 principles of design consideration for manufacturing. A full factorial design will be used as design of experiment in order to analyze the performance measured of the integration system with the current system in case study. From the result of the experiment, an ANOVA analysis will be done to study the performance measured. Thus, it is expected that influences can be seen from the improvement made in the system.

Innovation in Distance Education Learning Systems: The Case of the National Correspondence Institute of Tanzania, 1972-2002

ERIC Educational Resources Information Center

Mutanyatta, J. N. S.

2008-01-01

The paper attempts to provide relevant data on the achievements, albeit quantitatively, of the National Correspondence Institute of Tanzania over the past 30 years as a case study in distance education innovation. The case-study data reveal reasons for the near collapse of the distance education programme during the 1990s, and the renewed policy…

Improving Child Maltreatment Detection Systems: A Large-Scale Case Study Involving Health, Social Services, and School Professionals

ERIC Educational Resources Information Center

Cerezo, M.A.; Pons-Salvador, G.

2004-01-01

Objectives:: The purpose of this 5-year study was to improve detection in two consecutive phases: (a) To close the gap between the number of identified cases and the actual number of cases of child abuse by increasing detection; and (b) To increase the possibility of a broader spectrum of detection. Method:: The Balearic Islands (one of the…

Energy Sources and Systems Analysis: 40 South Lincoln Redevelopment District (Short Report)

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

Not Available

2011-08-01

This report presents the a brief overview of the results of a case study to analyze district energy systems for their potential use in a project that involves redeveloping 270 units of existing public housing, along with other nearby sites. When complete, the redevelopment project will encompass more than 900 mixed-income residential units, commercial and retail properties, and open space. The analysis estimated the hourly heating, cooling, domestic hot water, and electric loads required by the community; investigated potential district system technologies to meet those needs; and researched available fuel sources to power such systems. A full report of thismore » case study is also available.« less

Radial Basis Function Neural Network Application to Power System Restoration Studies

PubMed Central

Sadeghkhani, Iman; Ketabi, Abbas; Feuillet, Rene

2012-01-01

One of the most important issues in power system restoration is overvoltages caused by transformer switching. These overvoltages might damage some equipment and delay power system restoration. This paper presents a radial basis function neural network (RBFNN) to study transformer switching overvoltages. To achieve good generalization capability for developed RBFNN, equivalent parameters of the network are added to RBFNN inputs. The developed RBFNN is trained with the worst-case scenario of switching angle and remanent flux and tested for typical cases. The simulated results for a partial of 39-bus New England test system show that the proposed technique can estimate the peak values and duration of switching overvoltages with good accuracy. PMID:22792093

Developing a health information network within an integrated delivery system: a case study.

PubMed

Wager, K A; Heda, S; Austin, C J

1997-05-01

Changes in the health care environment, such as the growth of integrated delivery systems and the proliferation of managed care, are having a profound impact on the way in which health care organizations manage both clinical and financial information. Health information networks (HINs) are emerging to support the goals and internal needs of integrated delivery systems. In this environment, health care managers must assume a leadership role in planning for the development of HINs. The article provides an overview of the principal issues that should be addressed in an organization's information systems plan when a HIN is being developed and includes a case study that illustrates the key points discussed.

Study on the Enhanced Operation of Self-Ventilation-Based Coupling System for Domestic Wastewater Treatment

NASA Astrophysics Data System (ADS)

Kong, Lingwei; Wang, Lu; Zhang, Yi; Mei, Rongwu; Zhang, Yu

2018-06-01

In this study, a new coupling system of biological filter bed and subsurface-flow constructed wetland based on the self-ventilation network was proposed, and the comparative pollutant removal efficiency at low and high influent concentration of the pilot coupling system with different substrates configurations were investigated. The study found that: The comparison system (b) had better removal rates than that of the original system (a), and the removal rate when treating low influent concentration was 74.10%, 94.14%, 73.57% and 69.53%, while in high influent concentration case was 81.30%, 90.28%, 88.57% and 75.36% for CODCr , NH4+ -N, TN and TP, respectively. The removal of the above main water indexes of the comparison system (b) promoted by 11.00%, 11.55%, 2.69% and 8.09% respectively in low influent concentration case and 4.20%, 9.20%, 7.66% and 13.61% respectively in high influent concentration case when comparing to the original system (a), which showed that the optimized configuration of various kinds of substrates was significant and was more beneficial to the degradation and removal of pollutants. The adsorption and interception function of substrates in the constructed wetland was the main way of phosphorus removal. The function of self-ventilation ensured the amount of DO in the coupling system, making the phosphorus removal was less affected comparing to structure of traditional wetland.

[Agricultural policies and farming systems: A case study of landscape changes in Shizuitou Village in the recent four decades].

PubMed

Wang, Xiao-jun; Zhou, Yang; Yan, Yan-bin; Li, Lei

2015-01-01

Agricultural policy in China's rural heartland is driving profound changes to traditional farming systems. A case study covering four decades mapped and recorded farming patterns and processes in Shizuitou Village, a rural village in northwest Shanxi. An integrated geospatial methodology from geography and anthropology was employed in the case study to record the changing dynamics of farming systems in Shizuitou Village to discover the long-term impacts of China's agricultural policies on village farming systems. Positive and negative impacts of agricultural policies on village farming systems were mapped, inventoried and evaluated using Participatory Geographic Information Systems (PGIS). The results revealed traditional polycultures are being gradually replaced by industrialized monocultures. The driving forces behind these farming changes come from a series of government agricultural policies aiming at modernization of farming systems in China. The goal of these policies was to spur rapid development of industrial agriculture under the guise of modernization but is leading to the decay of traditional farming systems in the village that maintained local food security with healthy land for hundreds of years. The paper concluded with a recommendation that in future, agricultural policy makers should strike a more reasonable balance between short-term agricultural profits and long-term farming sustainability based on the principles of ecological sustainable development under the context of global changes.

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2014 CFR

2014-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2012 CFR

2012-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

22 CFR 96.48 - Preparation and training of prospective adoptive parent(s) in incoming cases.

Code of Federal Regulations, 2013 CFR

2013-04-01

... least ten hours (independent of the home study) of preparation and training, as described in paragraphs... cases where training cannot otherwise be provided, an extended home study process, with a system for..., and any other training or counseling needed in light of the child background study or the home study...

[A new methodological approach for leptospira persistence studies in case of mixed leptospirosis].

PubMed

Samsonova, A P; Petrov, E M; Vyshivkina, N V; Anan'ina, Iu V

2003-01-01

A new methodical approach for Leptospira persistence studies in case of mixed leptospirosis, based on the use of PCR test systems with different taxonomic specificity for the indication and identification of leptospires, was developed. Two PCR test systems (G and B) were used in experiments on BALB/c white mice to study patterns of the development of mixed infection caused by leptospires of serovar poi (genomospecies L. borgpeterseni) and grippotyphosa (genomospecies L. kirschneri). The conclusion was made of good prospects of this method application in studies on symbiotic relationships of leptospires both in vivo and in vitro.

How to reduce your inventory: a real world case study.

PubMed

Mack, J A; Jordan, H H

1994-08-01

This case study describes the use of a performance analysis system at the Safety Products Division of Mine Safety Appliances Company, which contributed to the reduction of excess inventories by more than $8,000,000 during the first two years of implementation.

Performance Support Case Studies from IBM.

ERIC Educational Resources Information Center

Duke-Moran, Celia; Swope, Ginger; Morariu, Janis; deKam, Peter

1999-01-01

Presents two case studies that show how IBM addressed performance support solutions and electronic learning. The first developed a performance support and expert coaching solution; the second applied performance support to reducing implementation time and total cost of ownership of enterprise resource planning systems. (Author/LRW)

A Usability Case Study Using TREC and ZPRISE.

ERIC Educational Resources Information Center

Downey, Laura L.; Tice, Dawn M.

1999-01-01

Examines the challenges involved in conducting an informal usability case study based on the introduction of a new information-retrieval system to experienced users. Identifies problems users were having with TREC (Text Retrieval Conference) and examines the usability of the new ZPRISE interface. (Author/LRW)

The -765G>C polymorphism in the cyclooxygenase-2 gene and digestive system cancer: a meta-analysis.

PubMed

Zhao, Fen; Cao, Yue; Zhu, Hong; Huang, Min; Yi, Cheng; Huang, Ying

2014-01-01

Published data regarding associations between the -765G>C polymorphism in cyclooxygenase-2 (COX-2) gene and digestive system cancer risk have been inconclusive. The aim of this study was to comprehensively evaluate the genetic risk of the -765G>C polymorphism in the COX-2 gene for digestive system cancer. A search was performed in Pubmed, Medline (Ovid), Embase, CNKI, Weipu, Wanfang and CBM databases, covering all studies until Feb 10, 2014. Statistical analysis was performed using Revman5.2. A total of 10,814 cases and 16,174 controls in 38 case-control studies were included in this meta-analysis. The results indicated that C allele carriers (GC+CC) had a 20% increased risk of digestive system cancer when compared with the homozygote GG (odds ratio (OR)=1.20, 95% confidence interval (CI), 1.00-1.44 for GC+CC vs GG). In the subgroup analysis by ethnicity, significant elevated risks were associated with C allele carriers (GC+CC) in Asians (OR = 1.46, 95% CI=1.07-2.01, and p=0.02) and Africans (OR=2.12, 95% CI=1.57-2.87, and p< 0.00001), but not among Caucasians, Americans and mixed groups. For subgroup analysis by cancer type (GC+CC vs GG), significant associations were found between the -765G>C polymorphism and higher risk for gastric cancer (OR=1.64, 95% CI=1.03-2.61, and p=0.04), but not for colorectal cancer, oral cancer, esophageal cancer, and others. Regarding study design (GC+CC vs GG), no significant associations were found in then population-based case-control (PCC), hospital-based case-control (HCC) and family-based case-control (FCC) studies. This meta-analysis suggested that the -765G>C polymorphism of the COX-2 gene is a potential risk factor for digestive system cancer in Asians and Africans and gastric cancer overall.

Do case-mix adjusted nursing home reimbursements actually reflect costs? Minnesota's experience.

PubMed

Nyman, J A; Connor, R A

1994-07-01

Some states have adopted Medicaid reimbursement systems that pay nursing homes according to patient type. These case-mix adjusted reimbursements are intended in part to eliminate the incentive in prospective systems to exclude less profitable patients. This study estimates the marginal costs of different patient types under Minnesota's case-mix system and compares them to their corresponding reimbursements. We find that estimated costs do not match reimbursement rates, again making some patient types less profitable than others. Further, in confirmation of our estimates, we find that the percentage change in patient days between 1986 and 1990 is explained by our profitability estimates.

Coding Response to a Case-Mix Measurement System Based on Multiple Diagnoses

PubMed Central

Preyra, Colin

2004-01-01

Objective To examine the hospital coding response to a payment model using a case-mix measurement system based on multiple diagnoses and the resulting impact on a hospital cost model. Data Sources Financial, clinical, and supplementary data for all Ontario short stay hospitals from years 1997 to 2002. Study Design Disaggregated trends in hospital case-mix growth are examined for five years following the adoption of an inpatient classification system making extensive use of combinations of secondary diagnoses. Hospital case mix is decomposed into base and complexity components. The longitudinal effects of coding variation on a standard hospital payment model are examined in terms of payment accuracy and impact on adjustment factors. Principal Findings Introduction of the refined case-mix system provided incentives for hospitals to increase reporting of secondary diagnoses and resulted in growth in highest complexity cases that were not matched by increased resource use over time. Despite a pronounced coding response on the part of hospitals, the increase in measured complexity and case mix did not reduce the unexplained variation in hospital unit cost nor did it reduce the reliance on the teaching adjustment factor, a potential proxy for case mix. The main implication was changes in the size and distribution of predicted hospital operating costs. Conclusions Jurisdictions introducing extensive refinements to standard diagnostic related group (DRG)-type payment systems should consider the effects of induced changes to hospital coding practices. Assessing model performance should include analysis of the robustness of classification systems to hospital-level variation in coding practices. Unanticipated coding effects imply that case-mix models hypothesized to perform well ex ante may not meet expectations ex post. PMID:15230940

How can crop intra-specific biodiversity mitigate the vulnerability of agricultural systems to climate change? A case study on durum wheat in Southern Italy

NASA Astrophysics Data System (ADS)

Monaco, Eugenia; Alfieri, Silvia Maria; Basile, Angelo; Menenti, Massimo; Bonfante, Antonello; De Lorenzi, Fracesca

2014-05-01

Climate evolution may lead to changes in the amount and distribution of precipitations and to reduced water availability, with constraints on the cultivation of some crops. Recently, foreseen crop responses to climate change raise a crucial question for the agricultural stakeholders: are the current production systems resilient to this change? An active debate is in progress about the definition of adaptation of agricultural systems, particularly about the integrated assessment of climate stressors, vulnerability and resilece towards the evaluation of climate impact on agricultural systems. Climate change represents a risk for rain-fed agricultural systems, where irrigations cannot compensate reductions in precipitations. The intra-specific biodiversity of crops can be a resource towards adaptation. The knowledge of the responses to environmental conditions (temperature and water availability) of different cultivars can allow to identify options for adaptation to future climate. Simulation models of water flow in the soil-plant-atmosphere system, driven by different climate scenarios, can describe present and foreseen soil water regime. The present work deals with a case-study on the adaptive capacity of durum wheat to climate change. The selected study area is a hilly region in Southern Italy (Fortore Beneventano, Campania Region). Two climate cases were studied: "reference" (1961-1990) and "future" (2021-2050). A mechanistic model of water flow in the soil-plant-atmosphere system (SWAP) was run to determine the water regime in some soil units, representative of the soil variability in the study area. From model output, the Relative Evapotranspiration Deficit (RETD) was determined as an indicator of hydrological conditions during the crop growing period for each year and climate case; and periods with higher frequencies of soil water deficits were identified. The timing of main crop development stages was calculated. The occurrence of water deficit at different development stages was thus assessed. Moreover, the yield response functions to water availability of several durum wheat cultivars were determined; cultivars' hydrologic requirements were thus defined and compared with the simulated values of RETD. The latter was evaluated against requirements for each soil unit, cultivar and year in both climate cases to assess adaptability. In the future climate scenario a significant reduction (about 80 mm) of rainfall is foreseen. The analyses of inter- and intra-annual courses of the indicator (RETD) showed higher RETD in one soil unit, which resulted less suitable for durum wheat cultivation. According to the soils' water regime and to the cultivar-specific yield responses, the adaptability of durum wheat cultivars was assessed. The difference between the two climate cases was significant; the adaptability of the cultivars was strongly influenced by the different rainfall regime and by the soil physical properties, which strongly affected the soil water balance. The case study showed how in the future climate case, for rainfed durum wheat, the intra-specific variability will allow to maintain the current crop production system. The work was carried out within the Italian national project AGROSCENARI funded by the Ministry for Agricultural, Food and Forest Policies (MIPAAF, D.M. 8608/7303/2008)

Rapid Detection of Mycobacterium tuberculosis and Rifampin Resistance by Use of On-Demand, Near-Patient Technology▿ † ‡

PubMed Central

Helb, Danica; Jones, Martin; Story, Elizabeth; Boehme, Catharina; Wallace, Ellen; Ho, Ken; Kop, JoAnn; Owens, Michelle R.; Rodgers, Richard; Banada, Padmapriya; Safi, Hassan; Blakemore, Robert; Lan, N. T. Ngoc; Jones-López, Edward C.; Levi, Michael; Burday, Michele; Ayakaka, Irene; Mugerwa, Roy D.; McMillan, Bill; Winn-Deen, Emily; Christel, Lee; Dailey, Peter; Perkins, Mark D.; Persing, David H.; Alland, David

2010-01-01

Current nucleic acid amplification methods to detect Mycobacterium tuberculosis are complex, labor-intensive, and technically challenging. We developed and performed the first analysis of the Cepheid Gene Xpert System's MTB/RIF assay, an integrated hands-free sputum-processing and real-time PCR system with rapid on-demand, near-patient technology, to simultaneously detect M. tuberculosis and rifampin resistance. Analytic tests of M. tuberculosis DNA demonstrated a limit of detection (LOD) of 4.5 genomes per reaction. Studies using sputum spiked with known numbers of M. tuberculosis CFU predicted a clinical LOD of 131 CFU/ml. Killing studies showed that the assay's buffer decreased M. tuberculosis viability by at least 8 logs, substantially reducing biohazards. Tests of 23 different commonly occurring rifampin resistance mutations demonstrated that all 23 (100%) would be identified as rifampin resistant. An analysis of 20 nontuberculosis mycobacteria species confirmed high assay specificity. A small clinical validation study of 107 clinical sputum samples from suspected tuberculosis cases in Vietnam detected 29/29 (100%) smear-positive culture-positive cases and 33/39 (84.6%) or 38/53 (71.7%) smear-negative culture-positive cases, as determined by growth on solid medium or on both solid and liquid media, respectively. M. tuberculosis was not detected in 25/25 (100%) of the culture-negative samples. A study of 64 smear-positive culture-positive sputa from retreatment tuberculosis cases in Uganda detected 63/64 (98.4%) culture-positive cases and 9/9 (100%) cases of rifampin resistance. Rifampin resistance was excluded in 54/55 (98.2%) susceptible cases. Specificity rose to 100% after correcting for a conventional susceptibility test error. In conclusion, this highly sensitive and simple-to-use system can detect M. tuberculosis directly from sputum in less than 2 h. PMID:19864480

Toward a Conceptual Synthesis and Ecological Approach to Case Studies of Curricular Innovation Implementation and University Restructuring in Russian HE

ERIC Educational Resources Information Center

Savelyeva, Tamara

2013-01-01

This study addresses the methodological and conceptual challenges associated with the application of disconnected frameworks of organizational theory and case studies, focused on "efficiency, effectiveness, and economy" to investigate complex educational phenomena in post-Soviet higher education systems under the condition of…

Case Studies in Educational Change: An International Perspective.

ERIC Educational Resources Information Center

Carter, David S. G., Ed.; O'Neill, Marnie H., Ed.

This book is the second in a two-volume series of studies of educational change organized around three themes--systemic change, the transformation of policy into practice, and curriculum contexts. The book presents case studies from Australia, Great Britain, Israel, the United States, and New Zealand to illustrate the cross-cultural complexity of…

The Adoption of Systems Innovations in Educational Organizations: A Case Study of Operation Guidance.

ERIC Educational Resources Information Center

Kester, Ralph J.; Howard, John, Jr.

To identify factors which affect the acceptance of innovation in school organizations, a career development product entitled Operation Guidance (OG) was the object of a case study. Five basic organizational characteristics were used to roughly quantify attributes of the organization of the six schools studied. The characteristics were:…

Curriculum Change and Self-Governing Agreements: A Yukon First Nation Case Study

ERIC Educational Resources Information Center

Lewthwaite, Brian Ellis; Owen, Thomas; Doiron, Ashley

2015-01-01

Recent developments in Canada's Yukon Territory draw attention to how political changes have potential for accelerating practices in education that are responsive to Indigenous Peoples' cultural knowledge systems and practices. In this study, through the use of case study methodology, an account of the changes that have occurred in one First…

A Case Study of Technical Assistance to Demonstration Programs for Young Handicapped Children. Part I.

ERIC Educational Resources Information Center

Behr, Shirley K.; And Others

The interim report presents an evaluation of TADS (Technical Assistance Development System) through case studies of TADS technical assistance to the staffs of two demonstration programs for preschool handicapped children and their families. Purposes of the study included obtaining indepth descriptions of the technical assistance process to…

The business case for connectivity

NASA Technical Reports Server (NTRS)

Adams, Dennis; Hirschheim, Rudy

1991-01-01

Information systems that provide competitive advantages to organizations can be broadly classified into those that improve the effectiveness of a business function and those that improve the reach of information in the organization. The latter, organizational connectivity systems, can be categorized as intraorganizational and interorganizational systems. Intraorganization systems provide connectivity to function areas within the business, while interorganizational systems support the exchange of business data between independent business units. These system are not confined to a single entity but span organizational boundaries which can be national or international in scope. A series of case studies was undertaken in an effort to better understand the issues and problems associated with providing an increased flow of information within and outside of an organization. Ten issues emerged from this study. In summary, it is necessary for firms to first consider how effective their internal communications systems are before launching projects that tie the organization to external systems.

Advanced information processing system: Fault injection study and results

NASA Technical Reports Server (NTRS)

Burkhardt, Laura F.; Masotto, Thomas K.; Lala, Jaynarayan H.

1992-01-01

The objective of the AIPS program is to achieve a validated fault tolerant distributed computer system. The goals of the AIPS fault injection study were: (1) to present the fault injection study components addressing the AIPS validation objective; (2) to obtain feedback for fault removal from the design implementation; (3) to obtain statistical data regarding fault detection, isolation, and reconfiguration responses; and (4) to obtain data regarding the effects of faults on system performance. The parameters are described that must be varied to create a comprehensive set of fault injection tests, the subset of test cases selected, the test case measurements, and the test case execution. Both pin level hardware faults using a hardware fault injector and software injected memory mutations were used to test the system. An overview is provided of the hardware fault injector and the associated software used to carry out the experiments. Detailed specifications are given of fault and test results for the I/O Network and the AIPS Fault Tolerant Processor, respectively. The results are summarized and conclusions are given.

Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study.

PubMed

Murnaghan, D; Morrison, W; Griffith, E J; Bell, B L; Duffley, L A; McGarry, K; Manske, S

2013-09-01

The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to generate and enhance the use of evidence in policy development, program planning and evaluation to improve youth health and chronic disease prevention. We applied a case study design to explore the lessons learned, that is, key conditions or processes contributing to the development of knowledge exchange capacity, using a multi-data collection method to gain an in-depth understanding. Data management, synthesis and analysis activities were concurrent, iterative and ongoing. The lessons learned were organized into seven "clusters." Key findings demonstrated that knowledge exchange is a complex process requiring champions, collaborative partnerships, regional readiness and the adaptation of knowledge exchange to diverse stakeholders. Overall, knowledge exchange systems can increase the capacity to exchange and use evidence by moving beyond collecting and reporting data. Areas of influence included development of new partnerships, expanded knowledge-sharing activities, and refinement of policy and practice approaches related to youth health and chronic disease prevention.

Appendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard

2012-02-01

As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005 in Poland but to 12,304 in France. Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.

Drug exposed infants in the social welfare system and juvenile court.

PubMed

Sagatun-Edwards, I J; Saylor, C; Shifflett, B

1995-01-01

The purpose of this research was to study how drug exposed infants were processed, following a positive toxicology screen, through the Social Services and Juvenile Court system and to construct a demographic profile of these cases. Using data (N = 284) from Social Services and Juvenile Court files in one large county this paper describes the socioeconomic profile of cases in the Social Services and Court system over an 18-month period and tracks the progress of these cases through their reviews and hearings. The data show an overrepresentation of African American and Hispanic cases compared to the relevant county population and an underrepresentation of Caucasian and Asian cases. A petition to Juvenile Court was filed in almost half of the initial cases. Among the children who were made dependents of the court, about 80% were removed from the mother and placed in reunification services. Of these one third were later returned to the family while the rest went to permanency placements outside the home.

Development of a computer-aided detection system for lung cancer diagnosis

NASA Astrophysics Data System (ADS)

Suzuki, Hideo; Inaoka, Noriko; Takabatake, Hirotsugu; Mori, Masaki; Sasaoka, Soichi; Natori, Hiroshi; Suzuki, Akira

1992-06-01

This paper describes a modified system for automatic detection of lung nodules by means of chest x ray image processing techniques. The objective of the system is to help radiologists to improve their accuracy in cancer detection. It is known from retrospective studies of chest x- ray images that radiologists fail to detect about 30 percent of lung cancer cases. A computerized method for detecting lung nodules would be very useful for decreasing the proportion of such oversights. Our proposed system consists of five sub-systems, for image input, lung region determination, nodule detection, rule-based false-positive elimination, and statistical false-positive elimination. In an experiment with the modified system, using 30 lung cancer cases and 78 normal control cases, we obtained figures of 73.3 percent and 89.7 percent for the sensitivity and specificity of the system, respectively. The system has been developed to run on the IBM* PS/55* and IBM RISC System/6000* (RS/6000), and we give the processing time for each platform.

Understanding Whole Systems Change in Health Care: Insights into System Level Diffusion from Nursing Service Delivery Innovations--A Multiple Case Study

ERIC Educational Resources Information Center

Berta, Whitney; Virani, Tazim; Bajnok, Irmajean; Edwards, Nancy; Rowan, Margo

2014-01-01

Our study responds to calls for theory-driven approaches to studying innovation diffusion processes in health care. While most research on diffusion in health care is situated at the service delivery level, we study innovations and associated processes that have diffused to the system level, and refer to work on complex adaptive systems and whole…

Using intensive case management to reduce violence by mentally ill persons in the community.

PubMed

Dvoskin, J A; Steadman, H J

1994-07-01

Aggressive and intensive case management and a comprehensive array of community support services are the keys to reducing the risk of violence by people with serious mental illness in the community. The authors describe the elements of intensive case management for potentially violent clients, including use of individual case managers responsible for small caseloads, 24-hour availability of case managers, and strong linkages to agencies providing mental health services, substance abuse treatment, and social services as well as to the criminal justice system. They summarize the results of three recent studies of intensive case management programs suggesting that this intervention is effective in reducing clients' dangerousness in the community. They discuss cultural and human resource issues that affect planning of intensive case management services. Intensive case managers need to be "boundary spanners" with the training, experience, and personality to bridge the often-broad gap between human service and criminal justice systems.

New York State Canal System : modern freight-way.

DOT National Transportation Integrated Search

2010-05-01

This study demonstrates the benefits of waterborne freight logistics and makes the case for instituting container-onbarge : service on the New York State Canal System. : We summarize numerous studies comparing the energy requirements and environmenta...

ED-WAVE tool design approach: Case of a textile wastewater treatment plant in Blantyre, Malawi

NASA Astrophysics Data System (ADS)

Chipofya, V.; Kraslawski, A.; Avramenko, Y.

The ED-WAVE tool is a PC based package for imparting training on wastewater treatment technologies. The system consists of four modules viz. Reference Library, Process Builder, Case Study Manager, and Treatment Adviser. The principles of case-based design and case-based reasoning as applied in the ED-WAVE tool are utilised in this paper to evaluate the design approach of the wastewater treatment plant at Mapeto David Whitehead & Sons (MDW&S) textile and garments factory, Blantyre, Malawi. The case being compared with MDW&S in the ED-WAVE tool is Textile Case 4 in Sri Lanka (2003). Equalisation, coagulation and rotating biological contactors is the sequencing of treatment units at Textile Case 4 in Sri Lanka. Screening, oxidation ditches and sedimentation is the sequencing of treatment units at MDW&S textile and garments factory. The study suggests that aerobic biological treatment is necessary in the treatment of wastewater from a textile and garments factory. MDW&S incorporates a sedimentation process which is necessary for the removal of settleable matter before the effluent is discharged to the municipal wastewater treatment plant. The study confirmed the practical use of the ED-WAVE tool in the design of wastewater treatment systems, where after encountering a new situation; already collected decision scenarios (cases) are invoked and modified in order to arrive at a particular design alternative. What is necessary, however, is to appropriately modify the case arrived at through the Case Study Manager in order to come up with a design appropriate to the local situation taking into account technical, socio-economic and environmental aspects.

Renin angiotensin aldosterone system altered in resistant hypertension in Sub-Saharan African diabetes patients without evidence of primary hyperaldosteronism.

PubMed

Edinga-Melenge, Bertille Elodie; Ama Moor, Vicky J; Nansseu, Jobert Richie N; Nguetse Djoumessi, Romance; Mengnjo, Michel K; Katte, Jean-Claude; Noubiap, Jean Jacques N; Sobngwi, Eugene

2017-01-01

The renin-angiotensin-aldosterone system may be altered in patients with resistant hypertension. This study aimed to evaluate the relation between renin-angiotensin-aldosterone system activity and resistant hypertension in Cameroonian diabetes patients with resistant hypertension. We carried out a case-control study including 19 diabetes patients with resistant hypertension and 19 diabetes patients with controlled hypertension matched to cases according to age, sex and duration of hypertension since diagnosis. After collection of data, fasting blood was collected for measurement of sodium, potassium, chloride, active renin and plasma aldosterone of which the aldosterone-renin ratio was derived to assess the activity of renin-angiotensin-aldosterone system. Then, each participant received 2000 ml infusion of saline solution after which plasma aldosterone was re-assayed. Potassium levels were lower among cases compared to controls (mean: (4.10 ± 0.63 mmol/l vs. 4.47 ± 0.58 mmol/l), though nonsignificant (p = 0.065). Active renin, plasma aldosterone both before and after the dynamic test and aldosterone-renin ratio were comparable between cases and controls (all p values > 0.05). Plasma aldosterone significantly decreased after the dynamic test in both groups (p < 0.001), but no participant exhibited a post-test value>280 pmol/l. We found a significant negative correlation between potassium ion and plasma aldosterone (ρ = -0.324; p  = 0.047), the other correlations being weak and unsignificant. Although this study failed to show an association between RH and primary hyperaldosteronism in our context, there was a hyperactivity of renin-angiotensin-aldosterone system. Moreover, this study confirms the importance of potassium dosage when screening the renin-angiotensin-aldosterone system.

The role of smart traffic centers in regional system operations : a Hampton Roads case study.

DOT National Transportation Integrated Search

2005-01-01

The objectives of this study were to define the role of smart traffic centers (STCs) in regional systems operations and to help identify performance measures for monitoring the performance of STCs in the scope of regional systems operations. Without ...

ICM: Bridging the Capability Gap between 1 January 2019 and the Replacement Munition

DTIC Science & Technology

2017-06-09

fires. This qualitative case study focused on the ICM capability gap and potential solutions for the U.S. Field Artillery cannon and rocket systems... one of those countries, the United States could find itself committed in their defense. This case study will be used to provide insight to the...context of the potential ramifications of the 2008 DoD Policy on Cluster Munitions and Unintended Harm to Civilians, a case study on Russian military

Analysis of Mission Effectiveness: Modern System Architecture Tools for Project Developers

DTIC Science & Technology

2017-12-01

operator input and scripted instructions to describe low-level flow. Note that the case study in Chapter IV describes one pass through evaluation...capability of the sensors. A constraint on the case study is that each sensor type must cover the entire operations area. Cost is a function of 53...completed. 5. Assessment This case study focuses on the first recursive refinement phase completed in a multi-phase effort to demonstrate the effects

Description of two waterborne disease outbreaks in France: a comparative study with data from cohort studies and from health administrative databases.

PubMed

Mouly, D; Van Cauteren, D; Vincent, N; Vaissiere, E; Beaudeau, P; Ducrot, C; Gallay, A

2016-02-01

Waterborne disease outbreaks (WBDO) of acute gastrointestinal illness (AGI) are a public health concern in France. Their occurrence is probably underestimated due to the lack of a specific surveillance system. The French health insurance database provides an interesting opportunity to improve the detection of these events. A specific algorithm to identify AGI cases from drug payment reimbursement data in the health insurance database has been previously developed. The purpose of our comparative study was to retrospectively assess the ability of the health insurance data to describe WBDO. Data from the health insurance database was compared with the data from cohort studies conducted in two WBDO in 2010 and 2012. The temporal distribution of cases, the day of the peak and the duration of the epidemic, as measured using the health insurance data, were similar to the data from one of the two cohort studies. However, health insurance data accounted for 54 cases compared to the estimated 252 cases accounted for in the cohort study. The accuracy of using health insurance data to describe WBDO depends on the medical consultation rate in the impacted population. As this is never the case, data analysis underestimates the total number of AGI cases. However this data source can be considered for the development of a detection system of a WBDO in France, given its ability to describe an epidemic signal.

Audit and internal quality control in immunohistochemistry

PubMed Central

Maxwell, P; McCluggage, W

2000-01-01

Aims—Although positive and negative controls are performed and checked in surgical pathology cases undergoing immunohistochemistry, internal quality control procedures for immunohistochemistry are not well described. This study, comprising a retrospective audit, aims to describe a method of internal quality control for immunohistochemistry. A scoring system that allows comparison between cases is described. Methods—Two positive tissue controls for each month over a three year period (1996–1998) of the 10 antibodies used most frequently were evaluated. All test cases undergoing immunohistochemistry in the months of April in this three year period were also studied. When the test case was completely negative for a given antibody, the corresponding positive tissue control from that day was examined. A marking system was devised whereby each immunohistochemical slide was assessed out of a possible score of 8 to take account of staining intensity, uniformity, specificity, background, and counterstaining. Using this scoring system, cases were classified as showing optimal (7–8), borderline (5–6), or unacceptable (0–4) staining. Results—Most positive tissue controls showed either optimal or borderline staining with the exception of neurone specific enolase (NSE), where most slides were unacceptable or borderline as a result of a combination of low intensity, poor specificity, and excessive background staining. All test cases showed either optimal or borderline staining with the exception of a single case stained for NSE, which was unacceptable. Conclusions—This retrospective audit shows that immunohistochemically stained slides can be assessed using this scoring system. With most antibodies, acceptable staining was achieved in most cases. However, there were problems with staining for NSE, which needs to be reviewed. Laboratories should use a system such as this to evaluate which antibodies regularly result in poor staining so that they can be excluded from panels. Routine evaluation of immunohistochemical staining should become part of everyday internal quality control procedures. Key Words: immunohistochemistry • audit • internal quality control PMID:11265178

Evaluation of the acute flaccid paralysis (AFP) surveillance system, Gokwe North district, Zimbabwe, 2015: a descriptive cross sectional study.

PubMed

Makoni, Annamercy; Chemhuru, Milton; Gombe, Notion; Shambira, Gerald; Juru, Tsitsi; Bangure, Donewell; Tshimanga, Mufuta

2017-01-01

AFP surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Gokwe North district with an estimated 119 655 children <15 years detected 2 cases, 4 cases and 1 case of AFP in 2012, 2013 and 2014 respectively against a target of 5 cases per year. We therefore set out to evaluate the system and find out why it was failing to detect at least 5 cases per year. A descriptive cross sectional study was carried out. All three hospitals in the district were purposively selected. Twelve of the nineteen health facilities were randomly selected and forty nine health workers were purposively recruited. An interviewer administered questionnaire and key informant interview guide were used to collect data. Quantitative data was analysed using Epi info. Out of the 49 respondents, 17(34.7%) knew the target age group for AFP surveillance. Twelve (24.5%) knew the number of notification forms to be filled. Seven (14.3%) and ten (20.4%) respondents knew when to follow up an AFP case and when an AFP case should be followed up and completely notified and investigated respectively. Forty one (83.7%) respondents were not trained on AFP surveillance. Nineteen (39%) had AFP notification forms at the clinic and 33(67%) had displayed AFP case definitions. All the 22 health facilities in the district participate in AFP surveillance; however, all have hard to reach areas. Seventeen (34.7%) reportedly took public health actions based on AFP data. The system was found to be useful, simple, acceptable, timely, unstable, not representative and not sensitive. The system was threatened by lack of health worker knowledge and community active search. Advocacy, communication and social mobilization on AFP surveillance might improve the performance of the system in Gokwe North district.

Effect of prospective reimbursement on nursing home costs.

PubMed

Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

1993-04-01

This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

Impacts of Valuing Resilience on Cost-Optimal PV and Storage Systems for Commercial Buildings

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

Laws, Nicholas D; Anderson, Katherine H; DiOrio, Nicholas A

Decreasing electric grid reliability in the US, along with increasing severe weather events, have greatly increased interest in resilient energy systems. Few studies have included the value of resilience when sizing PV and Battery Energy Storage Systems (BESS), and none have included the cost to island a PV and BESS, grid-connected costs and benefits, and the value of resilience. This work presents a novel method for incorporating the value of resilience provided by a PV and BESS into a techno-economic optimization model. Including the value of resilience in the design of a cost-optimal PV and BESS generally increases the systemmore » capacities, and in some cases makes a system economical where it was not before. For example, for a large hotel in Anaheim, CA no system is economical without resilience valued; however, with a $5317/hr value of resilience a 363 kW and 60 kWh solar and BESS provides a net present value of $50,000. Lastly, we discuss the effect of the 'islandable premium', which must be balanced against the benefits from serving critical loads during outages. Case studies show that the islandable premium can vary widely, which highlights the necessity for case-by-case solutions in a rapidly developing market.« less

The system evaluation for report writing skills of summary by HGA-SVM with Ontology: Medical case study in problem based learning

NASA Astrophysics Data System (ADS)

Yenaeng, Sasikanchana; Saelee, Somkid; Samai, Wirachai

2018-01-01

The system evaluation for report writing skills of summary by Hybrid Genetic Algorithm-Support Vector Machines (HGA-SVM) with Ontology of Medical Case Study in Problem Based Learning (PBL) is a system was developed as a guideline of scoring for the facilitators or medical teacher. The essay answers come from medical student of medical education courses in the nervous system motion and Behavior I and II subject, a third year medical student 20 groups of 9-10 people, the Faculty of Medicine in Prince of Songkla University (PSU). The audit committee have the opinion that the ratings of individual facilitators are inadequate, this system to solve such problems. In this paper proposes a development of the system evaluation for report writing skills of summary by HGA-SVM with Ontology of medical case study in PBL which the mean scores of machine learning score and humans (facilitators) score were not different at the significantly level .05 all 3 essay parts contain problem essay part, hypothesis essay part and learning objective essay part. The result show that, the average score all 3 essay parts that were not significantly different from the rate at the level of significance .05.

Analyzing simulation-based PRA data through traditional and topological clustering: A BWR station blackout case study

DOE PAGES

Maljovec, D.; Liu, S.; Wang, B.; ...

2015-07-14

Here, dynamic probabilistic risk assessment (DPRA) methodologies couple system simulator codes (e.g., RELAP and MELCOR) with simulation controller codes (e.g., RAVEN and ADAPT). Whereas system simulator codes model system dynamics deterministically, simulation controller codes introduce both deterministic (e.g., system control logic and operating procedures) and stochastic (e.g., component failures and parameter uncertainties) elements into the simulation. Typically, a DPRA is performed by sampling values of a set of parameters and simulating the system behavior for that specific set of parameter values. For complex systems, a major challenge in using DPRA methodologies is to analyze the large number of scenarios generated,more » where clustering techniques are typically employed to better organize and interpret the data. In this paper, we focus on the analysis of two nuclear simulation datasets that are part of the risk-informed safety margin characterization (RISMC) boiling water reactor (BWR) station blackout (SBO) case study. We provide the domain experts a software tool that encodes traditional and topological clustering techniques within an interactive analysis and visualization environment, for understanding the structures of such high-dimensional nuclear simulation datasets. We demonstrate through our case study that both types of clustering techniques complement each other for enhanced structural understanding of the data.« less

Using surveillance data to estimate pandemic vaccine effectiveness against laboratory confirmed influenza A(H1N1)2009 infection: two case-control studies, Spain, season 2009-2010

PubMed Central

2011-01-01

Background Physicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study. Methods We conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR)*100. Results We included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected. Conclusion Point estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations. PMID:22129083

A study on the predictability of acute lymphoblastic leukaemia response to treatment using a hybrid oncosimulator.

PubMed

Ouzounoglou, Eleftherios; Kolokotroni, Eleni; Stanulla, Martin; Stamatakos, Georgios S

2018-02-06

Efficient use of Virtual Physiological Human (VPH)-type models for personalized treatment response prediction purposes requires a precise model parameterization. In the case where the available personalized data are not sufficient to fully determine the parameter values, an appropriate prediction task may be followed. This study, a hybrid combination of computational optimization and machine learning methods with an already developed mechanistic model called the acute lymphoblastic leukaemia (ALL) Oncosimulator which simulates ALL progression and treatment response is presented. These methods are used in order for the parameters of the model to be estimated for retrospective cases and to be predicted for prospective ones. The parameter value prediction is based on a regression model trained on retrospective cases. The proposed Hybrid ALL Oncosimulator system has been evaluated when predicting the pre-phase treatment outcome in ALL. This has been correctly achieved for a significant percentage of patient cases tested (approx. 70% of patients). Moreover, the system is capable of denying the classification of cases for which the results are not trustworthy enough. In that case, potentially misleading predictions for a number of patients are avoided, while the classification accuracy for the remaining patient cases further increases. The results obtained are particularly encouraging regarding the soundness of the proposed methodologies and their relevance to the process of achieving clinical applicability of the proposed Hybrid ALL Oncosimulator system and VPH models in general.

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

Lundstrom, Blake; Chakraborty, Sudipta; Lauss, Georg

This paper presents a concise description of state-of-the-art real-time simulation-based testing methods and demonstrates how they can be used independently and/or in combination as an integrated development and validation approach for smart grid DERs and systems. A three-part case study demonstrating the application of this integrated approach at the different stages of development and validation of a system-integrated smart photovoltaic (PV) inverter is also presented. Laboratory testing results and perspectives from two international research laboratories are included in the case study.

Congruence between the courses of the biliary ductal and the hepatic arterial systems.

PubMed

Mlakar, Bostjan; Gadzijev, Eldar M; Ravnik, Dean; Hribernik, Marija

2005-07-01

The development of diagnostic methods and new surgical techniques means it is increasingly important to have accurate knowledge of the anatomy of the hepatic arterial and biliary systems, including their variations, at extrahepatic and intrahepatic levels. The aim of this study was to determine how often the biliary and arterial systems run together and branch in the same pattern. Fifty corrosion casts of the liver were used to analyse the origin and branching patterns of arteries and the confluences of bile ducts. In addition, both systems were analysed to determine the frequency of normal arrangements and variations. The congruence of the course of both systems was analysed at the porta hepatis and in the left and right hemilivers down to the segmental level. A congruent course of the arterial and the biliary systems was identified in 38% of cases at the porta hepatis, in 32% of cases in the left hemiliver and in 30% of the right hemiliver. The congruence of both systems at the porta hepatis and in the left hemiliver was identified only if both systems were normal. In the right hemiliver, however, the congruence of both systems was identified even when both systems were variable, but only in 10% of cases. The results of the study show that, on the basis of knowledge of the course and branching of one system, the other system cannot be predicted.

The necessity of HVAC system for the registered architectural cultural heritage building

NASA Astrophysics Data System (ADS)

Popovici, Cătălin George; Hudişteanu, Sebastian Valeriu; Cherecheş, Nelu-Cristian

2018-02-01

This study is intended to highlight the role of the ventilation and air conditioning system for a theatre. It was chosen as a case study the "Vasile Alecsandri" National Theatre of Jassy. The paper also sought to make a comparison in three distinct scenarios for HVAC Main Hall system - ventilation and air conditioning system of the Main Hall doesn't work; only the ventilation system of the Main Hall works and ventilation and air conditioning system of the Main Hall works. For analysing the comfort parameters, the ANSYS-Fluent software was used to build a 2D model of the building and simulation of HVAC system functionality during winter season, in all three scenarios. For the studied scenarios, the external conditions of Jassy and the indoor conditions of the theatre, when the entire spectacle hall is occupied were considered. The main aspects evaluated for each case were the air temperature, air velocity and relative humidity. The results are presented comparatively as plots and spectra of the interest parameters.

Immunoglobulin derived depositions in the nervous system: novel mass spectrometry application for protein characterization in formalin-fixed tissues.

PubMed

Rodriguez, Fausto J; Gamez, Jeffrey D; Vrana, Julie A; Theis, Jason D; Giannini, Caterina; Scheithauer, Bernd W; Parisi, Joseph E; Lucchinetti, Claudia F; Pendlebury, William W; Bergen, H Robert; Dogan, Ahmet

2008-10-01

Proteinaceous deposits are occasionally encountered in surgically obtained biopsies of the nervous system. Some of these are amyloidomas, although the precise nature of other cases remains uncertain. We studied 13 cases of proteinaceous aggregates in clinical specimens of the nervous system. Proteins contained within laser microdissected areas of interest were identified from tryptic peptide sequences by liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS). Immunohistochemical studies for immunoglobulin heavy and light chains and amyloidogenic proteins were performed in all cases. Histologically, the cases were classified into three groups: 'proteinaceous deposit not otherwise specified' (PDNOS) (n=6), amyloidoma (n=5), or 'intracellular crystals' (n=2). LC-MS/MS demonstrated the presence of lambda, but not kappa, light chain as well as serum amyloid P in all amyloidomas. lambda-Light-chain immunostaining was noted in amyloid (n=5), although demonstrable monotypic lymphoplasmacytic cells were seen in only one case. Conversely, in PDNOS kappa, but not lambda, was evident in five cases, both light chains being present in a single case. In three cases of PDNOS, a low-grade B-cell lymphoma consistent with marginal zone lymphoma was present in the brain specimen (n=2) or spleen (n=1). Lastly, in the 'intracellular crystals' group, the crystals were present within CD68+ macrophages in one case wherein kappa-light chain was found by LC-MS/MS only; the pathology was consistent with crystal-storing histiocytosis. In the second case, the crystals contained immunoglobulin G within CD138+ plasma cells. Our results show that proteinaceous deposits in the nervous system contain immunoglobulin components and LC-MS/MS accurately identifies the content of these deposits in clinical biopsy specimens. LC-MS/MS represents a novel application for characterization of these deposits and is of diagnostic utility in addition to standard immunohistochemical analyses.

Implementing a pilot work injury management program in Hong Kong.

PubMed

Lai, Hon-Sun; Chan, Chetwyn C H

2007-12-01

This paper reports the results of implementing a pilot case management system for work injuries in Hong Kong. The case management approach was characterized by use of a case manager who worked closely with each of the reported injury cases. The case manager undertook the roles of assessor, referral agent, counselor, work-site liaison, and return-to-work (RTW) expert. A quasi-experimental study design was used. The study compared the RTW and workers' compensation outcomes in injured workers in a cleaning company in a case management group (n = 296) and a conventional rehabilitation group (n = 137). Outcomes of the intervention were followed up at 6 months. The results indicated that the RTW rate was 97.0% and 94.2% for the case management and conventional rehabilitation groups respectively, with no significant differences between them. Participants in the case management group had significantly fewer days of sick leave (mean = 27.5 and 41.6 days, respectively) and lower compensation costs (mean = HK$7,212.2 and $20,617.3, respectively) than those in the comparison group. Age of the participants was found to influence the outcomes with those who were between 41 and 50 years old and received case management intervention had shorter sick leave and lower cost of compensation than their conventional rehabilitation counterpart. The majority of the participants who had returned to work in both the case management (95.8%) and the conventional rehabilitation (96.2%) groups were found to maintain their work status 6 months after the intervention. The findings suggested that applying the case management approach to the Hong Kong workers' compensation system was more effective overall. Nevertheless, the inherent problems associated with implementing such an approach within the existing system, which focuses on compensation and medical interventions, remained unresolved.

Cost Analysis of Non-Formal ETV Systems: A Case Study of the "Extra-Scolaire" System in the Ivory Coast.

ERIC Educational Resources Information Center

Klees, Steven J.

Building on previous evaluations of the ETV systems--both formal and informal--of the Ivory Coast, this study examines the system costs of the "Extra Scolaire" (E/S) program for rural adults. Educational television is utilized through the Ivorian primary system, and battery operated televisions have been widely distributed to schools in…

ITS Institutional and Legal Issues Program : Review of the SaFIRES Operational Test

DOT National Transportation Integrated Search

1995-06-30

The SaFIRES operational test was chosen by the FHWA to be the subject of a case study. Several case studies were performed under the Intelligent Transportation Systems ITS Institutional and Legal Issues Program, which was developed in response to the...

A case study : Chart II software upgrade, using a design competition to procure ITS software

DOT National Transportation Integrated Search

2000-03-01

This is one of a series of case studies that examine procurement approaches used to deliver Intelligent Transportation System (ITS) projects. The purpose of these reports is to provide examples of successful strategies that have been used to overcome...

The application of systems thinking concepts, methods, and tools to global health practices: An analysis of case studies.

PubMed

Wilkinson, Jessica; Goff, Morgan; Rusoja, Evan; Hanson, Carl; Swanson, Robert Chad

2018-06-01

This review of systems thinking (ST) case studies seeks to compile and analyse cases from ST literature and provide practitioners with a reference for ST in health practice. Particular attention was given to (1) reviewing the frequency and use of key ST terms, methods, and tools in the context of health, and (2) extracting and analysing longitudinal themes across cases. A systematic search of databases was conducted, and a total of 36 case studies were identified. A combination of integrative and inductive qualitative approaches to analysis was used. Most cases identified took place in high-income countries and applied ST retrospectively. The most commonly used ST terms were agent/stakeholder/actor (n = 29), interdependent/interconnected (n = 28), emergence (n = 26), and adaptability/adaptation (n = 26). Common ST methods and tools were largely underutilized. Social network analysis was the most commonly used method (n = 4), and innovation or change management history was the most frequently used tool (n = 11). Four overarching themes were identified; the importance of the interdependent and interconnected nature of a health system, characteristics of leaders in a complex adaptive system, the benefits of using ST, and barriers to implementing ST. This review revealed that while much has been written about the potential benefits of applying ST to health, it has yet to completely transition from theory to practice. There is however evidence of the practical use of an ST lens as well as specific methods and tools. With clear examples of ST applications, the global health community will be better equipped to understand and address key health challenges. © 2017 John Wiley & Sons, Ltd.

A performance analysis method for distributed real-time robotic systems: A case study of remote teleoperation

NASA Technical Reports Server (NTRS)

Lefebvre, D. R.; Sanderson, A. C.

1994-01-01

Robot coordination and control systems for remote teleoperation applications are by necessity implemented on distributed computers. Modeling and performance analysis of these distributed robotic systems is difficult, but important for economic system design. Performance analysis methods originally developed for conventional distributed computer systems are often unsatisfactory for evaluating real-time systems. The paper introduces a formal model of distributed robotic control systems; and a performance analysis method, based on scheduling theory, which can handle concurrent hard-real-time response specifications. Use of the method is illustrated by a case of remote teleoperation which assesses the effect of communication delays and the allocation of robot control functions on control system hardware requirements.

Insight into infection-mediated prostate damage: Contrasting patterns of C-reactive protein and prostate-specific antigen levels during infection.

PubMed

Milbrandt, Melissa; Winter, Anke C; Nevin, Remington L; Pakpahan, Ratna; Bradwin, Gary; De Marzo, Angelo M; Elliott, Debra J; Gaydos, Charlotte A; Isaacs, William B; Nelson, William G; Rifai, Nader; Sokoll, Lori J; Zenilman, Jonathan M; Platz, Elizabeth A; Sutcliffe, Siobhan

2017-05-01

To investigate mechanisms underlying our previous observation of a large rise in serum prostate-specific antigen, a marker of prostate pathology, during both sexually transmitted and systemic infections, we measured serum high-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation, in our previous case-control study of young, male US military members and compared our findings to those for PSA. We measured hsCRP before and during infection for 299 chlamydia, 112 gonorrhea, and 59 non-chlamydial, non-gonococcal urethritis (NCNGU) cases; before and after infection for 55 infectious mononucleosis (IM) and 90 other systemic/non-genitourinary cases; and for 220-256 controls. Only gonorrhea cases were significantly more likely to have a large hsCRP rise (≥1.40 mg/L or ≥239%) during infection than controls (P < 0.01). However, gonorrhea, IM, and other systemic/non-genitourinary cases were more likely to have a rise of any magnitude up to one year post-diagnosis than controls (p = 0.038-0.077). These findings, which differ from those for PSA, suggest distinct mechanisms of elevation for hsCRP and PSA, and support both direct (eg, prostate infection) and indirect (eg, systemic inflammation-mediated prostate cell damage) mechanisms for PSA elevation. Future studies should explore our PSA findings further for their relevance to both prostate cancer screening and risk. © 2017 Wiley Periodicals, Inc.

Anthrax Vaccine and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus in the U.S. Military: A Case-Control Study.

PubMed

Bardenheier, Barbara H; Duffy, Jonathan; Duderstadt, Susan K; Higgs, Jay B; Keith, Michael P; Papadopoulos, Patricia J; Gilliland, William R; McNeil, Michael M

2016-10-01

U.S. military personnel assigned to areas deemed to be at high risk for anthrax attack receive Anthrax Vaccine Adsorbed (AVA). Few cases of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been reported in persons who received AVA. Using a matched case-control study design, we assessed the relationship of RA and SLE with AVA vaccination using the Defense Medical Surveillance System. We identified potential cases using International Classification of Diseases, 9th Revision, Clinical Modification codes and confirmed cases with medical record review and rheumatologist adjudication. Using conditional logistic regression, we estimated odds ratios (OR) for AVA exposure during time intervals ranging from 90 to 1,095 days before disease onset. Among 77 RA cases, 13 (17%) had ever received AVA. RA cases were no more likely than controls to have received AVA when looking back 1,095 days (OR: 1.03; 95% confidence interval [CI]: 0.48-2.19) but had greater odds of exposure in the prior 90 days (OR: 3.93; 95% CI: 1.08-14.27). Among the 39 SLE cases, 5 (13%) had ever received AVA; no significant difference in receipt of AVA was found when compared with controls (OR: 0.91; 95% CI: 0.26-3.25). AVA was associated with recent onset RA, but did not increase the risk of developing RA in the long term. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

The Stillbirth Classification System for the Safe Passage Study: Incorporating Mechanism, Etiology, and Recurrence

PubMed Central

Boyd, Theonia K.; Wright, Colleen A.; Odendaal, Hein J.; Elliott, Amy J.; Sens, Mary Ann; Folkerth, Rebecca D.; Roberts, Drucilla J.; Kinney, Hannah C.

2017-01-01

OBJECTIVE Describe the classification system for the assignment of the cause of death for stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD funded PASS Network (The Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network). The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. METHODS The PASS Network classification system is based upon 5 ‘sites of origin’ for cause of stillbirth (Fetal, Placental, Maternal, External/Environmental, or Undetermined), further subdivided into mechanism subcategories (e.g., Placental Perfusion Failure). Both site of origin and mechanism stratification are employed to assign an ultimate cause of death. Each PASS stillbirth (n=19) in the feasibility study was assigned a cause of death, and status of sporadic versus recurrent. Adjudication involved review of the maternal and obstetrical records, and fetal autopsy and placental findings, with complete consensus in each case. Two published classification systems, i.e., INCODE and ReCoDe, were used for comparison. RESULTS Causes of stillbirth classified were: fetal (n=5, 26%), placental (n=10, 53%), external (n=1, 5%), and undetermined (n=3, 16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was complete agreement for the cause of death across the three classification systems in 26% of cases, and a combination of partial or complete agreement in 68% of cases. Complete vs. partial agreements were predicated upon the classification schemes used for comparison. CONCLUSIONS The proposed PASS system is a user-friendly classification system that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability for use by perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations. PMID:27116324

When More is Less: The Case of Disconnected Information Systems in Indonesian Public Health Facilities

NASA Astrophysics Data System (ADS)

Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari

2018-03-01

The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.

How Choice Changes the Education System: A Michigan Case Study

NASA Astrophysics Data System (ADS)

Plank, David; Sykes, Gary

1999-11-01

In countries around the world policy makers propose that parents should exercise more control over the choice of schools that their children attend. This paper considers the ways in which the introduction of new opportunities for school choice changes the education system. It argues that choice affects the education system as a whole by introducing new actors into the system, by changing the terms of relationships among existing actors, and by creating new pressures within the system that require new responses. The nature, magnitude, and consequences of these effects cannot be predicted in advance, as they depend on a number of factors including the social and economic context. The empirical basis for this paper derives from a case study of the implementation of choice policies in the state of Michigan in the US, but the conceptual issues raised have important implications for the study of school choice wherever such policies are adopted.

First row transition metal atoms embedded in multivacancies in a rippled graphene system

NASA Astrophysics Data System (ADS)

Mombrú, Dominique; Faccio, Ricardo; Mombrú, Alvaro W.

2018-03-01

Ab-initio calculations based on density functional theory (DFT) have been performed to study systems where a first row transition metal atom is embedded in a rippled graphene due to the existence of an 8-order multivacancy. In addition to these cases, also the inclusion of a zinc atom, with a 3d10 electron configuration, was also studied. Structural distortions and magnetic response for each system were studied. A correlation was found for the magnitude of the rippling and the distortion in the vacancy. Variation in the trends was found for Cu and Zn cases, which were explained on the basis of the filling of the 3dx2-y2 orbital. All the systems exhibit lower magnetic moment in comparison to the metal-less system. The quenching of the magnetic moment due to the carbon atoms in the vacancy is observed for Sc and Cu.

Parametric study of the mode coupling instability for a simple system with planar or rectilinear friction

NASA Astrophysics Data System (ADS)

Charroyer, L.; Chiello, O.; Sinou, J.-J.

2016-12-01

In this paper, the study of a damped mass-spring system of three degrees of freedom with friction is proposed in order to highlight the differences in mode coupling instabilities between planar and rectilinear friction assumptions. Well-known results on the effect of structural damping in the field of friction-induced vibration are extended to the specific case of a damped mechanical system with planar friction. It is emphasised that the lowering and smoothing effects are not so intuitive in this latter case. The stability analysis is performed by calculating the complex eigenvalues of the linearised system and by using the Routh-Hurwitz criterion. Parametric studies are carried out in order to evaluate the effects of various system parameters on stability. Special attention is paid to the understanding of the role of damping and the associated destabilisation paradox in mode-coupling instabilities with planar and rectilinear friction assumptions.

Site-Based Management versus Systems-Based Thinking: The Impact of Data-Driven Accountability and Reform

ERIC Educational Resources Information Center

Mette, Ian M.; Bengtson, Ed

2015-01-01

This case was written to help prepare building-level and central office administrators who are expected to effectively lead schools and systems in an often tumultuous world of educational accountability and reform. The intent of this case study is to allow educators to examine the impact data management has on the types of thinking required when…

Another Link in the Chain: State Policies and Practices for Case Management and Environmental Investigation for Lead-Poisoned Children.

ERIC Educational Resources Information Center

Guthrie, Anne M.; McLaine, Pat

Policy and practice for screening children for lead poisoning have dominated the dialogue about the health care system's role in lead poisoning prevention, with little attention directed to how the health care system responds to a lead-poisoned child once identified. This report details a study of the case management and environmental…

Systemic sclerosis and sarcoidosis: a rare case of chronic intestinal pseudo-obstruction.

PubMed

Bernardo, Sónia; Gonçalves, Ana Rita; Araújo-Correia, Luís

2018-06-01

The coexistence of systemic sclerosis (SSc) and sarcoidosis is an extremely rare phenomenon; some studies question its existence. We report the case of a male with a diagnosis of sarcoidosis that was admitted due to abdominal distension and pain. After a thorough investigation, he was diagnosed with severe chronic intestinal pseudo-obstruction as a manifestation of SSc.

Cholecystectomy and Diagnosis-Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries

PubMed Central

Paat-Ahi, Gerli; Aaviksoo, Ain; Świderek, Maria

2014-01-01

Background: As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods: National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results: European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion: Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement. PMID:25489596

Hybrid modelling for ATES planning and operation in the Utrecht city centre

NASA Astrophysics Data System (ADS)

Jaxa-Rozen, Marc; Bloemendal, Martin; Kwakkel, Jan; Rostampour, Vahab

2016-04-01

Aquifer Thermal Energy Storage (ATES) systems can significantly reduce the energy use and greenhouse gas emissions of buildings in temperate climates. However, the rapid adoption of these systems has evidenced a number of emergent issues with the operation and management of urban ATES systems, which require careful spatial planning to avoid thermal interferences or conflicts with other subsurface functions. These issues have become particularly relevant in the Netherlands, which are currently the leading market for ATES (Bloemendal et al., 2015). In some urban areas of the country, the adoption of ATES technology is thus becoming limited by the available subsurface space. This scarcity is partly caused by current approaches to ATES planning; as such, static permits tend to overestimate pumping rates and yield excessive safety margins, which in turn hamper the energy savings which could be realized by new systems. These aspects are strongly influenced by time-dependent dynamics for the adoption of ATES systems by building owners and operators, and by the variation of ATES well flows under uncertain conditions for building energy demand. In order to take these dynamics into account, previous research (Jaxa-Rozen et al., 2015) introduced a hybrid simulation architecture combining an agent-based model of ATES adoption, a Matlab control design, and a MODFLOW/SEAWAT aquifer model. This architecture was first used to study an idealized case of urban ATES development. This case evidenced a trade-off between the thermal efficiency of individual systems and the collective energy savings realized by ATES systems within a given area, which had already been suggested by other research (e.g. Sommer et al., 2015). These results also indicated that current layout guidelines may be overly conservative, and limit the adoption of new systems. The present study extends this approach to a case study of ATES planning in the city centre of Utrecht, in the Netherlands. This case is particularly relevant due to a combination of dense ATES development and complex subsurface conditions. An agent-based model of ATES adoption was thus parameterized to represent historical development patterns in the area over the 1998-2015 period, as well as plausible future adoption dynamics under a range of socio-technical uncertainties. An existing geohydrological model (Deltares, 2009) was used to represent local subsurface conditions. Preliminary results from this case study indicate that the idealized dynamics obtained in the previous case can also be observed under more realistic conditions; the geographic constraints introduced by building plot layouts and other spatial features tend to further constrain the adoption of new systems, emphasizing the risk of a scarcity of space under current layout guidelines. Furthermore, order effects appear to play a more significant role for system efficiency than in the idealized case. Earlier adopters thus tend to benefit from higher thermal efficiency due to the transient development of thermal bubbles, which could make older systems more robust to thermal interactions. In order to better understand the relationships between these processes and the operation of ATES wells under uncertainty, the case study will be extended by incorporating a Model Predictive Control approach for simulated ATES operation. References Bloemendal, M., Olsthoorn, T., & van de Ven, F. (2015). Combining climatic and geo-hydrological preconditions as a method to determine world potential for aquifer thermal energy storage. Science of the Total Environment, 538, 621-633. Deltares (2009). Ontwikkeling HDSR hydrologisch modelinstrumentarium - HYDROMEDAH. Deelrapport 1: Beschrijving MODFLOW model. Delft, The Netherlands: Deltares. Jaxa-Rozen, M., Kwakkel, J., & Bloemendal, M. (2015). The adoption and diffusion of common-pool resource-dependent technologies: The case of Aquifer Thermal Energy Storage systems. In Proceedings of the 2015 Portland International Conference on Management of Engineering and Technology (PICMET) (pp. 2390-2408). Sommer, W., Valstar, J., Leusbrock, I., Grotenhuis, T., & Rijnaarts, H. (2015). Optimization and spatial pattern of large-scale aquifer thermal energy storage. Applied Energy, 137(2015), 322-337.

A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders.

PubMed

Ganz, Jennifer B; Earles-Vollrath, Theresa L; Heath, Amy K; Parker, Richard I; Rispoli, Mandy J; Duran, Jaime B

2012-01-01

Many individuals with autism cannot speak or cannot speak intelligibly. A variety of aided augmentative and alternative communication (AAC) approaches have been investigated. Most of the research on these approaches has been single-case research, with small numbers of participants. The purpose of this investigation was to meta-analyze the single case research on the use of aided AAC with individuals with autism spectrum disorders (ASD). Twenty-four single-case studies were analyzed via an effect size measure, the Improvement Rate Difference (IRD). Three research questions were investigated concerning the overall impact of AAC interventions on targeted behavioral outcomes, effects of AAC interventions on individual targeted behavioral outcomes, and effects of three types of AAC interventions. Results indicated that, overall, aided AAC interventions had large effects on targeted behavioral outcomes in individuals with ASD. AAC interventions had positive effects on all of the targeted behavioral outcome; however, effects were greater for communication skills than other categories of skills. Effects of the Picture Exchange Communication System and speech-generating devices were larger than those for other picture-based systems, though picture-based systems did have small effects.

Effects of a mobility monitoring system on the cost of care in relation to reimbursement at Swiss nursing homes: learnings from a randomized controlled trial.

PubMed

Stark, Mario; Tietz, Rigo; Gattinger, Heidrun; Hantikainen, Virpi; Ott, Stefan

2017-12-01

Nursing homes in Switzerland are under pressure to efficiently coordinate staff activities to cover their personnel costs under the care financing system. In this study, the use of a mobility monitoring system accompanied with case conferences was investigated in order to improve sleep quality and estimate the cost benefit of this intervention. In an open two-phase randomized controlled trial at three nursing homes, residents with cognitive impairment were randomly assigned to an intervention group and a control group. In the intervention group, a 10-week period of intensive use of the monitoring system and case conferences led by an advanced nurse practitioner (Phase I) was followed by 3 months of reduced use of the monitoring system and case conferences led by an internal registered nurse (Phase II). In the control group, the monitoring system was only used for data acquisition. Nurses reported the activities with a specifically developed tool. Based on the recorded activities, the cost of care was calculated. The correlating reimbursement per patient was calculated from the care levels in the Swiss reimbursement system. Data from 44 residents was included in the analysis with a linear mixed model. Although analysis revealed no statistically significant effects, results indicate that the use of a monitoring system can guide nurses in organizing their tasks to increase effectiveness. Information systems such as the mobility monitor can help to identify single outliers that do not correspond with the overall situation. In the health care system, problematic individual cases can account for a disproportionally high cost levels. It was shown that information systems can have a significant economic impact in the long run. The study is registered at the German Clinical Trials Register under the Nr. DRKS00006829 .